OUTCOME OF TRIGGER FINGER TREATMENT IN DIABETES

Trigger finger is an underdiagnosed hand disorder causing disability i n longstanding diabetic patients. Sixty diabetic patients [39 insulin- dependent diabetes mellitus (IDDM) and 21 non-insulin-dependent diabet es mellitus (NIDDM)] and 60 nondiabetic patients were examined. All we re initially treated by steroid injections: failure to alleviate sympt oms was the indication for surgery. The incidence of multiple digit in volvement was higher in IDDM patients as compared with the control gro up (p < 0.001). The diffuse type was 1.45 times more frequent in IDDM and NIDDM than in nondiabetic patients (p < 0.008). The diabetic patie nts had a relatively longer duration of symptoms (p < 0.003). Signific antly, a higher recovery rate upon steroid injection was achieved in c ontrol patients as compared with the diabetic ones (p < 0.001). IDDM p atients required more surgery compared with NIDDMs and, in 13.3% of di abetic patients, the surgical outcome was not successful. Diabetic pat ients should be diagnosed early for multiple and diffuse types of trig ger digits. Steroid injection as the first mode of therapy is highly r ecommended although not always successful. Surgery is the definitive t reatment but requires a long course of physiotherapy and may be associ ated with some complications. (C) 1997 Elsevier Science Inc.