Back to 2026 Abstracts
The Association Between Spontaneous Flexor Tendon Rupture and Corticosteroid Injection as Treatment for Stenosing Tenosynovitis
Sophia Jacobi, BA, Jonah Dewing, BS, Emily Davidovic-Katz, BA, Samara Moll, BA, Janos Barrera, MD; Jacques H. Hacquebord, MD
NYU Langone Health, New York, NY
Introduction: Corticosteroid injections are an effective, conservative treatment for stenosing tenosynovitis; however, their use is often limited by fear of spontaneous tendon rupture. This study aims to evaluate the relationship between corticosteroid injection and the occurrence of spontaneous flexor tendon rupture. We hypothesize there is a rather weak association between the two with a nominal incidence.
Methods: A retrospective review of all patients stenosing tenosynovitis from 2020 to 2024 at a single institution was conducted. Chart review was performed to assess whether a diagnosis of spontaneous flexor tendon rupture was documented at any time following the diagnosis of stenosing tenosynovitis. Additionally data from the US nationwide health record Epic Cosmos was used to conduct the same analysis. Patients were stratified into two groups for both reviews: those who received a corticosteroid injection into the hand and those who did not. The primary outcome was the diagnosis of spontaneous flexor tendon rupture.
Results: A total of 21,219 patients were included in the retrospective review from a single institution. 14,276 patient received a corticosteroid injection in the affected finger. Of these, 3 patients had a spontaneous flexor tendon rupture. 6,943 patients did not receive a steroid injection however, 2 patients still went onto spontaneous flexor tendon rupture. Tendon rupture occurred in 0.02% of patients following corticosteroid injection. The odds ratio for the association between corticosteroid injection and spontaneous tendon rupture was 0.72, suggesting no increased risk.
From Epic COSMOS, a total of 1,678,278 patients diagnosed with stenosing tenosynovitis were included in this review. Out of 544,385 patients treated with a corticosteroid injection in the affected finger, 154 were diagnosed with a spontaneous flexor tendon rupture, corresponding to an incidence rate of 0.028 ± 0.002%. Conversely, among 1,133,893 patients who did not receive a corticosteroid injection for trigger finger, 296 developed a spontaneous flexor tendon rupture, resulting in an incidence rate of 0.026 ± 0.002%. The odds ratio for the association between corticosteroid injection and spontaneous tendon rupture was 1.084, indicating no significant increase in risk.
Conclusion: At present, many hand surgeons restrict the number of corticosteroid injections administered for trigger finger out of concern that such treatment may elevate the risk of tendon rupture. We found that this is an extremely rare complication with an incidence rate of 0.02 to 0.03% and no significant association. Therefore, corticosteroid injections should remain a standard of care not limited by the risk of tendon rupture.
Back to 2026 Abstracts
