TETİK PARMAK TEDAVİSİNDE STEROİD ENJEKSİYONU MU? AÇIK CERRAHİ Mİ?

Amaç: Açık cerrahi ve steroid enjeksiyonu uygulanan tetik parmak hastaları arasında fark olup olmadığını değerlendirdik.Gereç ve Yöntem: Kasım/2012 ile Mayıs/2015 tarihleri arasında başvuran 108 hastanın(64 bayan,44 erkek) el baş parmağına bir gruba (34 bayan,20 erkek) açık cerrahi uygulandı.Diğer gruba (30 bayan,24 erkek) steroid enjeksiyonu uygulandı.Bu hastalar Wolfe sınıflamasına göre değerlendirildi.Bu hastalarda yineleme oranı ve memnuniyet oranları değerlendirildi.Cerrahi yapılan hastalarda yara yeri enfeksiyonu, sinir hasarı, yarada açılma, fleksör tendonda ok-yayı deformitesi, eklem hareket açıklığında kısıtlanma komplikasyonları değerlendirilmiştir.Bulgular: Hastaların yaş ortalaması 38,2 .Wolfe sınıflamasına göre 46(%42,5) olgu evre 2,62(%57,5) olgu evre 3 idi.Hastaların 64'ü(%59,2) bayan,44'ü(%40,8) erkek idi.Hastalar ortalama 12 ay takip edildi.Steroid enjeksiyonu uygulanan grupta 20(%37) hastada yineleme görüldü.Yineleme görülen hastalara açık cerrahi uygulandı.Açık cerrahi uygulanan grupta yineleme izlenmedi.Cerrahi uygulanan hastaların tamamı tedaviden memnun kaldıklarını belirtti. Sonuç: Steroid enjeksiyonu tetik parmak tedavisinde bir tedavi seçeneği olmasına rağmen,açık cerrahi uygulanan hastaların nüks ve komplikasyon gelişmemesi açısından daha yararlı bir yöntem olduğu görüldü.

Steroid Injection Versus Open Surgery in the Treatment of Trigger Finger

Aim: This study aims to compare steroid injections and open surgery in the treatment of trigger finger. Material and Methods: Between November 2012 and May 2015, a total of 108 patients (64 females, 44 males; mean age: 38.2 years; range, 20 to 68 years) who were admitted to our clinic were included. The patients were assigned into two groups, including Group 2 undergoing open surgery, and Group 1 receiving steroid injections. Trigger finger was graded according to the Wolfe classification. The rate of recurrence and satisfaction rates were evaluated. The patients undergoing surgery were also evaluated for the wound site infection, nerve injury, wound dehiscence, bow-stringing deformity, and reduced range of motion of the joint.Results: The mean follow-up was 12 months (range, 5 to 21). According to the Wolfe classification, 46 patients (42.5%) had Stage 2 disease, while 62 patients (57.5%) had Stage 3 disease. Recurrence occurred in 20 patients (37%) in the steroid injection group; however,no recurrence was seen in patients undergoing open surgery. Satisfactory results were achieved in all patients in the surgery group.Conclusion: Although steroid injection is a therapeutic option in trigger finger, open surgery appears to be a more beneficial method thanks to the lack of recurrence and complications.

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