What are treatment options for volar flexor tenosynovitis?

Updated: Nov 22, 2019
  • Author: Mark R Foster, MD, PhD, FACS; Chief Editor: Harris Gellman, MD  more...
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Peritendinous lidocaine-corticosteroid injection is the treatment of choice for volar FT (ie, trigger finger). [32] In a randomized trial, patients with this condition who were treated with corticosteroid injection showed a greater reduction in pain severity and frequency of triggering than did patients treated with placebo. The short-term effects were maintained during a 12-month follow-up phase. [33]

In a double-blind, randomized, controlled study from Taiwan that compared ultrasound-guided injection of hyaluronic acid with steroid injection in 36 patients with trigger finger (39 digits), Liu et al found the former treatment yielded promising results for the treatment of this condition, though optimal regimens remained to be defined. [34]

Treatment also includes activity modification (ie, avoidance of activities that cause triggering) and NSAIDs. Splinting is another treatment modality that has been studied. This is appropriate for patients who do not want to have a steroid injection.

Consider surgical tendon release if injection fails. Surgical release for trigger finger has success rates higher than 90%.

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