Prognosis

Most patients respond to conservative measures with adjustment of daily activities that exacerbate the symptoms.

In resistant cases, surgical treatment is highly successful.

Trigger finger

Splinting alone can be effective in 55% to 66% of cases.[3]​​[77] Corticosteroid injections are successful in 48% to 93% of cases.[6][7][8][23][43][44][45][46][47] Successful percutaneous release has been reported in 58% to 100% of cases.[55][56][57][58][59][60][61][62]

Open trigger digit release remains the definitive treatment. One Cochrane review found low-quality evidence suggesting greater success after open surgery compared with corticosteroid injections, at least during short-term follow-up.[78]

For trigger finger in patients with diabetes mellitus, immediate release may be the most cost-effective strategy due to the high risk of recurrence after corticosteroid injection.[79]

de Quervain disease

Splinting alone is not highly effective.[80] One or two corticosteroid injections are successful in 50% to 80% of cases.[2][5]​​[22][46][65]​ In one small prospective study, the combination of corticosteroid injection and splinting was more effective than injection alone.[66]​​

For resistant cases, open release is the definitive treatment. Endoscopic release has also been described.[71]

In pregnancy and lactation, nonoperative treatment is highly effective; the condition tends to resolve after cessation of lactation.[14]​​[72][73] 

All other tendovaginitides

Most patients respond to conservative measures with adjustment of daily activities that exacerbate the symptoms. The use of splinting for temporary immobilization or rest, particularly at night, can be useful. In resistant cases, surgical treatment is highly successful.

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