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.
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 – these were MCP splint for trigger finger, MCP blocking splint and pip joint splint.
reduction was observed in both groups, but pain reduction was greater with PIP
joint splinting compared to the MCP joint splinting group. 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, most
likely due to improved comfort.
Bringing it Home- Findings suggests 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.
Rationale for rating. Small sample size. All patients with comorbidities were excluded limiting the generalizability of finding. 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 for 24 hours in order to reduce triggering symptoms followed by night-time splint wear for another 3-4 weeks.
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