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A prospective clinical study was performed to investigate the clinical results of extrasynovial (subcutaneous) steroid injection for trigger finger. One hundred and twenty-nine trigger fingers were investigated in 100 adult patients; 76 were women and 24 were men. Their mean age was 60 years (range: 17 to 88 years). We classified trigger fingers into three different grades according to clinical severity at a medical examination. All patients were injected with betamethasone mixed with lidocaine. Surgical release of the A1 pulley was performed at the patients' request if steroid injection therapy was not effective. Pain and snapping were relieved in 98% and 74% of cases, respectively. Recurrence occurred in about half our patients, but the same clinical benefit was obtained after re-injection. Surgery was performed for seven fingers. No complications of steroid injections were observed. This study suggests that extrasynovial steroid injection is a valuable conservative treatment for trigger finger and it is not necessary to try and inject into the tendon sheath to get a good result and markedly reduce the risk of causing damage to tendons and other structures.

We present a rare case of bilateral extensor pollicis longus tendon rupture in a professional football goalkeeper following steroid injection for extensor tenosynovitis. The potential pathogenesis mechanisms are discussed.

Background: Osteoarthritis of the finger proximal interphalangeal joints (PIPJ's) is common and severely limits hand function. Intra-articular steroid injections are frequently used, but there is little research assessing this treatment option.

Methods: This was a prospective audit of patients undergoing intra-articular steroid injections into the PIPJ under image intensifier guidance. The aims were to assess the duration of pain relief, hand function and range of movement following this procedure. Fifty injected joints were followed up at six weeks, three and six months.

Results: There were significant improvements in both pain scores and the range of movement for up to three months. Analgesia requirements decreased and hand function improved up to three months. By six months, patients were approaching their preinjection scores.

Conclusions: X-ray guided injections are a simple procedure which can be effectively performed in the out- patient setting, resulting in satisfied patients with improved hand function and pain scores.

Background: Steroid injection is a proven treatment for trigger digits. The time taken for resolution of triggering following an injection is a question often asked by patients and one that has not been adequately addressed in existing literature. The aim of this study was to determine the time taken for triggering to resolve after a single steroid injection in patients presenting for the first time with a trigger digit.

Methods: A prospective study was conducted in patients with first presentation of a grade II or grade III trigger digit(s) that received a steroid injection. Data with regards to age, gender, digit(s) involved, duration of symptoms, trigger grade, and presence of diabetes were collected. They were given a stamped addressed postcard with instructions to fill in the date that the triggering resolved and mail the postcard back to us. If the postcard was not received at three weeks, we contacted the patient by telephone to ask for the date of resolution of trigger.

Results: 56 patients with 66 trigger digits were included in the study. 52 out of 66 digits (79%) had resolution of the trigger at one month. The mean duration for resolution of trigger was 8.8 days (range 1–30 days).

Conclusions: Patients can be counselled that a steroid injection is effective in resolving the trigger in 79% of trigger digits presenting for the first time and that the mean time taken for resolution of triggering is 8.8 days. It is recommended to wait for at least one month before considering another injection or alternative treatments.