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
Volkmann’s Contracture
Written by Melissa Miller Introduction Volkmann’s contracture is a rare condition that occurs after injury to the elbow and upper arm, typically from a crush injury. This condition can occur when acute compartment syndrome is left untreated. If unrecognized, Volkmann’s contracture can lead to a permanent deformity in the hand and forearm. Hand therapists are…
Read More
What to Know as a Hand Therapist When Choosing Thermoplastic Orthosis Material
By: Kelsey Melton Thermoplastic materials can have a variety of properties. Each supplier has a different version of each combination of variables for the therapist to choose from. The most common brands used for orthosis fabrication are Orfit, NorthCoast Medical (NCM), and Raylan. These brands all have their versions of thermoplastic material that vary in…
Read More
Sesamoid Bones: What are they and what do they do?
By Brittany Carrie A Student’s Perspective During the first few weeks of my rotation, I was exposed to many new and exciting things that I had not been exposed to in the classroom setting. I observed and helped treat patients who had undergone severe trauma from lacerating tendons to complete amputations, saw different splinting techniques,…
Read More
Management of a TFCC Injury in Hand Therapy
By: Taylor Volentine The wrist is composed of very complex joints that assists with movement in individuals of all ages and abilities. For instance, an active individual who participates in sports such as tennis, football, or gymnastics may increase the probability for wrist complications and injury (Morrison, 2019). Individuals with repetitive trauma from work or…
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?