Stenosing Tenosynovitis, Trigger Digit, Trigger Finger
Conditions
Keywords
treatment outcome, hand therapy, physical therapy, occupational therapy
Brief summary
Trigger finger is a common disorder of the hand which causes pain at the A1 pulley, inflammation, stiffness and/or snapping during movement. This observational study compared all of the possible treatments and combinations of treatments for trigger finger at the A1 pulley, including surgery, cortisone injections and hand therapy.
Detailed description
Trigger finger is a common disorder of the hand which causes pain at the A1 pulley, inflammation, stiffness or snapping during movement. This can be very debilitating. Current treatment includes local steroid injection, oral NSAIDS, resting orthoses, physical or occupational therapy and surgical intervention. The aim of this prospective study with an observational design was to determine the outcome between surgical, hand therapy rehabilitation, and corticosteroid injection interventions for trigger finger. There were 6 treatment groups: surgery, corticosteroid injection, 1 visit of hand therapy for orthosis fabrication and therapeutic exercise, hand therapy in combination with cortisone injection, Modality hand therapy alone (ongoing visits) or with corticosteroid injections.
Interventions
PROCEDUREsurgery
A1 pulley release of finger
PROCEDUREcorticosteroid injections
corticosteroid injection to A1 pulley
OTHERHand Therapy
orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education,
OTHERModality Hand Therapy
orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, plus modalities such as ultrasound, iontophoresis
Sponsors
University of Massachusetts, Worcester
University of Massachusetts, Lowell
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* trigger finger in digit 2-5
Exclusion criteria
* if prior treatment for trigger finger, or Trigger thumb
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain on a likert scale 6 months | 1 day, 6 months | Baseline to 6 months pain on a 0-10 scale |
| Change in Functional use using Quick DASH 6 weeks | Day 1, 6 weeks | Change from baseline to 6 weeks Quick DASH |
| Change in Functional use using Quick DASH 3 months | Day 1, 3 months | Change from baseline to 3 months Quick DASH |
| Change in Functional use using Quick DASH 6 months | Day 1, 6 months | Change from baseline to 6 months Quick DASH |
| Change in Edema 6 weeks | day 1, 6 weeks | Baseline to 6 weeks Circumferential measurement in centimeters of the proximal phalanx |
| Change in Edema 3 months | day 1, 3 months | Baseline to 3 months weeks Circumferential measurement in centimeters of the proximal phalanx |
| Change in Edema 6 months | day 1, 6 months | Baseline to 6 months weeks Circumferential measurement in centimeters of the proximal phalanx |
| Change in Pain on a likert scale 6 weeks | 1 day, 6 weeks | Baseline to 6 weeks pain on a 0-10 scale |
| Change in Pain on a likert scale 3 months | 1 day, 3 months | Baseline to 3 months pain on a 0-10 scale |
| Change in Range of motion 6 weeks | 1 day, 6 weeks | Baseline to 6 weeks flexion and extension range of motion at metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) using a finger goniometer. |
| Change in Range of motion 3 months | 1 day, 3 months | Baseline to 3 months flexion and extension range of motion at metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) using a finger goniometer. |
| Change in Range of motion 6 months | 1 day, 6 months | Baseline to 6 months flexion and extension range of motion at metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) using a finger goniometer. |
| Change in Severity or Grade of triggering 6 weeks | 1 day, 6 weeks | Baseline to 6 weeks Using the scale by Patel and Bassini to measure the amount of triggering 1=normal joint, 6=locked in flexion |
| Change in Severity or Grade of triggering 3 months | 1 day, 3 months | Baseline to 3 months Using the scale by Patel and Bassini to measure the amount of triggering 1=normal joint, 6=locked in flexion |
| Change in Severity or Grade of triggering 6 months | 1 day, 6 months | Baseline to 6 months Using the scale by Patel and Bassini to measure the amount of triggering 1=normal joint, 6=locked in flexion |
Outcome results
None listed