Comparing IP and MCP joint splinting for Trigger Finger

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

MCP joint splint

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

  1. Christine Callaway on August 9, 2021 at 5:25 am

    Trigger finger is easy to fix with surgery release. I’ve had it done. Piece of cake.

    • Derek on August 9, 2021 at 8:13 am

      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?

    • npatel on August 9, 2021 at 10:13 am

      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

  2. Liana on August 9, 2021 at 12:02 pm

    What are some suggestions for pediatric trigger finger in the thumb?

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