无注射频率限制的小剂量曲安奈德注射液治疗扳机指的安全性和有效性

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-03-01 DOI:10.1016/j.jhsg.2025.01.005

Jo Watanabe MD, PhD , Yusuke Matsuura MD, PhD , Takahiro Yamazaki MD, PhD , Toshiyuki Yamada MD, PhD , Seiji Ohtori MD, PhD

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引用次数: 0

摘要

目的曲安奈德肌腱鞘注射是一种有效的非手术治疗扳机指的方法；然而，并发症，如肌腱断裂，和过量给药引起的感染，已被报道。考虑到并发症的风险，我们在肌腱鞘内注射4 mg曲安奈德，注射次数不限，间隔至少1个月。本研究旨在回顾性检查在多个设施注射曲安奈德肌腱鞘治疗扳机指的结果。方法研究对象包括2009年4月至2021年10月期间到访4家医疗机构、接受至少1次曲安奈德肌腱鞘注射并可评估其有效性的扳机指患者。排除首次注射后随访期为3个月的患者和16岁的儿科患者。收集Quinnell的严重程度分级、每指注射次数、注射间隔（≥2次）、并发症、糖尿病比例、糖化血红蛋白（HbA1c）水平、需要手术的比例。结果共纳入病例356例，715指(男性260指；女人，455个手指)。参与者的平均年龄为64.9岁（17-92岁），平均每人受影响的手指数为1.9（1-7个手指）。中位随访期为27（3-134）个月。根据Quinnell的严重程度分类，234、274、126和50个手指分别被划分为1、2、3和4级。平均每指注射3.3次。平均注射间隔为6.3个月。未观察到肌腱断裂或感染等并发症。糖尿病发生率为22.4%，HbA1c中位值为7.2%。总共有9.8%的患者需要手术。结论4 mg曲安奈德注射间隔至少1个月未见并发症。研究类型/证据水平：治疗性Ⅳ。

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Safety and Efficacy of Low-Dose Triamcinolone Injection without Injection Frequency Limitation for Trigger Finger

Purpose

Triamcinolone tendon sheath injection is a useful nonsurgical treatment for trigger finger; however, complications, such as tendon rupture, and infections caused by excessive administration, have been reported. Considering the complication risk, we inject 4 mg triamcinolone into the tendon sheath without limitation on the number of injections at intervals of at least 1 month. This study aimed to retrospectively examine the results of triamcinolone tendon sheath injections for trigger finger at multiple facilities.

Methods

The participants included patients with trigger finger who visited four facilities between April 2009 and October 2021, received at least one triamcinolone tendon sheath injection, and could be evaluated for effectiveness. Patients with a follow-up period of <3 months from the initial injection, and pediatric patients aged <16 years old were excluded. Quinnell’s severity classification, number of injections per finger, interval of injections (when performed ≥2 times), complications, proportion of diabetes, hemoglobin A1c (HbA1c) levels, and proportion that required surgery were collected.

Results

Overall, 356 cases and 715 fingers were included (men, 260 fingers; women, 455 fingers). The mean age of the participants was 64.9 years (17–92 years), and the mean number of affected fingers per person was 1.9 (1–7 fingers). The median follow-up period was 27 (3–134) months. According to Quinnell’s severity classification, 234, 274, 126, and 50 fingers were classified as grade 1, 2, 3, and 4, respectively. The average number of injections per finger was 3.3. The mean interval between injections was 6.3 months. Complications, such as tendon rupture, or infection, were not observed. The rate of diabetes was 22.4%, and the median HbA1c value was 7.2%. In total, 9.8% of all patients required surgery.