This is for our readers who practice pain management.
Authors: Wojahn RD et al., J Bone Joint Surg Am 2014 Nov 19; 96:1849
Almost half of patients required no additional injections.
The estimated lifetime risk for trigger finger is about 3% in the general population and as high as 10% in diabetic patients. Treatment options include observation, splinting, nonsteroidal anti-inflammatory drugs, and corticosteroid injections. In this retrospective review, researchers report long-term outcomes of first-time injections for trigger finger in 366 patients (24% with diabetes) who were followed for 5 to 10 years. Treatment was considered to be successful if patients did not need second injections or surgical trigger-finger release.
Overall, 45% of patients benefited after a single injection. Sex and number of trigger fingers at presentation correlated with treatment success: At 10 years, success rates among patients with single trigger fingers were higher in women than in men (56% vs. 35%), but among women and men with multiple trigger fingers, success rates were similar (39% vs. 37%). Most treatment failures occurred within 2 years of initial injections. Age and diabetes status did not predict outcome.
Comment
In this retrospective study, patients with trigger finger were followed for 5 to 10 years after initial injection; until now, data on long-term treatment outcomes have been sparse. The findings give physicians and patients an estimate of the likelihood (i.e., 45%) that a single injection will be effective in the long term. In addition, a patient with a good result after 2 years has an excellent chance of sustaining that outcome.