Survey on Efficacy of Sonographically Guided Intra Flexor Sheath Corticosteroid Injection in the Management of Trigger Thumb

Entrapment of flexor pollicis longus at the level of A1 pulley is the most common cause of snapping or painful thumb upon flexion and extension motion; the so called which is called «Trigger Thumb». The aim of this study is to assess the efficacy of sonographically-guided intra tendon sheath corticosteroid injection in the management of trigger thumb. In a prospective study 104 patients (7 males، 97 females، 112 trigger thumbs) with the mean age of 52. 11±7. 63 who had trigger thumb underwent intra flexor sheath corticosteroid injection under the guide of ultrasound in a 2 year period in Rasht-Iran. Improvement was measured using the «Quinnell» grading system before and in intervals after 3 and 6 weeks; 3، 6 and 12 months after injection. From the 112 thumbs، 15 (13. 4%) required reinjection and/or surgery. Twelve (80%) of these 15 thumbs were simply re-injected، 2 (13. 3%) underwent surgery without re-injection but because of no improvement، underwent surgery. Reduction in Quinnell grade after the first injection was significant (p<. 0001). One year after the first injection، 111 of 112 thumbs (99. 1%) were symptom-free. Sonographically guided intra flexor sheath corticosteroid injectionis an effective method in the management of trigger thumb and would reduce the need for surgical release.