PURPOSE: The purpose of this study was to compare the failure rate of primary trigger finger corticosteroid injections (CSIs) using triamcinolone versus betamethasone.
METHODS: This was a retrospective cohort study of all primary trigger finger CSIs given by a single fellowship-trained, hand surgeon over two 8-month periods. From June 2022 to January 2023, all trigger finger CSIs were performed with triamcinolone (1 mL, 40 mg/mL). From June 2023 to January 2024, all trigger finger CSIs were performed with betamethasone (1 mL, 6 mg/mL). Patient charts were reviewed at 1 year following the CSI to determine the failure rate of the CSI. Failure was defined as reintervention with either a repeat CSI or trigger finger surgery. For those patients who failed the primary CSI, the time to failure was recorded.
RESULTS: The two cohorts were similar in terms of finger laterality and finger distribution. In the triamcinolone cohort, 284 fingers in 238 patients received a primary trigger finger CSI. Within 1 year, 47 fingers (16.5%) had undergone either a repeat CSI (43 [15.1%]) or trigger release surgery (4 [1.4%]). In the betamethasone cohort, 255 fingers in 223 patients received a primary trigger finger CSI. Within 1 year, 89 fingers (34.9%) had undergone either a repeat CSI (73 [28.6%]) or trigger release surgery (16 [6.3%]). The percentage of patients undergoing repeat intervention was significantly greater in the betamethasone cohort (P < .05). Moreover, the betamethasone cohort had a significantly shorter mean time to failure as compared with the triamcinolone cohort (167 days vs 273 days, P < .05).
CONCLUSIONS: For primary trigger fingers, patients treated with a betamethasone CSI were significantly more likely to undergo a repeat CSI or trigger finger release surgery within 1 year of the CSI compared with patients treated with a triamcinolone CSI (P < .05). Betamethasone CSIs resulted in a significantly shorter time to failure than triamcinolone CSIs (P < .05).
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