M. Pathuri1, J. Strelzow1 1University Of Chicago, Chicago, IL, USA
Introduction: Corticosteroid injections are commonly used in the treatment of many orthopedic conditions due to their anti-inflammatory properties. Despite the prevalence of their usage in hand surgery, there is a limited body of research evaluating the efficacy of different dosing regimens of corticosteroids. Previous studies are lacking focusing primarily on outcomes and complications in trigger fingers at lower dose corticosteroids. The purpose of this study was to compare the efficacy of a high-dose (40mg) injection group against a low-dose (<10mg) group treated for common hand conditions including trigger finger, carpal tunnel, and DeQuervian’s Tenosynovitis.
Methods:
The study is a retrospective chart review of patients presenting between January 1st, 2020 and February 28, 2023. Patients who received a corticosteroid injection for primarily trigger finger, carpal tunnel, DeQuervian’s Tenosynovitis and other tendinopathies were divided into a high-dose injection group (40mg) and a low-dose injection group (< 10mg). The primary outcomes were rates of second injection with secondary outcomes being estimated time of relief from the injection,and conversion to surgery.
Results:
A total of 217 patients (297 injections) were reviewed for this study. 68% of the injections were for trigger finger, 15% for carpal tunnel, 14% for De Quervian’s Tenosynovitis, and 3% for other (ECU Tendinitis, cubital tunnel, and radial tunnel syndrome). The high-dose group had significantly lower rates of repeat injection (19% vs 30%), lower rates of surgery (10% vs 19%), and a lower rate of patients who continued to experience symptoms but declined acute intervention (27% vs 41%), and longer months of symptom-free relief (5.5 months vs 3.0 months), when compared to the low-dose group. Complications did not vary between groups.
Conclusion:
Corticosteroid injection for common hand pathologies is a frequently used modality of treatment. This study offers insight into the use of high versus low dose steroid and suggests that use of high-dose steroid may provide significantly longer lasting relief and success compared to low dose steroid. Orthopedic hand surgeons should consider the benefit of high-dose corticosteroid injections when deciding on a treatment modality for common hand conditions. Further research in the form of a randomized-control trial will be the next step to validate the results of our study.