Introduction: Trigger finger is frequently encountered in outpatient department, mostly idiopathic but seen especially in diabetic, hypothyroid or gout patients, the cause being, stenosing tenosynovitis at the A1 pulley, which is usually progressive. There are various treatment options available for this problem.
Objective: The aim of this study was to compare the efficacy of USG guided corticosteroid injection, USG guided percutaneous pulley release and open surgery for the treatment of trigger finger in view of cure, relapse and complication rates.
Methods: Sixty patients, >20 years of age with a trigger on any finger of the hand (Quinnell Type II - IV) were randomly categorized into one of the 3 treatment groups, each consisting of 20 patients, with one of the 3 treatment modalities allocated equally, from 60 sealed nontransparent envelopes, were studied and followed up for at least 6 months for cure, relapse and failure rates.
Group A (N = 20) – Patients to be treated with conservative steroid injection under USG guidance
Group B (N = 20) – Patients to be treated with percutaneous pulley release under USG guidance and
Group C (N = 20) – Patients to be treated with open surgery as minor OT procedure.
Results: Cure rate for first (steroid inj.) group of patients was 60%, and in some patients second injection was repeated, which escalated the cure rate to 85%.
For USG guided percutaneous release and open surgery groups, there was complete remission in all cases.
Conclusions: The percutaneous release and open surgery methods were equally effective and proved superior to local steroid injections method in terms of trigger cure and relapse rates.