• Jonas L Matzon, Cory Lebowitz, Jack G Graham, Ludovico Lucenti, Kevin F Lutsky, and Pedro K Beredjiklian.
• Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA. Electronic address: jonas.matzon@rothmanortho.com.
• J Hand Surg Am. 2020 Apr 1; 45 (4): 310-316.

PurposeTo determine the risk for infection in trigger finger release surgery after preoperative corticosteroid injection.MethodsWe retrospectively evaluated all patients undergoing trigger finger release by 16 surgeons over a 2-year period. Data collected included demographic information, medical comorbidities, trigger finger(s) operated on, presence of a prior corticosteroid injection, date of most recent corticosteroid injection, postoperative signs of infection, and need for surgery owing to deep infection. Superficial infection was defined per Centers for Disease Control criteria. Deep infection was defined as the need for surgery related to a surgical site infection.ResultsIn this cohort of 2,480 fingers in 1,857 patients undergoing trigger release surgery, 53 (2.1%) developed an infection (41 superficial [1.7%] and 12 deep [0.5%]). Before surgery, 1,137 fingers had no corticosteroid injection. These patients developed 1 deep (0.1%) and 17 superficial (1.5%) infections. In contrast, 1,343 fingers had been given a corticosteroid injection before surgery. These patients developed 11 deep (0.8%) and 24 superficial (1.8%) infections. Median time from corticosteroid injection to trigger release surgery was shorter for fingers that developed a deep infection (63 days) compared with those that developed no infection (183 days). The risk for developing a deep infection in patients who were operated on within 90 days of an injection (8 infections in 395 fingers) was increased compared with patients who were operated on greater than 90 days after an injection (3 infections in 948 fingers).ConclusionsPreoperative corticosteroid injections are associated with a small but statistically significantly increased rate of deep infection after trigger finger release surgery. The risk for postoperative deep infection seems to be time dependent and greater when injections are performed within 90 days of surgery, especially in the 31- to 90-day postinjection period.Type Of Study/Level Of EvidenceTherapeutic IV.Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

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