Percutaneous Release of Trigger Finger With and Without Steroid Injection A Systematic Review and Meta-Analysis.

ABSTRACT

PURPOSE: This study sought to determine if concomitant steroid administration with percutaneous release (PRS) of trigger finger leads to better functional outcomes, less postoperative pain, lower rates of trigger recurrence, and lower rates of subsequent open release versus percutaneous release (PR) alone. METHODS: Articles related to trigger finger disorder, percutaneous release of trigger finger, and steroid admin- istration were assessed by two independent reviewers ac- cording to PRISMA guidelines. Data related to satisfaction, pain, disability, recurrence, and need for open release was abstracted from relevant studies. A meta-analysis using random effects models was performed to calculate pooled effect size estimates controlling for heterogeneity between studies. Sensitivity analyses were performed to identify pos- sible sources of heterogeneity between studies. RESULTS: Forty-five studies with a total of 4,188 digits were included in the PR group and seven studies with a total of 700 digits were included in the PRS group. Our meta-analysis showed no significant difference between treatment options with regard to overall satisfaction, postoperative pain, recur- rence rates, or subsequent need for open release. A small difference between groups was observed in postoperative disability, with lower levels of disability following PRS versus PR. CONCLUSIONS: Based on current literature, both PR and PRS are safe and effective treatments for trigger finger. Steroid administration with percutaneous release may lead to lower rates of postoperative disability, but due to the small difference observed and the modest sample size of studies that examined this outcome, further studies are needed to elucidate if the difference seen in disability is clinically relevant.