Trigger finger treatment: a comparison of 2 splint designs.

PURPOSE

To compare the effectiveness of 2 splint designs in treating trigger finger.

METHODS

This prospective, randomized study of 30 subjects evaluated splinting efficacy for trigger finger, comparing 2 splint designs: a custom metacarpophalangeal (MCP) joint blocking splint and a distal interphalangeal (DIP) joint blocking splint. We evaluated range of motion, grip strength, severity and frequency of triggering, functional impact, and performance measure scores. Subjects recorded frequency of splint use, splint comfort, and functional impact of the splint. We undertook statistical analysis of splint effectiveness before and after treatment and of differences between the 2 splint groups. We evaluated qualitative data to identify trends in subjective preference toward splint design.

RESULTS

Both groups showed quick and significant improvement of triggering; however, the MCP joint blocking splint was successful in providing at least partial relief of triggering and pain in 10 of 13 trigger finger subjects, whereas the DIP joint blocking splint provided at least partial relief of triggering and pain in 7 of 15 subjects after 6 weeks of treatment. Data showed statistically significant improvement in both groups at 6 weeks, which was maintained in a minority of the cohort for 1 year. There was little difference between the 2 splint groups for impact on function. Subjects who wore the MCP joint blocking splint reported higher rates of comfort compared with those who wore the DIP joint blocking splint.

CONCLUSIONS

Subject comfort with the MCP joint blocking splint allowed for longer periods of usage. Selection of a splint design depends on clinical presentation, vocation, and leisure activities. Initiating conservative treatment with the MCP joint blocking splint has value for patients with trigger finger and positive outcomes in 77% of subjects, whereas use of the DIP joint splint was effective in about half of subjects.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.