The Journal of hand surgery
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Comparative Study
Injection versus surgery in the treatment of trigger finger.
One hundred nine trigger fingers in 102 patients were reviewed with respect to management plan and response to treatment. Thirty-four digits eventually underwent surgical release of the A1 pulley, while the other 75 digits were treated with local steroid injection only. All patients were evaluated with respect to clinical resolution of symptoms, dollar cost of treatment, and general satisfaction as measured with a post-treatment questionnaire. ⋯ Although surgical release of the A1 pulley cost our Medicare patients $250.00 more than a second injection, this additional cost may be offset by the benefit conferred through permanency of relief. Subjective data from the patient questionnaire responses also support surgery as a reasonable choice after one injection failure. The information from this study better delineates differences between injection and surgery as treatment choices and may aid the patient and physician in choosing an individually optimal care plan.
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To evaluate the efficacy of arthroscopic repair of the triangular fibrocartilage complex (TFCC) tears treated within 4 months after injury, functional outcome after repair was determined following arthroscopic repair in 24 patients. The patients' average age was 31 years (range, 22-38 years); the average follow-up period was 34 months (range, 26-48 months). All patients had wrist pain limiting their participation in work prior to surgery. ⋯ Postoperatively, there was a significant relief of pain (p < .01). Postoperative range of motion averaged 89% +/- 9% SD of the contralateral side, and grip strength averaged 85% +/- 20% SD of the contralateral side. Thirteen of the 19 patients returning to work did so in their original jobs.
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Comment Letter
Repetitive strain injuries and cumulative trauma disorders.
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Comment Letter
Electrodiagnostic testing and carpal tunnel release outcome.