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

Background: 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. Methods: 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. Results: 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. Conclusion: Sonographically guided intra flexor sheath corticosteroid injectionis an effective method in the management of