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
Wrist Proprioception Ideas for Hand Therapy
Wrist Proprioception Intervention Ideas: By Ammie Ingwaldson Lack of wrist proprioception exercises can affect clients in the hand therapy setting with neurological and musculoskeletal conditions. Proprioception limitations are found in common conditions such as carpal tunnel syndrome, distal radius fracture, and CRPS (Valdes, Naughton & Algar, 2014). Proprioception is necessary during daily tasks to provide…
Read More
Sensory Kit for Hypersensitivity
Written by Melissa Miller Introduction After injury or surgery, nerves in the skin and surrounding the injured area can become overly sensitive. This can cause pain or an unpleasant sensation by stimuli that would not typically cause discomfort. For example, a light touch from a shirt or a certain material can feel like needles to…
Read More
Our Favorite Mallet Finger Splints
By: Josh MacDonald Fabricating a custom splint for a mallet finger injury is challenging. Fingers are tiny and they have small tolerances for errors and adjustments with custom splints. Making a splint for a mallet finger injury is probably the hardest type of finger splint for a therapist to make. Treatment recommendations vary, with some…
Read More
Arthrodesis vs Arthroplasty in Thumb CMC OA
Piacenza A, Vittonetto D, Rossello MI, Testa M. Arthrodesis Versus Arthroplasty in Thumb Carpometacarpal Osteoarthritis: Impact on Maximal Voluntary Force, Endurance, and Accuracy of Pinch. J Hand Surg Am. 2021 May 24:S0363-5023(21)00199-4. doi: 10.1016/j.jhsa.2021.03.023. Epub ahead of print. PMID: 34045112. The Skinny: This was a retrospective study based on a convenience sample of individuals who…
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?