Effectiveness of Percutaneous Pulley Release with Infiltration, Versus Infiltration Alone in Trigger Finders

Launched by CENTRE HOSPITALIER DEPARTEMENTAL VENDEE · Sep 7, 2021

Keywords

ClinConnect Summary

This clinical trial is studying a treatment for a condition called trigger finger, which causes pain and a catching sensation in the fingers when they bend. The researchers want to compare two approaches: one involves a small surgical procedure to release a part of the finger called the A1 pulley, followed by a corticosteroid injection, while the other involves just a second corticosteroid injection alone. The goal is to see which method is more effective in relieving symptoms.

To be eligible for the trial, participants need to be at least 18 years old and have a diagnosed trigger finger that has not improved after their first corticosteroid injection. They should also have certain ultrasound findings related to the condition. If you join the study, you will either receive the surgical treatment with the injection or just the injection, and all procedures will be done under local anesthesia to minimize discomfort. It's important to know that certain health conditions or treatments may prevent someone from participating, such as being pregnant, having certain allergies, or taking blood-thinning medications.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patient ≥ 18 years old,
• • Presence of a trigger finger (thumb or long fingers) to be treated
• • Quinnell score \>1
• • Episode of trigger characterized on questioning or clinical examination
• • Failure of a first corticosteroid infiltration \> 3 months before inclusion
• • First infiltration within 15 months of inclusion
• • Thickening A1 pulley on ultrasound ≥ 0.5 mm
• • Patient who has the capacity to understand the protocol and has given consent to participate in the research,
• • Patient with social security coverage
• Exclusion Criteria:
• • Presence of several symptomatic fingers requiring treatment by ultrasound-guided section of the pulley
• • Patient who are pregnant, breastfeeding, or who have the potential to become pregnant without effective contraception at the time of inclusion
• • Known allergy to corticoid (Hydrocortancyl®) including its excipients ((benzyl alcohol, sodium carmellose, sodium chloride, polysorbate 80)
• • Known allergies to lidocaine
• • Ongoing anticoagulant treatments (AVK, New Oral Anti-Coagulants)
• • Local or general infection, or suspicion of infection
• • Live vaccines
• • Evolving viruses (hepatitis, herpes, varicella, shingles)
• • Severe or uncontrolled hypertension
• • Unbalanced diabetes
• • Underlying progressive cardiovascular disease
• • Hemodialysis patients
• • Prosthesis on the finger to be treated
• • Echographic tendon fissure
• • Inflammatory disease (rheumatoid arthritis, spondyloarthritis, connective tissue diseases, etc.) with tenosynovitis.
• • History of surgery on the fingers
• • Dupuytren's disease
• • Patient participating in another interventional clinical research protocol involving a drug or medical device
• • Patient under guardianship, curators or legal protection