Pataradool Kawee, Lertmahandpueti Chayanin
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Hand Ther. 2021 Sep;26(3):85-90. doi: 10.1177/17589983211018717. Epub 2021 May 22.
Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger.
This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at the dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis.
There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference -29.0 (95%CI -34.5 to -23.4); p < 0.001), SST (mean difference -1.4 (95%CI -1.8 to -1.0); p < 0.001) and VAS (mean difference -3.4 (95%CI -4.3 to -2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high.
Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.
扳机指是一种常见且会限制功能的病症。使用矫形器械固定手指是治疗该病症的保守治疗选择之一。先前描述的用于扳机指的最常见矫形器是掌指关节固定。描述近端指间关节矫形器治疗扳机指有效性的研究有限。
本研究采用单组前后测设计。招募患有单指特发性扳机指的成年患者，并要求他们全天佩戴矫形器6周。前后的结局指标包括快速DASH评分、狭窄性腱鞘炎分期（SST）、疼痛视觉模拟量表（VAS）、十个主动握拳中的扳机事件数量以及参与者对症状改善的满意度。矫形器械由热塑性材料制成，在背侧用可调节的尼龙搭扣带制作。所有参与者都收到了关于这种疾病、矫形器护理和滑动练习的书面资料。采用配对t检验来确定佩戴矫形器前后结局指标的变化。
本研究纳入了30名参与者。在使用近端指间关节矫形器6周后的评估显示，从入组时起，快速DASH评分（平均差异-29.0（95%置信区间-34.5至-23.4）；p<0.001）、SST（平均差异-1.4（95%置信区间-1.8至-1.0）；p<0.001）和VAS（平均差异-3.4（95%置信区间-4.3至-2.5）；p<0.001）有统计学上的显著改善。没有严重不良事件，患者对治疗的满意度很高。
尽管我们的研究规模较小，但使用近端指间关节矫形器6周在功能、疼痛和扳机症状方面有统计学上的显著改善，并且在孤立性特发性扳机指患者中的接受率也很高。
