TETİK PARMAK TEDAVİSİNDE STEROİD ENJEKSİYONU MU? AÇIK CERRAHİ Mİ? Steroid Injection Versus Open Surgery in the Treatment of Trigger Finger
Abstract
ÖZET
Amaç: Açık cerrahi ve steroid enjeksiyonu uygulanan tetik parmak hastaları arasında fark olup
olmadığını değerlendirdik.
Gereç ve Yöntem: Kasım/2012 ile Mayıs/2015 tarihleri arasında başvuran 108 hastanın(64 bayan,
44 erkek) el baş parmağına bir gruba (34 bayan,20 erkek) açık cerrahi uygulandı.Diğer gruba
(30 bayan,24 erkek) steroid enjeksiyonu uygulandı.Bu hastalar Wolfe sınıflamasına göre değerlendirildi.
Bu hastalarda yineleme oranı ve memnuniyet oranları değerlendirildi.Cerrahi yapılan
hastalarda yara yeri enfeksiyonu, sinir hasarı, yarada açılma, fleksör tendonda ok-yayı deformitesi,
eklem hareket açıklığında kısıtlanma komplikasyonları değerlendirilmiştir.
Bulgular: Hastaların yaş ortalaması 38,2 (20-68).Wolfe sınıflamasına göre 46(%42,5) olgu evre
2,62(%57,5) olgu evre 3 idi.Hastaların 64’ü(%59,2) bayan,44’ü(%40,8) erkek idi.Hastalar ortalama
12 ay(5-21) takip edildi.Steroid enjeksiyonu uygulanan grupta 20(%37) hastada yineleme görüldü.
Yineleme görülen hastalara açık cerrahi uygulandı.Açık cerrahi uygulanan grupta yineleme
izlenmedi.Cerrahi uygulanan hastaların tamamı tedaviden memnun kaldıklarını belirtti.
Sonuç: Steroid enjeksiyonu tetik parmak tedavisinde bir tedavi seçeneği olmasına rağmen,açık
cerrahi uygulanan hastaların nüks ve komplikasyon gelişmemesi açısından daha yararlı bir yöntem
olduğu görüldü.
Anahtar Sözcükler: Cerrahi tedavi; Steroid enjeksiyonu; Tetik başparmak
ABSTRACT
Aim: This study aims to compare steroid injections and open surgery in the treatment of trigger
finger.
Material and Methods: Between November 2012 and May 2015, a total of 108 patients (64
females, 44 males; mean age: 38.2 years; range, 20 to 68 years) who were admitted to our clinic
were included. The patients were assigned into two groups, including Group 2 undergoing open
surgery, and Group 1 receiving steroid injections. Trigger finger was graded according to the
Wolfe classification. The rate of recurrence and satisfaction rates were evaluated. The patients
undergoing surgery were also evaluated for the wound site infection, nerve injury, wound
dehiscence, bow-stringing deformity, and reduced range of motion of the joint.
Results: The mean follow-up was 12 months (range, 5 to 21). According to the Wolfe
classification, 46 patients (42.5%) had Stage 2 disease, while 62 patients (57.5%) had Stage 3
disease. Recurrence occurred in 20 patients (37%) in the steroid injection group; however,no
recurrence was seen in patients undergoing open surgery. Satisfactory results were achieved in
all patients in the surgery group.
Conclusion: Although steroid injection is a therapeutic option in trigger finger, open surgery
appears to be a more beneficial method thanks to the lack of recurrence and complications.
Keywords: Open surgery; Steroid injection; Trigger finger.
References
- 1. Nimigan AS, Ross DC, Gain BS. Steroid injections in the management of trigger fingers. American Journal of Physical Medicine and Rehabilitation 2006; 85(1): 36–43. 2. Fitzgerald BT, Hofmeister EP, Fan RA, Thompson MA. Delayed flexor digitorum superficialis and profundus ruptures in a trigger finger after a steroid injection: a case report. Journal of Hand Surgery 2005; 30(3):479-82. 3. Yam A, Teoh LC, Yong FC. Necrotising fasciitis after corticosteroid injection for trigger finger: a severe complication from a “safe” procedure. J Hand Surg Eur 2009; 34(5):689-90. 4. Park J, Dumanian GA. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: Case Report. J Hand Surg 2009; 34(2):313-6. 5. Gyuricza C, Umoh E, Wolfe SW. Multiple pulley rupture following corticosteroid infection for trigger digit: case report. J Hand Surg 2009;34A:1444-8. 6. Thorpe AP. Results of surgery for trigger finger. Journal of Hand Surgery 1988; 13B: 199–201. 7. Finsen V, Hagen S. Surgery for trigger finger. Hand Surgery 2003; 8(2):201–3. 8. Moriya K, Uchiyama T, Kawaji Y. Comparison of the surgical outcomes for trigger finger and trigger thumb: preliminary results. Hand Surgery 2005;10(1): 83–6.
Abstract
References
- 1. Nimigan AS, Ross DC, Gain BS. Steroid injections in the management of trigger fingers. American Journal of Physical Medicine and Rehabilitation 2006; 85(1): 36–43. 2. Fitzgerald BT, Hofmeister EP, Fan RA, Thompson MA. Delayed flexor digitorum superficialis and profundus ruptures in a trigger finger after a steroid injection: a case report. Journal of Hand Surgery 2005; 30(3):479-82. 3. Yam A, Teoh LC, Yong FC. Necrotising fasciitis after corticosteroid injection for trigger finger: a severe complication from a “safe” procedure. J Hand Surg Eur 2009; 34(5):689-90. 4. Park J, Dumanian GA. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: Case Report. J Hand Surg 2009; 34(2):313-6. 5. Gyuricza C, Umoh E, Wolfe SW. Multiple pulley rupture following corticosteroid infection for trigger digit: case report. J Hand Surg 2009;34A:1444-8. 6. Thorpe AP. Results of surgery for trigger finger. Journal of Hand Surgery 1988; 13B: 199–201. 7. Finsen V, Hagen S. Surgery for trigger finger. Hand Surgery 2003; 8(2):201–3. 8. Moriya K, Uchiyama T, Kawaji Y. Comparison of the surgical outcomes for trigger finger and trigger thumb: preliminary results. Hand Surgery 2005;10(1): 83–6.
Details
| Journal Section | Original Research |
|---|---|
| Authors | |
| Publication Date | September 10, 2017 |
| Published in Issue | Year 2017 Volume: 7 Issue: 3 |