Indian Journal of Health and Wellbeing

Mahashankar Yadav ¹, Dhruv Sharma ¹, Kuljit Kumar ¹, Neha Yadav ²

Affiliations
1 Department of Orthopaedics, ESIC Medical College & Hospital, Faridabad, Haryana, IN
2 Department of Dermatology, ESIC Medical College & Hospital, Basaidarapur, New Delhi, IN

Abstract

Trigger finger is basically caused by the mismatch between the volume of the flexor tendon sheath and its contents resulting in a narrowed tunnel for tendon excursion. Treatment modalities includes conservative management and Surgical management (open or percutaneous Al pulley release). To compare clinical and functional outcome of percutaneous release and corticosteroid injection in management of trigger digits. Inclusion criteria- Adults aged more than 18 years with Qumnell grade I III. Sixty patients were divided into two groups, Group 1 (n = 30) treated with percutaneous release and Group 2 (n = 30) treated with percutaneous triamcinolone injections. Mean age of patients in group 1 was 43.83 years and in group 2 was 41.87 years. Thumb was the most commonly affected digit and little finger, the least commonly affected digit. Significant improvement (p value <0.001) in the VAS score was seen in group 1 when compared with group 2 from 1st week of follow up till the end of the study. Percutaneous release was found superior to Corticosteroid group regards of VAS score, Roles and Maudsley score and residual triggering.

Keywords

Percutaneous Release, Corticosteroid Injection, Trigger Digit.

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Dhruv Sharma ¹, Kuljit Kumar ¹, Laxmi Sharma ², Neha Yadav ³

Affiliations
1 Department of Orthopedics, ESIC Medical College and Hospital, Faridabad, Haryana, IN
2 Department of Physiotherapy Holy Family Hospital, New Delhi, IN
3 Department of Dermatology, ESIC PGIMER Basaidarapur, New Delhi, IN

Abstract

Contrast bath is commonly used therapy in plantar fascitis. However there is no standard regimen followed as to the order and time ratio of hot and cold fomentation. This study was conducted to establish a standard hot: cold fomentation ratio to achieve maximum efficacy of contrast bath in plantar fascitis. 75 patients of plantar fasciitis were equally divided into three groups, A: 3 cycles of alternate 3 minutes hot fomentation and 1 minute of cold fomentation, B: hot fomentation for 3 minutes followed by 1 minute cold fomentation followed by a sustained 12 minutes of hot fomentation and C: cold fomentation for 5 minutes followed by 21/2 minutes of hot and again 5 minutes cold fomentation. Thrice daily regimen was followed. VAS score was used to note the initial pain, pain relief at 1 week and 1 month. The mean pain value in group A was 7.52±1.27 SD on initial evaluation, was 6.32±1.31 SD at 1 week and 2.8±1.42 SD at 1 month. Respective values in group B was 6.8±1.37 SD, 5.8±1.25 SD and 2.6±1.31 SD and in group C was 7.81±1.43 SD, 6.37±1.09 SD and 3.1±1.49 SD. In plantar fascitis, only temperature fluctuations at subcutaneous level are required to bring a local pumping effect. This needs only alternation of hot and cold fomentation, the order of fomentation and time duration of each cycle is not specific. No time ratio is superior to another.

Keywords

Hot Fomentation, Cold Fomentation, Plantar Fascitis.

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