Radzeli, Mohd Ramli
(2011)
Comparison between triamcinalone
injection and hydrocortisone
injection in treatment of trigger
finger: a prospective singled-
blinded randomized controlled study.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
Trigger finger is a term for stenosing tenovaginitis affecting the
excursion of the long flexor of the hand at the area of zone II of the digit.
Steroid injection is one of the treatment option. Triamcinolone is the
steroid mainly used for trigger finger treatment. Hydroc'ortisone is used
only in paeditric trigger finger. Therefore result and outcome of
hydrocortisone in treatment of adult trigger finger still not establish.
PURPOSE: This study was designed to test the nu11 hypothesis that there
is no difference in resolution of trigger finger in term of pain, tenderness
and triggering/locking in 3 months after injection with triamcinolone, a
depot form of potent steroid or hydrocortisone, a highly soluble form but
less potent steroid.
METHODS: Seventy patients were enrolled in a prospective randomized
controlled study comparing triamcinolone and hydrocortisone injection
for idiopathic trigger finger. They were randomized into two groups;
triamcinolone group and hydrocortisone group. All patients required to
answer DASH questionnaire, give VAS score and evaluated for
triggering/locking and tenderness at A 1 pulley before injection,
immediately after injection and 3 months after injection. Fifty-nine
patients completed the 3 months follow-up (28 triamcinolone arm, 31
dexamethasone arm). Outcome measures included the Disabilities of the
Arm, Shoulder, and Hand (DASH) questionnaire, presence/absence of
triggering/locking finger, presence/absence of A1 puiiey tenderness and pains severity base on visual analog scale. A Chi-square test and student
t-test were used to compare both groups.
RESULTS: Immediately after injection, absence of triggering was
documented in 24 of 34 patients (70.6%) in the triamcinolone group and
in 28 of 36 patients (77.8%) in the hydrocortisone group. The rates of
resolution of triggering 3 months after injection were 22 of 28 (78.6%) in
the triamcinolone group and 26 of 31 (83.9%) in the hydrocortisone
group. In term of tenderness of AI pulley, immediately after injection,
absence of tenderness was documented in 26 of 34 patients (76.5%) in the
triamcinolone group and in 28 of 36 patients (77 .8%) in the
hydrocortisone group. The rates of resolution of tenderness 3 months after
injection were 18 of 28 (64.3%) in the triamcinolone group and 22 of 31
(71 %) in the hydrocortisone group. There were no significant differences
between Disabilities of the Arm, Shoulder, and Hand scores and Visual
Analog Scale score for pain immediately after injection and the 3-month
follow-up. After the close of the study, there was no complication in both
treatment groups.
CONCLUSIONS: There is no significant different in term of resolution of
tenderness over AI pulley, resolution triggering/locking, pain and
physical disabilities score improvement between the two types of steroid
injection.
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