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Войти в исследования The Permanente journal · 2025
Choice of Corticosteroid Is Associated With the Possibility of Subsequent Surgery for Trigger Finger: A Retrospective Cohort Study.
СтатьяПоддержка исследования: вне правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Theman Todd A, Frueh Bradley, Horton Brandon, Cai Lawrence, Schmittdiel Julie A
Аннотация
INTRODUCTION: Trigger finger is one of the most common conditions treated by hand surgeons. Although corticosteroid injection is a common first-line treatment, there is no consensus regarding the most effective type of steroid.
METHODS: The authors performed a retrospective cohort study of patients with a diagnosis of trigger finger within Kaiser Permanente Northern California, a large, community-based, integrated health system with a comprehensive electronic medical record. Patients were potentially exposed to 4 different steroid regimens: betamethasone, dexamethasone, methylprednisolone, and triamcinolone. The primary outcome was the possibility of subsequent trigger finger surgery following initial corticosteroid treatment.
RESULTS: Among 20,141 patients with an injection for trigger finger diagnosis, 1668 (8.3%) had a trigger finger release procedure following injection. Compared with patients injected with triamcinolone, dexamethasone patients had a hazard ratio of 4.12 for surgery (95% confidence interval [CI], 3.06-5.54), betamethasone patients had a hazard ratio of 2.40 (95% CI, 1.86-3.10), and methylprednisolone had a hazard ratio of 1.77 (95% CI, 1.32-2.37).
DISCUSSION: This large, retrospective observational study suggests that the type of corticosteroid used for trigger finger may influence the possibility of subsequent surgery.
CONCLUSIONS: This information may inform corticosteroid choice for treating trigger finger, but findings should be confirmed in a prospective study.
METHODS: The authors performed a retrospective cohort study of patients with a diagnosis of trigger finger within Kaiser Permanente Northern California, a large, community-based, integrated health system with a comprehensive electronic medical record. Patients were potentially exposed to 4 different steroid regimens: betamethasone, dexamethasone, methylprednisolone, and triamcinolone. The primary outcome was the possibility of subsequent trigger finger surgery following initial corticosteroid treatment.
RESULTS: Among 20,141 patients with an injection for trigger finger diagnosis, 1668 (8.3%) had a trigger finger release procedure following injection. Compared with patients injected with triamcinolone, dexamethasone patients had a hazard ratio of 4.12 for surgery (95% confidence interval [CI], 3.06-5.54), betamethasone patients had a hazard ratio of 2.40 (95% CI, 1.86-3.10), and methylprednisolone had a hazard ratio of 1.77 (95% CI, 1.32-2.37).
DISCUSSION: This large, retrospective observational study suggests that the type of corticosteroid used for trigger finger may influence the possibility of subsequent surgery.
CONCLUSIONS: This information may inform corticosteroid choice for treating trigger finger, but findings should be confirmed in a prospective study.