Trigger finger is a common hand condition managed frequently with corticosteroid injections (CSI), though there is little consensus on the optimal steroid type, dosage, and injection technique. This systematic review evaluated the comparative effectiveness and safety of methylprednisolone versus triamcinolone for achieving remission in adult patients with trigger finger.
Materials & Methods
A systematic review of PubMed, Embase, and MEDLINE was conducted from inception to May 2024, identifying randomized controlled trials assessing methylprednisolone or triamcinolone for adult trigger finger. Primary outcome was symptom remission, defined as resolution of triggering and functional limitation. Data extraction and risk-of-bias assessment were performed in duplicate using the Cochrane RoB 2 tool.
Results
Thirteen randomized trials involving 1,116 patients (1,153 digits) met inclusion criteria. Methylprednisolone (n=408 digits) had a cumulative remission rate of 83.6%, while triamcinolone (n=745 digits) had a remission rate of 44.8%. Variations in injection technique (intra-sheath vs. extra-sheath, ultrasound-guided vs. blind) did not significantly affect outcomes. Secondary injections improved remission in patients with partial initial responses. Adverse events occurred in 2.8% of triamcinolone-treated patients, including skin atrophy and steroid flare; no adverse events were reported in methylprednisolone groups.
Conclusions
Methylprednisolone is more effective and appears safer than triamcinolone for treating trigger finger. Neither injection technique nor adjunctive therapies significantly altered outcomes. Further research is needed to account for patient-specific factors such as diabetes and follow-up duration to optimize treatment strategies.
