Abstract
Objectives
To investigate the effects of ultrasound-guided injections of hyaluronic acid (HA)
versus steroid for trigger fingers in adults.
Design
Prospective, double-blinded, randomized controlled study.
Setting
Tertiary care center.
Participants
Subjects with a diagnosis of trigger finger (N=36; 39 affected digits) received treatment
and were evaluated.
Interventions
Subjects were randomly assigned to HA and steroid injection groups. Both study medications
were injected separately via ultrasound guidance with 1 injection.
Main Outcome Measures
The classification of trigger grading, pain, functional disability, and patient satisfaction
were evaluated before the injection and 3 weeks and 3 months after the injection.
Results
At 3 months, 12 patients (66.7%) in the HA group and 17 patients (89.5%) in the steroid
group exhibited no triggering of the affected fingers (P=.124). The treatment results at 3 weeks and 3 months showed similar changes in the
Quinnell scale (P=.057 and .931, respectively). A statistically significant interaction effect between
group and time was found for visual analog scale (VAS) and Michigan Hand Outcome Questionnaire
(MHQ) evaluation (P<.05). The steroid group had a lower VAS at 3 months after injection (steroid 0.5±1.1
vs HA 2.7±2.4; P<.001). The HA group demonstrated continuing significant improvement in MHQ at 3 months
(change from 3wk: steroid −2.6±14.1 vs HA 19.1±37.0; P=.023; d=.78).
Conclusions
Ultrasound-guided injection of HA demonstrated promising results for the treatment
of trigger fingers. The optimal frequency, dosage, and molecular weight of HA injections
for trigger fingers deserve further investigation for future clinical applications.
Keywords
List of abbreviations:
DM (diabetes mellitus), HA (hyaluronic acid), MHQ (Michigan Hand Outcome Questionnaire), TAM (total active motion), UGI (ultrasound-guided injection), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 01, 2015
Footnotes
Supported by the Ministry of Science and Technology (grant nos. 101-2627-B-075-001) from Ministry of Science and Technology, and by Taipei Veterans General Hospital (grant no. 101-X2-06).
Clinical Trial Registration No.: NCT01950793.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
