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
Occupation Based Interventions in Hand Therapy
Keeping Occupation Based Interventions in Hand Therapy By: Tristany Hightower Are your treatments occupation based? Do you tailor your activity choices to fit the needs of each patient? As occupational therapists, we should be specialists in creating goals and interventions that are directed at returning our patients to meaningful occupations. Too often, hand therapy can…
Does mirror therapy work for hand therapy patients with general orthopedic conditions?
By: Maddie Mott Rostami, R. H., Arefi, A., & Tabatabaei, S. (2013). Effect of mirror therapy on hand function in patients with hand orthopaedic injuries: a randomized controlled trial. Disability and Rehabilitation, 35(19). 1647-1651. DOI: 10.3109/09638288.2012.751132 The Skinny: How does mirror therapy work? Mirror therapy (MT) is performed by placing the patient’s injured extremity into…
The function of the Glenohumeral Joint Ligaments
Glenohumeral Joint Ligaments The Glenohumeral (GH) joint is composed of the head of the humerus and the glenoid fossa. The fossa is relatively small compared to the humeral head, making the joint highly mobile, which also leads to an increased risk of instability. The glenoid labrum is a fibrocartilagenous rim attached around the…
A Fun Fact from a Hand Therapy Student
By: Ammie Ingwaldson Level 2 Fieldwork at a hand therapy clinic is a fast paced and continuous learning experience. The perfect example of this occurred last week while observing a therapist provide a client with their home CMC arthritis program. The therapist was educating the client on how to oppose their thumb to their small…
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?