Trigger Finger
Conditions
Keywords
Hyaluronic acid, trigger finger
Brief summary
The study is to compare the effect between steroid injection and Hyaluronic acid in treatment trigger finger. Using sonoguided injection technique achieves more accurate injection location and therapeutic effect. We hypothesize hyaluronic acid has both lubricant and anti-inflammation effect in treatment of trigger finger, and can provide better outcome and lower adverse effect than steroid injection.
Detailed description
This is a prospective, randomized, double-blinded controlled study. Patients with the diagnosis of trigger finger will be recruited and enrolled from Taipei Veteran General Hospital PM&R outpatient clinic. Subjects will be randomized into two groups; hyaluronic acid and triamcinolone acetonide injections, both via ultrasound-guided with one injection only.We hypothesize that through the anti-inflammatory property of the hyaluronate acid, the treatment effects will be as effective as the traditionally used steroid injections with equal or even lower recurrence rate for treatment of trigger finger. We expect that injections of hyaluronate into tendon sheath could become a new treatment option for trigger finger.
Interventions
DRUGtriamcinolone acetonide
used ultrasound-guided inject 1c.c triamcinolone acetonide 10mg/mL (Shincort®, YSP, Taiwan)into the sheath of the flexor tendons, penetrated to the A1 pulley. One injection only Steroid
DRUGHyaluronic Acid
used ultrasound-guided inject 1c.c Hyaluronic acid (Artz®, Seikagaku, Japan)into the sheath of the flexor tendons, penetrated to the A1 pulley. One injection only
Sponsors
Taipei Veterans General Hospital, Taiwan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients with trigger digits and patients * without previous treatment of the trigger digit
Exclusion criteria
* patients with prior treatment of the trigger digit (eg, splinting, injection, or therapy), * patients less than * 20 years old, * patients with allergy or contraindication to hyaluronic acid, * patients with trigger digits due to rheumatoid arthritis, * and patients with infection at the site of injection.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quinnell classification | Pre-injection; 3-weeks and 3-months post-injections | he Quinnell system grades trigger fingers as: 0 - normal movement 1. \- uneven movement 2. \- locking can be corrected with active motion 3. \- locking corrected with passive motion 4. \- unable to correct deformity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| hand functional evaluation | Pre-injection; 3-weeks and 3-months post-injections | using the Michigan Hand Outcome Questionnaire (MHQ) |
| visual analog scale | Pre-injection; 3-weeks and 3-months post-injections | — |
| total active motion (TAM) | Pre-injection; 3-weeks and 3-months post-injections | Defi ned as the total ROM achieved when all three joints-metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) of a digit are actively fl exed or extended simultaneously, minus any extension defi cit at any of the three joints |
| grip strength | Pre-injection; 3-weeks and 3-months post-injections | dynamometer strength test (JAMAR grip) |
Countries
Taiwan
Outcome results
None listed