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
Common Median Nerve Injuries
Common Median Nerve Injuries By: Madison Mott Did you know!? Aside from the most common upper extremity nerve compression, carpal tunnel syndrome (CTS), there are several additional median nerve injuries. Pronator SyndromeCompression of the median nerve between the two heads of pronator teres. Result of recurrent, forceful gripping, forearm rotation, or elbow flexion. Signs include…
Scapholunate Wrist Injuries in Hand Therapy
Scapholunate Wrist Injuries in Hand Therapy In outpatient hand therapy, we get a variety of referrals ranging from post-operative patients to those looking to avoid or prolong surgery. These referrals come from a variety of sources ranging from primary care doctors to experienced hand surgeons. The therapy orders can be vague to very specific. …
Differentiating Proximal Median Nerve Entrapment from Carpal Tunnel Syndrome
By: Brittany Day Proximal Median Nerve Entrapment, Pronator Syndrome, or Lacertus Syndrome? Pronator syndrome is a term used to describe proximal median nerve entrapment (PMNE) in the forearm. Pronator syndrome and lacertus syndrome are sometimes used interchangeably to describe proximal median nerve entrapment distal to the ligament of Struthers and proximal to the flexor superficialis…
Vagus Nerve Stimulation (VNS) for Various Etiologies
What is it: Vagus nerve stimulation (VNS) is a medical treatment that uses a device to deliver electrical impulses to the vagus nerve, which runs on both sides of the body from the lower brain through the neck to the chest and stomach. The left vagus nerve is typically used for this procedure, as simulating…
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?