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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
36
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
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
Taipei Veterans General Hospital
Taipei, Taiwan
Quinnell classification
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
Time frame: Pre-injection; 3-weeks and 3-months post-injections
hand functional evaluation
using the Michigan Hand Outcome Questionnaire (MHQ)
Time frame: Pre-injection; 3-weeks and 3-months post-injections
visual analog scale
Time frame: Pre-injection; 3-weeks and 3-months post-injections
total active motion (TAM)
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
Time frame: Pre-injection; 3-weeks and 3-months post-injections
grip strength
dynamometer strength test (JAMAR grip)
Time frame: Pre-injection; 3-weeks and 3-months post-injections
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