Stenosing tenosynovitis of the fingers and thumb. Results of a prospective trial of steroid injection and splinting

Abstract

In a prospective study of conservative treatment of stenosing tenosynovitis of the fingers and thumb, 53 fingers and thumbs were injected with 1 cm3 of methylprednisolone and 1 cm3 of 1% lidocaine and immobilized for three weeks. Thirty-eight (72%) of the 53 digits had a successful outcome (mean follow-up period, 25 months). Fifteen (29%) digits in ten patients were only temporarily improved. Treatment was successful in most patients with symptoms and signs of less than four months' duration. Only 41% of the digits causing symptoms for greater than four months had a successful outcome. Patients with multiple-digit involvement did not respond as well (12 satisfactory and ten failed) as those with single-digit involvement (39 satisfactory and two unsatisfactory). The patient with stenosing tenosynovitis in a single digit with less than four months of symptoms responded most favorably to the conservative regimen.