Introductions: Patients of stenosing tenosynovitis or trigger finger presents with pain, swelling, limitation of finger movement, and triggering. Thickening of the A1 pulley, with resultant entrapment of flexor tendons, is the primary pathology. In failed conservative treatment, surgical release by open or percutaneous technique is used. The aim of this study was to evaluate the results of percutaneous release of trigger fingers using hypodermic 18-gauge needle under local anesthesia. Methods: A cross sectional study of percutaneous release of trigger fingers using hypodermic 18-gauge needle under local anesthesia was performed in outpatient clinic at Janaki Medical College Teaching Hospital, Janakpur, Nepal, from July 2016 to September 2017. Informed consent was obtained. All the patients were followed up on 3rd day, 1st week and one month in outpatient department, and further telephone follow up at three and six months after surgery. Results: There were 38 patients, female 25 and male 13, age 24 to 67 years. Successful release was achieved in 36/38 (95%) with normal activities within 48 hours. None had complications like digital neurovascular injury or tendon bowstringing. One patient had superficial skin infection and was treated successfully with oral antibiotics. Two (5.2%) had pain and recurrent triggering requiring open release in the first week. At one, three and six months follow up patients reported no triggering of released fingers. Conclusions: Percutaneous release with hypodermic 18-gauge needle under local anesthesia in the treatment of trigger finger was an effective and convenient method with a low complication rate.

Background and Objectives: Early techniques of splint immobilization work well for simple metacarpal fractures. However, if significantly shorting, rotational deformity, and angulations occur, surgical treatment is required. The aim of this article was to study the functional outcome of metacarpal fractures treated by open reduction and internal fixation with mini plates and screw in low resource condition of Nepal.Material and Methods: This retrospective study was done over a period of one year 2012 to 2013 in Bir Hospital, Patan hospital and Shree Birendra hospital. The functional outcome after treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH-TAF).Results: Out of 30 patients twenty three were male (76.7%) and seven were female (23.3%). Among them, 7 patients (23.3%) showed union in 6 weeks. 18 Patients (60%)  had union in 4 weeks. 3 patients (10%) had at five weeks and 2 patients had union at 6 weeks. We observed ASSH-TAF score at 2 weeks, 1month, 3 months, and 6 months. Results showed 24 patients (80%) had excellent, 4(13.3%) had good and 2(6.7%) had poor result.Conclusion: The use of miniplate and screws is a reasonable option for treating in displaced metacarpal fracture as it provides a rigid, Secure an anatomical stable reduction, which is sufficient to allow early mobilization of the adjacent joints, hence the mini plate fixation is effective means of immobilization of fracture of metacarpal with less complication and excellent functional outcome.

Background and Objectives: Trigger finger is a condition that causes triggering, snapping or locking on flexion of the involved digit. Treatment modalities are conservative (Non-steroidal anti-inflammatory drugs, splints or corticosteroid injections) or operative (percutaneous or open release of A1 pulley- the first annular pulley of the fibro-osseous sheath of the fingers situated at the level of the metacarpophalengeal joint). The aim of this study is to evaluate the efficacy of corticosteroid injection for trigger finger in adults.Material and Methods: Fifty patients with 54 trigger digits were treated by one or two injections of methylprednisolone acetate with 1% lignocaine. Patients were followed-up for a period of 6 months.Results: Symptoms and signs resolved in 79.63% of the injected digits. Local adverse reactions to steroid injection- pain at the injection site and steroid flare were self-limiting. There was no tendon rupture or post-injection infection.Conclusion: The study concludes that steroid injection is an effective first line treatment for trigger finger in most patients.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 13-18

Background and Objectives: Plantar fasciitis is a common pathological condition that affects the hind foot. Management of plantar fasciitis employs use of various non-surgical and surgical treatment methods. The aim of this study was to evaluate the efficacy of steroid injection in the treatment of plantar fasciitis in adults. Materials and Methods: From January 2016 to June 2017, fifty patients aged >18 years with plantar fasciitis symptomatic for three months or more were injected with a single dose of methylprednisolone acetate with 2% lignocaine. Assessment was done using visual analogue scale (VAS) and foot function index (pain sub-scale). Patients were followed-up for a period of 6 months. Results:There was significant reduction in VAS score and improvement in foot function index at 1 and 3 month follow-up (p<0.001) as compared to pre-injection score but this VAS reduction or improvement in foot function index was not significant at 6 month follow-up (p=0.057 and 0.729 respectively). There were no major adverse effects of the steroid injection. Conclusion: A single dose of corticosteroid injection provides only a short term benefit in plantar fasciitis.