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
Carpal Tunnel Treatment: Splinting Only vs Splinting & Conservative Treatment
Short-term clinical outcome of orthosis alone vs combination of orthosis, nerve, and tendon gliding exercises and ultrasound therapy for treatment of carpal tunnel syndrome. Sim, Sze En et al. Journal of Hand Therapy, Volume 32, Issue 4, 411 – 416 The Skinny- Carpal tunnel syndrome (CTS) is the most common compression neuropathy. Compression of the…
Read More
Article Review: Trapeziectomy and LRTI: What can patients with CMC osteoarthritis expect 12 months after the procedure?
Janakiramanan, N., Miles, O., Collon, S., Crammond, B., McCombe, D., & Tham, S. K. (2021). Functional Recovery Following Trapeziectomy and Ligament Reconstruction and Tendon Interposition (Trapeziectomy and LRTI): A Prospective Longitudinal Study. The Journal of hand surgery, S0363-5023(21)00304-X. Advance online publication. https://doi.org/10.1016/j.jhsa.2021.04.036 The skinny: Patients with trapeziometacarpal (TMC) osteoarthritis who are candidates for a trapeziectomy and…
Read More
Hand Therapy Interventions for Distal Upper Extremity Injuries and Conditions
Takata, S.C., Wade, E.T., & Roll, S.C. (2019). Hand therapy interventions, outcomes, and diagnoses evaluated over the last 10 years: A mapping review linking research to practice. Journal of Hand Therapy, 32(1), 1–9. Written by Brittany Carrie The Skinny Approximately 26.9% of orthopedic injuries and disorders of the upper extremity occur worldwide. Injuries are most…
Read More
Conservative Therapy for OA in the Fingers: A Literature Review
Beasley, J., Ward, L., Knipper-Fisher, K., Hughes, K., Lunsford, D., & Leiras, C. (2018). Conservative therapeutic interventions for osteoarthritic finger joints: A systematic review. Journal of Hand Therapy, 32. 153-164. The Skinny – The article reviews the evidence on the effectiveness of conservative treatment for those who experience osteoarthritis in fingers and in their finger…
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?