Trigger finger, also
known as stenosing tenosynovitis or stenosing tendovaginitis, is a common
disorder characterized by catching, snapping or locking of the involved finger
flexor tendon. It occurs when inflammation narrows the space within the sheath
that surrounds the tendon in the affected finger. And if the trigger finger is
severe, the finger may become locked in a bent position. Commonly, IT is
difficult to straighten out without pulling on it by the other hand.
Based on research, it
has been found that it can be treated by non-surgical management, such as activity
modification, non-steroidal anti-inflammatory medications, and corticosteroid
injection. Due to corticosteroid injection can be delivered via two techniques:
palmar and midaxial approaches, the authors in this paper compared the accuracy
of these two approaches for delivery of corticosteroids into the flexor tendon
sheath in a cadaver model.
In the experiment, a
total of 50 injections were performed, 25 via midaxial technique and 25 via
palmar technique. A one inch, 25-gauge needle was used to inject 1 mL of Isovue
contrast dye into the flexor tendon sheath under live fluoroscopy. The
fluoroscopic images were examined after injection to determine intrasheath
versus extrasheath delivery of the dye, with visualization of contrast filling
the sheath defining a successful injection. After experiment, the authors analyzed
and discussed the findings. The findings showed that the midaxial approach had
a success rate of 52% compared to the conventional palmar approach success rate
of 36%, p = 0.5. The ring finger was the most common location of trigger finger
and the rates of success were equal between groups for this digit (80%).
In conclusions: based
on the research findings, there was no statistical difference in the accuracy
of intrasheath injection between the midaxial technique and palmar technique.
The midaxial technique could be considered as an alternative to the palmar
technique for trigger finger injection.
Article by John R. Fowler, et al, from
USA.
Full access: http://mrw.so/2PX21R
Image by epiclectic, from Flickr-cc.
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