Beyond the first year: Long-term outcome of shockwave therapy versus corticosteroid infiltration in the management of trigger finger.

Abstract

Trigger finger is a common tendinopathy with an increasing incidence in the aging and metabolically compromised populations. While corticosteroid infiltration (INF) remains the most frequently used conservative treatment, extracorporeal shock wave therapy (ESWT) is a non-invasive alternative with potential long-term benefits. A prospective, non-randomized comparative study was conducted including 42 patients with Quinnell grade II-III trigger finger. Patients were allocated sequentially to treatment with either ESWT (<i>n</i> = 21) or INF (<i>n</i> = 21). Outcomes were assessed at baseline, 6 months, 1 year and 2 years including pain, functional status, grip strength, Quinnell classification, Roles and Maudsley score, patient satisfaction and conversion to surgery. At 6 months, outcomes were comparable between the groups across most assessed variables. Most of the patients in the ESWT group achieved substantial pain relief at 1 and 2 years. Functional outcomes differed between the groups at 1 year. Grip strength gains were maintained in the ESWT group. Patient satisfaction remained stable in the ESWT group and decreased in the INF group. Surgical conversion occurred less frequently in the ESWT group than in the INF group at 2 years. In this study, both ESWT and INF were associated with clinical improvement in patients with moderate trigger finger. Differences between treatments emerged at longer follow-up intervals, particularly in pain-related outcomes and rates of surgical conversion. These findings indicate that ESWT is a non-invasive treatment option associated with sustained clinical outcomes over time. II.