The temporal effect of corticosteroid injections into large joints prior to trigger finger release on infection

• Published in: Hand surgery and rehabilitation 2023-10, Vol.42 (5), p.419-423
• Main Authors: Chen, Zhongming, Bains, Sandeep S., Dubin, Jeremy A., Monárrez, Rubén, Remily, Ethan A., Sax, Oliver C., Ingari, John V.
• Format: Article
• Language: English
• Subjects: Corticosteroid; Infection; Injection; Large joints; Trigger finger
• ISSN: 2468-1229; 2468-1210
• DOI: 10.1016/j.hansur.2023.05.008

Trigger finger may be treated with open surgical release. Local corticosteroid injections have also demonstrated success. Studies suggest recipients of flexor sheath corticosteroid up to 90-days prior to open surgery are at increased risk of post-operative infection. However, the possible link between large joints corticosteroid prior to trigger finger release remains unexplored. Therefore, this study aimed to provide complication risks for trigger finger release recipients after large joint corticosteroid. We reviewed a national, all-payer database and examined patients who did not receive and did receive corticosteroid two, four, or six weeks prior to trigger finger release. Primary outcomes assessed were 90-day risk for antibiotics, infection, and irrigations and debridement. Multivariate logistic analyses compared cohorts using odds ratios with 95% confidence intervals. No trends were found regarding antibiotic requirements, infection, as well irrigations and debridement within 90-days for recipients of corticosteroid into large joints two, four, or six weeks prior to open trigger finger release. Elixhauser Comorbidity Index, alcohol abuse, diabetes mellitus, and tobacco use were identified as independent risks for requiring antibiotics as well as irrigations and debridement (all Odds Ratios > 1.06, all p ≤ 0.048). Patients who underwent trigger finger release after receiving a corticosteroid into a large joint two, four, or six weeks prior has no association with 90-day antibiotics, infection, or irrigations and debridement. While the comfort levels for individual surgeons vary, optimizing these comorbidities prior to surgery is an important goal discussed with patients to lower risks for infections. Level III.