Outcomes of Corticosteroid Treatment for Trigger Finger by Stage.

Background: While steroid injection remains a common first-line treatment of trigger fingers, clinical experience suggests that not all trigger fingers respond the same. The purpose of this study was to utilize a classification system for trigger finger that is simple, reproducible, and produces clearly definable, clinically relevant cutoff points to determine if responsiveness to steroid injection correlates to clinical staging. Methods: This was a prospectively-collected longitudinal study of trigger finger patients separated into four stages of severity. Each subject received a single injection of 6 mg dexamethasone acetate. One-month outcomes were analyzed to evaluate efficacy of steroid injection. These outcomes were further stratified based on baseline characteristics and stage of triggering Results: A total of 99 digits and 69 subjects were included. Two variables were found to be significant in predicting response to initial injection: 1. multiple affected digits, and 2. stage severity. Patients with multiple involved fingers were 5.8 times more likely to have no resolution of symptoms compared with those with a single affected finger. For every level of stage increase, the odds doubled for having no resolution of symptoms. Conclusions: Steroid injection remains a viable first-line option for patients presenting with mild triggering (Stage 1 and 2). For more severe triggering (Stage 3 and 4) or multiple affected digits, success of steroid injection is significantly lower at one month. For the latter patients, surgery may be a more reasonable initial treatment. Presented at: The American Association of Plastic Surgeons Annual Meeting, Austin, TX, 2017 Financial Disclosure Statement: Funded by a 2012 PSF/AAHS research grant Products Mentioned: N/A Corresponding Author: Robert A. Weber, MD, 2401 S. 31st St. Temple, TX, USA. E-mail address: Robert.Weber@BSWHealth.org ©2018American Society of Plastic Surgeons

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