Which is better: Splinting the MCP or PIP joint when managing Trigger Finger?

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 trigger finger orthosis treatment

trigger finger orthosis

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.   

Pain 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. 

10 Comments

  1. Elizabeth Carter on June 3, 2019 at 8:18 am

    This is great! Keep them coming!

  2. kate martin on June 3, 2019 at 4:26 pm

    really interesting- thanks

    • Josh MacDonald on June 5, 2019 at 6:20 am

      We’re glad you liked it. We will keep them coming.

  3. Nicole on June 3, 2019 at 7:46 pm

    Love this!!! Thank you.

    • Josh MacDonald on June 5, 2019 at 6:17 am

      Glad you liked it!

  4. Mesplie on June 6, 2019 at 10:33 pm

    Thanks for sharing !
    What about PIP range of motion ?

    • Miranda Materi on June 9, 2019 at 11:07 am

      Typically we instruct the patient with prom and to avoid active if it is causing the triggering to occur.

  5. Masha Pinsky on November 20, 2021 at 9:54 am

    Thanks for sharing!
    Important to know.

  6. Justine on January 24, 2023 at 1:47 pm

    This is great – curious if there was a time frame of symptoms present for inclusion criteria and or for splinting to be effective? ie if the patient had triggering for less than 3 months splinting was found to be effective; or were patients who had symptoms for longer than x-amount of weeks/months were not included, etc etc? I have always been under the impression if symptoms are too severe/present for more than 4 weeks cortisone injection is kind of the gold standard as splinting is less effective at that point? Thank you!

    • Miranda Materi on February 3, 2023 at 5:27 pm

      Yes, the longer the condition goes on the more difficult it is to treat. From personal experience, I have had patients resolve their symptoms for trigger fingers that have been going on for 6 months

Leave a Comment






More To Read

The Importance of Purposeful Activities Following Surgical Repair of a Distal RadiusFracture

September 23, 2023

By: Kelsey Melton Collis, J. M., Mayland, E. C., Wright-St Clair, V., Rashid, U., Kayes, N., & Signal, N.(2022). An evaluation of wrist and forearm movement during purposeful activities andrange of movement exercises after surgical repair of a distal radius fracture: A randomizedcrossover study. Journal of Hand Therapy. https://doi.org/10.1016/j.jht.2022.07.009 The Skinny: This randomized crossover study…

Read More

Graded Motor Imagery in Hand Therapy

January 5, 2020

The 3 Stages of Graded Motor Imagery  We’ve all heard of mirror box therapy, but do you know the details of how it works? There’s actually 3 stages involved that exercise the brain and take advantage of its plasticity.  There is a great deal of evidence supporting these three stages and you can use them…

Read More

7 Best Ways to Master Occupational Therapy Continuing Education Online

August 28, 2024

Introduction to Occupational Therapy Continuing Education What Is Occupational Therapy Continuing Education? Occupational therapy continuing education refers to post-licensure training that helps occupational therapists maintain their credentials and stay updated with new techniques, theories, and practices. It’s a vital part of professional development, ensuring therapists remain competent in a rapidly evolving healthcare environment. Why It…

Read More
Envelope_1

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.