Management of Stenosing Flexor Tenosynovitis: Maximizing Nonoperative Success without Increasing Morbidity

Plastic and Reconstructive Surgery
Alyssa R GolasRobert S Reiffel

Abstract

Traditional nonoperative management of stenosing tenosynovitis is limited to one corticosteroid injection, followed by surgery in the case of failure. Recently, nonoperative strategies have been extended to include two or three injections despite the absence of large prospective studies supporting this practice. A prospective study was performed of all patients presenting with stenosing tenosynovitis to a single surgeon (R.S.R.) over a 22-year period. Patients with potentially confounding comorbidities were excluded. All digits received one to three injections of triamcinolone acetonide plus local anesthetic into the tendon sheath. Data were analyzed by digit. Five hundred seventy-one digits (401 patients) were included. Digits that were symptomatic for 3 months or less were more likely to resolve after one injection than those that were symptomatic for more than 3 months (OR, 2.6; 95 percent CI, 1.67 to 4.0; p < 0.01). For the digits that failed to resolve after the first injection, those that were symptomatic for 5 months or less before one injection were more likely to respond to a second injection than those that were symptomatic for more than 5 months (OR, 9.4; 95 percent CI, 3.0 to 29.7; p < 0.01). Eight digits received t...Continue Reading

References

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Sep 6, 2014·Hand : Official Journal of the American Association for Hand Surgery·Emran SheikhCharles Leinberry

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Citations

Feb 24, 2017·Journal of Computer Assisted Tomography·Joslyn JohnKatherine H Taber
May 10, 2019·Foot & Ankle International·Brianna R FramDavid I Pedowitz
May 19, 2020·Hand : Official Journal of the American Association for Hand Surgery·Ted WelmanMaxim D Horwitz

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