Teo, S. H., Ng D. C., Wong, Y.K.(2018). Effectiveness of proximal interphalangeal joint blocking orthosis vs metacarpophalangeal joint blocking orthosis in trigger digit: A randomized clinical trial. Journal of Hand Therapy, 1-7.
The Skinny- This study compared PIP joint immobilization via an Oval-8TM with a custom MCP blocking orthosis in the treatment of trigger finger.
In the Weeds – Patient (n=35) with Trigger Finger (n=43) were analyzed. Twenty-three patients were allocated to the PIP joint splinting group and 20 patients were in the MCP splinting group. Patients wore the orthosis for eight weeks.
Pain reduction was observed in both groups, but pain reduction was greater with PIP joint splinting compared to the MCP joint splinting group (MCP joint splint). There was only significant improvement in QuickDASH for the PIP splinting Group. Patients wore the pip joint splint significantly longer during the day compared to the MCP splinting group (MCP splint), most likely due to improved comfort.
Bringing it Home- Findings suggest both orthoses are effective in reducing QuickDASH scores, reducing pain and improving overall trigger finger symptoms based on Green’s Classification. However, the pip joint immobilization splint was better for improved function and improved compliance.
The rationale for the rating. Small sample size. All patients with comorbidities were excluded limiting the generalizability of findings. Immobilizing the PIP joint compared to the MCP allows more function and improved compliance. When immobilizing the MCP you limit intrinsic grasp which is a necessity for function. The authors recommend wearing the orthosis for a 4-week duration of 24 hours in order to reduce triggering symptoms followed by night-time splint wear for another 3-4 weeks.
4 Comments
Leave a Comment
More To Read
Multiple Avenues of Pin Site Care in Hand Therapy
By: Megan Prather The prevalence of external fixation with pins in the upper extremity setting and the high rates of pin site infection make identifying a protocol for pin site care important for therapists. Across literature, there are many different pin site care protocols varying in frequency, solutions, materials, and manual cleaning. Despite many studies…
Read More
The Use of Neuromuscular Electrical Stimulation with Upper Extremity Paralysis
The Use of Neuromuscular Electrical Stimulation with Upper Extremity Paralysis By: Mikayla Murphy Martin, R., Johnston, K., & Sadowsky, C. (2012). Neuromuscular electrical stimulation–assisted grasp training and restoration of function in the tetraplegic hand: A case series. The American Journal of Occupational Therapy, 66(4), 471-477. https://doi.org/10.5014/ajot.2012.003004 The Skinny The purpose of the study was to…
Read More
3 Different Ways to Incorporate Weighted Balls into Hand Therapy Treatment Sessions:
By: Kelsey Melton 3 Different Ways to Incorporate Weighted Balls into Treatment Sessions: Weighted balls can be incorporated into hand therapy treatment sessions in various ways. This is a great therapeutic intervention for many limitations and is simple to grade up or down based on patient needs. Here are some exercise ideas to get you…
Read More
Sign-up to Get Updates Straight to Your Inbox!
Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.
Trigger finger is easy to fix with surgery release. I’ve had it done. Piece of cake.
Have seen a pt lose a finger due to a freak release surgery accident. Have seen the scar tissue left behind following a surgical release replicate a trigger digit. Have seen conservative management effectively treat a trigger digit.
Even simple surgeries carry risks for pts, especially if there are preexisting conditions like diabetes or Raynaud’s. So maybe it is best to explore all aspects of treatment before throwing out a blanket statement, right?
why go to surgery before all conservative measures? Before surgery I would certainly consider CSI, which most times resolve the situation. another thing, is inflammation in the body due yo metabolic issues also need to be considered
What are some suggestions for pediatric trigger finger in the thumb?