Corticosteroid Injection in Diabetic Patients with Trigger Finger: A Prospective, Randomized, Controlled Double-Blinded Study

Author(s): Baumgarten KM, Gerlach D, Boyer MI

Source: J Bone Joint Surg 89-A (12): 2604-2611, 2007.

Summary:

This prospective randomized controlled double-blinded study compared the efficacy of corticosteroid injections for the treatment of trigger digits in thirty diabetic patients (thirty-five digits) and twenty-nine nondiabetic patients (twenty-nine digits).  The diabetic group was randomized into a corticosteroid group (twenty digits) or placebo group (fifteen digits).  After one or two injections, twenty-five of the twenty-nine digits in the nondiabetic group had a successful outcome compared to twelve of the nineteen in the diabetic group and eight of fifteen in the diabetic placebo group.  Overall, there were no significant differences found between the diabetic groups.  Surgery was performed in three of the twenty-nine digits in the nondiabetic group compared with seven of the nineteen in the diabetic corticosteroid group and six of the fifteen in the diabetic placebo  group.  Overall, there was a significant difference in the prevalence of surgery between the nondiabetic group and both the diabetic corticosteroid group and the diabetic placebo group.

This study confirms the efficacy of corticosteroid injections in the digits of nondiabetic patients.  However, corticosteroid injections for trigger digits in diabetes did not decrease the surgical rate or improve symptom relief when compared with placebo.

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