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
New Distal Bicep Tendinopathy Provocative Test for Hand Therapist
Caekebeke, P., Schenkels, E., Bell, S. N., & van Riet, R. (2021). Distal biceps provocation test. The Journal of Hand Surgery. The Skinny: These surgeons were looking for a provocative test for distal bicep tendinopathy (distal biceps tendonitis test), specifically partial tears, that was more sensitive and specific. Complete tears are more easily tested in…
Read More
INTEROSSEOUS MUSCLE TIGHTNESS TESTING
May 2012 No. 19 INTEROSSEOUS MUSCLE TIGHTNESS TESTING Judy Colditz, OT/L, CHT, FAOTA INTEROSSEOUS MUSCLE TIGHTNESS TESTING – ARE YOU DOING IT CORRECTLY? The common term “Intrinsic Tightness Testing” is a misnomer as it describes a maneuver specifically designed to test tightness of the interosseous muscles. The interosseous muscles are small, short-fibered muscles contained within…
Read More
A Fun Fact from a Hand Therapy Student
By: Ammie Ingwaldson Level 2 Fieldwork at a hand therapy clinic is a fast paced and continuous learning experience. The perfect example of this occurred last week while observing a therapist provide a client with their home CMC arthritis program. The therapist was educating the client on how to oppose their thumb to their small…
Read More
Prevention and Management of Upper Extremity injuries in Modern Mass Production
Injuries and Upper Extremty Pitts, G., Custer, M., Foister, R. D., & Uhl, T. (2021). The hand therapist’s role in the preventionand management of upper extremity injuries in the modern mass production industrial setting.Journal of Hand Therapy, 34(2), 237–249. https://doi.org/10.1016/j.jht.2021.04.019 By: Kaylen Kallander The Skinny: This study included four case studies to determine the impact…
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?