Email updates

Keep up to date with the latest news and content from Journal of Orthopaedic Surgery and Research and BioMed Central.

Open Access Research article

Biomechanical effects of steroid injections used to treat pyogenic flexor tenosynovitis

Blake R Turvey, Paul S Weinhold, Reid W Draeger, Donald K Bynum and Laurence E Dahners*

Author Affiliations

University of North Carolina, School of Medicine, Department of Orthopaedics, Campus Box #7055, Bioinformatics Building, Chapel Hill, NC 27599-7055, USA

For all author emails, please log on.

Journal of Orthopaedic Surgery and Research 2012, 7:34  doi:10.1186/1749-799X-7-34

Published: 9 October 2012

Abstract

Background

A recent study from our laboratory has demonstrated improved range of motion in the toes of broiler chickens afflicted with pyogenic flexor tenosynovitis when treated with local antibiotic and corticosteroid injections, without surgical drainage. However, the use of corticosteroids as an adjunct treatment raised peer concern, as steroids are thought to have deleterious effects on tendon strength. The purpose of this study was to compare the tensile strength of the aforementioned steroid treated tendons, to a group of tendons administered with the current standard treatment: systemic antibiotics, surgical drainage and no corticosteroids.

Methods

Twenty-three tendons’ structural and material properties were investigated (fifteen receiving the standard treatment, eight receiving the steroid treatment). The measurements from each group were interpreted via Student’s unpaired t-test and a post-hoc power analysis.

Results

The steroid treated tendons did demonstrate a trend toward decreased mechanical properties when compared with the standard treatment group, but the results were not statistically significant.

Conclusions

Treatment of septic tenosynovitis with local corticosteroid and local antibiotic injections resulted in better digital motion, without a significant loss of tendon strength, over a twenty-eight day recovery period.

Keywords:
Pyogenic flexor tenosynovitis; Corticosteroids; Tensile strength; Biomechanical properties; Closed-space infection