Injection of Hyaluronic Acid Versus Corticosteroid for Treatment of Trigger Finger
- Conditions
- Trigger Finger
- Interventions
- Drug: hyaluronic acid (20 mg/2 mL)
- Registration Number
- NCT04645303
- Lead Sponsor
- Dubai Health Authority
- Brief Summary
The aim of the study is to compare the therapeutic effects of hyaluronic acid versus steroid injections in treating trigger fingers using ultrasound guidance
- Detailed Description
A prospective randomized controlled study designed to compare the outcomes of injecting patients with trigger finger with hyaluronic acid versus corticosteroid under ultrasound guidance
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 100
- Adult (>18 years)
- Patients with a clinical diagnosis of trigger finger grade 1-3 on the Quinnell grading scale and confirmed diagnosis by ultrasound.
- Quinnell's classification grade IV (contracture)
- Prior injection within 6 months
- Prior operation of the affected finger
- Presence of any contracture in the proximal interphalangeal or metacarpophalangeal joint, and
- History of diabetes, hypothyroidism, and
- Rheumatic or connective tissue disease
- Allergy to triamcinolone or hyaluronic acid
- Pregnancy
- Secondary triggering e.g. Trauma, infection
- Trigger finger symptoms duration >6 months
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Hyaluronic acid hyaluronic acid (20 mg/2 mL) 1mL of hyaluronic acid (20 mg/2 mL; Hyalgan, Fidia, Abano Terme, Italy) infiltration at A1-Pulley under ultrasound guidance after subcutaneous 2% lidocaine without epinephrine infiltration of the skin overlying the A1-pulley. Triamcinolone acetonide Triamcinolone acetonide 10mg/ml 1 mL of Triamcinolone acetonide 10mg/ml infiltration at A1-Pulley under ultrasound guidance after subcutaneous 2% lidocaine without epinephrine infiltration of the skin overlying the A1 pulley.
- Primary Outcome Measures
Name Time Method Change in Quinnell trigger finger grading system: 1 and 3 months post-injection Change in Quinnell grading overtime within 3 months after injection. Trigger fingers are rated as follows: Grade 0: normal finger movements, Grade 1: uneven finger movements, Grade 2: actively correctable triggering, Grade 3: passively correctable triggering, and Grade 4: locked digit.
- Secondary Outcome Measures
Name Time Method Changes in Grip strength 1 and 3 months post-injection Measured by the dynamometer strength test (Jamar grip dynamometer)
The Quick Disability of the Arm, Shoulder and Hand score 1 and 3 months post-injection Patients will be asked to fill a questionnaire form. It is an 11-item form that assesses the upper limb function on a scale of 1-5, with scores ranging from 11 to 55, with the higher scores representing more disability and worse upper limb function.
Visual analogue scale (VAS) of pain 1 and 3 months post-injection Change in pain Visual analogue scale will be recorded. The patient marks on the 100 mm in length line the point that he/she feels to represent his/her perception of pain at the current state. The VAS score is determined by measuring in millimetres from the left hand end of the line to the point that the patient marks ( a higher score indicates greater pain intensity). Categorization of none, mild, moderate and severe pain will be also used (none = 0, mild = 1-4, moderate = 5-6, and severe = 7-10).
Frequency of tender trigger nodules 1 and 3 months post-injection Identifying the presence of tender nodules at A1-pulley of the affected finger by palpation
Patient satisfaction with therapy 1 and 3 months post-injection Participating patients will be asked to classify their result into 1 of 4 categories: (1) complete resolution of symptoms, (2) improved result, but incomplete resolution of symptoms, not warranting further treatment, (3) partial response, but unsatisfactory, warranting further treatment, and (4) no response.
Ultrasound evaluation of A1-Pulley 1 and 3 months post-injection Detailed ultrasonography evaluation of A1-Pulley. Comparing the A1-Pulley ultrasonographic parameters over 3 months after injection (at the follow-up appointment)
Trial Locations
- Locations (1)
Dubai Hospital- Dubai Health Authority
🇦🇪Dubai, United Arab Emirates