Female patients who received a single corticosteroid injection for treatment of their first trigger finger had the highest rate of long-term treatment success, according to study results.
Researchers analyzed 366 first-time corticosteroid injections in flexor tendon sheaths from January 2000 to December 2007 with a minimum follow-up duration of 5 years. Among the patients, 66% were female, 44% had multiple trigger fingers and 24% had diabetes at the time of injection.
The study’s primary outcome was treatment failure, which was defined as subsequent injection or surgical trigger finger release of the affected digit. The researchers used Kaplan-Meier analyses with log-rank test and Cox regression analysis to assess the effect of baseline patient and disease characteristics on injection success.
Results showed that after a single injection, 45% of patients demonstrated long-term treatment success. According to the final regression model, the single predictor for treatment success was the interaction of sex and the number of trigger fingers. The researchers found a 10-year success rate associated with 56% of female patients presenting for the first time with a trigger finger vs. 35% of male patients, as well as with 39% in female patients vs. 37% in male patients with multiple trigger fingers.
Treatment failures occurred at a rate of 84% within the first 2 years after injection, according to the researchers. Patient age, symptom type and undifferentiated diabetes status were not predictive of treatment success.
Disclosure: Gelberman received personal fees from the Journal of Bone and Joint Surgery Board of Trustees, Healthpoint Capital, Wolters Kluwer and Medartis. Gelberman’s institution, the Washington University School of Medicine, received grants from the National Institute of Health.