Editor's choice| Volume 42, ISSUE 5, P359-366, May 2017

Open Surgery Versus Ultrasound-Guided Corticosteroid Injection for Trigger Finger: A Randomized Controlled Trial With 1-Year Follow-up

  • Rehne L. Hansen
    Center for Planned Surgery, Regional Hospital Silkeborg, Silkeborg, Aarhus C, Denmark

    Orthopaedic Research Unit, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus C, Denmark
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  • Morten Søndergaard
    Center for Planned Surgery, Regional Hospital Silkeborg, Silkeborg, Aarhus C, Denmark
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  • Jeppe Lange
    Corresponding author: Jeppe Lange, MD, PhD, Center for Planned Surgery, Regional Hospital Silkeborg, Falkevej 1-3, 8600 Silkeborg, Denmark.
    Center for Planned Surgery, Regional Hospital Silkeborg, Silkeborg, Aarhus C, Denmark

    Interdisciplinary Research Unit, Center for Planned Surgery, Regional Hospital Silkeborg, Silkeborg, Aarhus C, Denmark

    Orthopaedic Research Unit, Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus C, Denmark
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Published:March 21, 2017DOI:


      Trigger finger is a common condition with a lifetime prevalence of 2%. Corticosteroid injection is a treatment often considered as a first-line intervention with reported cure rates between 60% and 90% in observational cohorts. Nevertheless, open surgery remains the most effective treatment with reported cure rates near 100%. Head-to-head trials on these treatments are limited. We investigated the efficacy of open surgery compared with ultrasound-guided corticosteroid injections.


      The study was performed as a single-center, randomized, controlled trial with a 1-year follow-up. A total of 165 patients received either open surgery (n = 81) or ultrasound-guided corticosteroid injection (n = 84). Follow-up was conducted at 3 and 12 months. If the finger had normal movement or normal movement with discomfort at latest follow-up, the outcome was considered a success. Secondary outcomes were postprocedural pain and complications.


      The groups were similar at baseline except for lower alcohol consumption in the open surgery group. At 3 months, 86% and 99% were successfully treated after corticosteroid injection and open surgery, respectively. At 12 months, 49% and 99% were considered successfully treated after corticosteroid injection and open surgery, respectively. The pain score at latest follow-up was significantly higher in the corticosteroid injection group. Complications after open surgery were more severe and included 3 superficial infections and 1 iatrogenic nerve lesion. After corticosteroid injection 11 patients experienced a steroid flare and 2 had fat necrosis at the site of injection.


      Open surgery is superior to ultrasound-guided corticosteroid injections. Complications after open surgery are more severe; this must be taken into account when advising patients with regard to treatment.

      Type of study/level of evidence

      Therapeutic I.

      Key words

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