Cost-Effective Management of Stenosing Tenosynovitis

Halim, Andrea; Sobel, Albert E.; Eltorai, Adam E.M.; Mansuripur, Kaveh P.; Weiss, Arnold‐Peter C.

doi:10.1016/j.jhsa.2018.04.013

Cited by 19 publications

(8 citation statements)

References 23 publications

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“…Corticosteroids are typically used as the first-line treatment for trigger fingers. 8,9 Their antiinflammatory properties are beneficial in the treatment of this condition, but they are also immunosuppressive and can increase the risk for infection. 18 In the joint arthroplasty literature, corticosteroid injections have been shown to increase infection rates when performed less than 3 months before surgery.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Infection in Trigger Finger Release Surgery Following Corticosteroid Injection

Matzon

Lebowitz

Graham

et al. 2020

The Journal of Hand Surgery

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Purpose To determine the risk for infection in trigger finger release surgery after preoperative corticosteroid injection.Methods We retrospectively evaluated all patients undergoing trigger finger release by 16 surgeons over a 2-year period. Data collected included demographic information, medical comorbidities, trigger finger(s) operated on, presence of a prior corticosteroid injection, date of most recent corticosteroid injection, postoperative signs of infection, and need for surgery owing to deep infection. Superficial infection was defined per Centers for Disease Control criteria. Deep infection was defined as the need for surgery related to a surgical site infection. ResultsIn this cohort of 2,480 fingers in 1,857 patients undergoing trigger release surgery, 53 (2.1%) developed an infection (41 superficial [1.7%] and 12 deep [0.5%]). Before surgery, 1,137 fingers had no corticosteroid injection. These patients developed 1 deep (0.1%) and 17 superficial (1.5%) infections. In contrast, 1,343 fingers had been given a corticosteroid injection before surgery. These patients developed 11 deep (0.8%) and 24 superficial (1.8%) infections. Median time from corticosteroid injection to trigger release surgery was shorter for fingers that developed a deep infection (63 days) compared with those that developed no infection (183 days). The risk for developing a deep infection in patients who were operated on within 90 days of an injection (8 infections in 395 fingers) was increased compared with patients who were operated on greater than 90 days after an injection (3 infections in 948 fingers).Conclusions Preoperative corticosteroid injections are associated with a small but statistically significantly increased rate of deep infection after trigger finger release surgery. The risk for postoperative deep infection seems to be time dependent and greater when injections are performed within 90 days of surgery, especially in the 31-to 90-day postinjection period. (J

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Section: Discussionmentioning

confidence: 99%

“…5e7 Given this riskebenefit profile, corticosteroid injections are often recommended before surgery. 8,9 Although repeat injections have demonstrated some benefit, they seem to be less effective than initial injections. 10 The effect of corticosteroid injections on subsequent trigger finger release surgery is poorly understood.…”

mentioning

confidence: 99%

Risk of Infection in Trigger Finger Release Surgery Following Corticosteroid Injection

Matzon

Lebowitz

Graham

et al. 2020

The Journal of Hand Surgery

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“…The efficacy of a single injection at preventing the need for further treatment has been reported to be between 44% and 66% (Dala-Ali et al., 2012; Halim et al., 2018; Ryzewicz and Wolf, 2006; Wojan et al., 2014), and the overall success between 47% and 92% (Castellano et al., 2015; Dala-Ali et al., 2012; Mathew, 2014; Murphy et al., 1995). Our results were consistent with the previously published data as the success after the initial injection was 49% and the overall success was 62% with no statistically significant differences between techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Most trigger digits can be cost-effectively and safely treated by corticosteroid injection, with a reported successful outcome ranging from 45% to 92% depending on the number of injections (Castellano et al., 2015; Dala-Ali et al., 2012; Halim et al., 2018; Mathew, 2014; Murphy et al., 1995; Wolfe, 2011).…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial of dorsal web space versus palmar midline injection of steroid in the treatment of trigger digits

Jiménez

Garcés

Marcos-García

et al. 2020

J Hand Surg Eur Vol

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One hundred and sixty patients were enrolled in a prospective randomized controlled trial to assess whether a steroid injection through the dorsal web space was less painful than the palmar midline technique in the treatment of trigger digits and whether they were equally effective. There were 116 women and 44 men with a mean age of 60 years. The mean visual analogue score for pain during the injection was 3.6 in the dorsal web space group and 5.4 in the palmar midline group on a scale of 0–10. The overall success of treatment in the dorsal group was 67%, whereas it was 56% in the palmar group. No complications were noted. We concluded from this study that the dorsal web space technique is less painful and at least as effective as the palmar midline technique. Level of evidence: I

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“…A prospective study was designed to evaluate the implementation of the fully ambulatory WALANT process of care for the surgical treatment of 2 common conditions: carpal tunnel syndrome (CTS) and trigger finger (TF). 23 , 24 , 25 , 26 …”

mentioning

confidence: 99%

Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System

Far-Riera¹,

Serrano²,

González³

2023

Journal of Hand Surgery Global Online

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Cost-Effective Management of Stenosing Tenosynovitis

Cited by 19 publications

References 23 publications

Risk of Infection in Trigger Finger Release Surgery Following Corticosteroid Injection

Risk of Infection in Trigger Finger Release Surgery Following Corticosteroid Injection

A randomized controlled trial of dorsal web space versus palmar midline injection of steroid in the treatment of trigger digits

Impact of WALANT Hand Surgery in a Secondary Care Hospital in Spain. Benefits to the Patient and the Health System

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