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
Exploring Unique Hand Anatomy
Exploring Unique Hand Anatomy The human hand is a marvel of intricate design with a combination of fine motor capabilities and strength that enable us to perform fine motor tasks ranging from delicate surgery to more gross motor tasks such as carrying heavy loads. However, no two hands are exactly alike. Anatomical variations while they…
Read MoreA Review on the Conservative Management of Trigger Finger
Lunsford, D., Valdes, K., & Hengy, S. (2017). Conservative management of trigger finger: A systematic review. Journal of Hand Therapy, 32(2), 212-221. https://doi.org/10.1016/j.jht.2017.10.016 The Skinny The main purpose of the literature review was to determine the efficacy of conservative management of trigger finger (TF) through the use of an orthosis in addition to therapy. The review…
Read More
Why Burnout Happens in Hand Therapy and What We Can Do About It.
Why Burnout Happens in Hand Therapy There are several reasons why burnout can occur, this is especially true for healthcare workers. What We Can Do About It Final Thought:Burnout isn’t a personal failure, it is often a systemic issue. But we do have power over how we respond. As hand therapists, we are experts at…
Read More
Thumbs up for treating thumb pain in the hand therapy clinic
What do “Mommy’s thumb,” “gamer’s thumb,” and “radial styloid tenosynovitis” have in common? They are all officially called de Quervain’s tenosynovitis De Quervain’s involves the tendons within the first dorsal compartment, abductor pollicis longus (APL) and extensor pollicis brevis (EPB) and arises when the tendons are inflamed and are not able to move through the…
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?