Abstract
Introduction: Trigger finger or stenosing tenosynovitis is a common cause of painful fingers and thumb that result in painful triggering, snapping or locking of fingers on flexion and extension of involved digit. Available treatment options for this condition are NSAID, splints, intralesional steroid injection, percutaneous release and open release of tendon sheath.
 Objectives: To study the clinical and functional outcomes and complications of corticosteroid injection and percutaneous release in management of trigger finger.
 Methodology: In this prospective study, sixty patients who presented with Grade 2 to Grade 3 trigger finger were placed into two groups. Group A(30 patients) were treated with intralesional steroid (40 mg of methylprednisolone) injection. Group B (30 patients) underwent percutaneous surgical release of affected tendon sheath. Both group of patients were treated in outpatient department. Patients of both groups were then asked to follow on scheduled time interval of two-week, six-week, three-months and six-months of period and their progress were recorded.
 Results: The baseline VAS score before intervention in group A (5.82) and group B (6.12) was statistically significant. In group B there was significant improvement of VAS score till 6 months of follow up. However, in group A there was significant improvement of VAS score by 3 months of follow-up, but by end of 6 months it again raised to 2.14. Yet it was far better than baseline VAS score.
 Conclusion: In our study both corticosteroid injection and percutaneous trigger finger release were found to be much effective in management of trigger finger.
Highlights
IntroductionThe flexor tendons of fingers are enveloped by a doublewalled connec ve ssue cylindrical sheath
Entrapment of flexor tendon of fingers, known as trigger finger or stenosing tenosynovi s is a common tendinopathy and was first described by No a in 1851.1 This entrapment of flexor tendon is frequently associated with pain on movement and later results in triggering, snapping or locking of involved digit on finger flexion.The flexor tendons of fingers are enveloped by a doublewalled connec ve ssue cylindrical sheath
In group A there was significant improvement of visual analogue score (VAS) score by 3 months of follow-up, but by end of 6 months it again raised to 2.14. It was far be er than baseline VAS score. In our study both cor costeroid injec on and percutaneous trigger finger release were found to be much effec ve in management of trigger finger
Summary
The flexor tendons of fingers are enveloped by a doublewalled connec ve ssue cylindrical sheath These flexor tendon sheath are held in place around tendon by three cruciform (C1-C3) and five annular pulleys ( A1-A5).This triggering of finger is caused by mismatch between the size of tendon and its sheath, and is most probably due to hypertrophy of the first annular pulley(A1).[2]. This hypertrophied A1 pulley results in narrow fibro-osseous canal in which flexor tendon excursion with difficulty and causes painful triggering in fingers. The life me prevalence of trigger finger among nondiabe cs is approximately 2.6% It commonly affects digits of dominant hand. Male to female ra o is 1:6 and right to le ra o is about 3:2.4
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