Assessing Injection Techniques in the Treatment of Trigger Finger英文文献资料.docVIP

Modern Plastic Surgery, 2012, 2, 83-86 83 /10.4236/mps.2012.24020 Published Online October 2012 (http://www.SciRP.org/journal/mps) Assessing Injection Techniques in the Treatment of Trigger Finger John R. Fowler , Lauren Ogrich , Perry Evangelista , Alyssa A. Schaffer 1 2 3 1 1 Temple University Hospital, Department of Orthopaedics, Philadelphia, USA; Temple University School of Medicine, Philadelphia, 2 3 USA; University of Pennyslvania School of Medicine, Philadelphia, USA. Email: john.fowler@ Received June 7 , 2012; revised July 8 , 2012; accepted August 6 , 2012 th th th ABSTRACT Background: Trigger finger is characterized by the inability to smoothly flex and extend the digit. Corticosteroids are an accepted non-surgical treatment option and can be delivered via two techniques. While the palmar approach is more commonly used, some have suggested that the mid-axial approach may be less painful for patients and yield higher in- trasheath injection rates. The purpose of this study is to compare the accuracy of the palmar and midaxial approaches for delivery of corticosteroids into the flexor tendon sheath using radio-opaque dye in a cadaver model. Methods: A total of 50 injections were performed, 25 via midaxial technique and 25 via palmar technique. A one inch, 25-gauge needle was used to inject 1 mL of Isovue contrast dye into the flexor tendon sheath under live fluoroscopy. The fluoro- scopic images were examined after injection to determine intrasheath versus extrasheath delivery of the dye, with visu- alization of contrast filling the sheath defining a successful injection. Results: The midaxial approach had a success rate of 52% compared to the conventional palmar approach success rate of 36%, p = 0.5. The ring finger is the most com- mon location of trigger finger and