Efficacy of steroid injection versus physiotherapy treatment in work related trigger finger

• Main Authors: Mustapha, Mohd Farid, Khalid, Kamarul Ariffin, Ismail, Raffael, Kassim, KM, Singh, ASJ
• Format: Conference or Workshop Item
• Language: English; English; English; English
• Published: 2019
• Subjects: RD701 Orthopedics
• Online Access: http://irep.iium.edu.my/79981/1/reply%20-%20Mohd%20%20Farid.pdf; http://irep.iium.edu.my/79981/2/TF%20poster%20abstract.pdf; http://irep.iium.edu.my/79981/3/Abstract%20edit%201.1.pdf; http://irep.iium.edu.my/79981/4/Program%20Book_15%20MSSH%20ASM%202019%20%40%202019-10-14%20%28HD%29.pdf; http://irep.iium.edu.my/79981/

Introduction Stenosing tenosynovitis or trigger finger is a common problem among patients seeking treatment in the orthopaedic clinic. Trigger finger is characterized by locking or painful snapping when flexing the. Multiple approaches can be used to treat a patient with trigger finger. It can be divided into two major groups, either conservative or operative treatment. Conservative treatment varies in modalities. It includes non-steroidal anti-inflammatory drugs, ice packing, extension splint, physiotherapy, or corticosteroid injection. Operative treatment release the annular A1 pulley percutaneously or open. Objective This study to compare the functional outcome of steroid injection versus physiotherapy between service and professional workers. Method We are using observational cohort study. Michigan Hand Outcomes Questionnaire (MHQ) used for trigger finger grade I, II, and III. Patient was observed with pre-treatment visits, 6 months and 12 months. Patient was divided into two group steroid injection and physiotherapy for evaluation of functional outcome and recurrence rate. We used Malaysia Standard Classification of Occupation 2013 (MASCO) to identify 2 working group between professional and service & sales worker group. Result The total number of patients recruited is 149. It can be divided into 2 main groups, a professional group with a total number of patients of 75 and a service & sales worker with around 74 patients. Out of the 149 patients, 80 were treated with physiotherapy and 69 were treated with steroid injection. There was no association between the occupation and the grading of trigger finger and the trigger finger itself. Functional outcome using MHQ score for steroid group shows a good 12 months outcome (P values <0.01). Functional outcome in terms of physiotherapy was lower compared to steroid injection at 6 months and 12 months. The recurrence rate in physiotherapy was higher than in the steroid injection group. Conclusion Single steroid injection had better functional outcome after 6 months and 12 months post intervention compared with physiotherapy. Physiotherapy treatment can be suggested to patients with grade 1, 2, and 3 of trigger finger who refused any steroid injection.