Orthotic intervention options to non-surgically manage adult and pediatric trigger finger: A systematic review

Leong L 1 , Chai SC 2 , Howell JW 3 , Hirth MJ 4

Affiliations 

  • 1 Occupational Therapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Occupational Therapy Unit, Hospital Sultan Haji Ahmad Shah, Pahang, Malaysia
  • 2 Occupational Therapy Programme, Centre for Rehabilitation and Special Needs Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. Electronic address: sc.chai@ukm.edu.my
  • 3 Self-employed Hand Therapy Consultant, Saint Joseph, MI, United States
  • 4 Occupational Therapy Department, Austin Health, Victoria, Australia; Malvern Hand Therapy, Malvern, Victoria, Australia
J Hand Ther, 2023;36(2):302-315.
PMID: 37391318 DOI: 10.1016/j.jht.2023.05.016

Abstract

BACKGROUND: The design and efficacy of orthotic intervention to non-surgically manage adult and pediatric trigger finger vary widely.

PURPOSE: To identify types of orthoses (including relative motion), effectiveness, and outcome measurements used to non-surgically manage adult and pediatric trigger finger.

STUDY DESIGN: Systematic review.

METHODS: The study was undertaken according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement and registered with the International Prospective Register of Systematic Reviews Registry, number CRD42022322515. Two independent authors electronically and manually searched, and screened 4 databases; selected articles following pre-set eligibility criteria; assessed the quality of the evidence using the Structured Effectiveness for Quality Evaluation of Study; and extracted the data.

RESULTS: Of the 11 articles included, 2 involved pediatric trigger finger and 9 adult trigger finger. Orthoses for pediatric trigger finger positioned finger(s), hand, and/or wrist of children in neutral extension. In adults, a single joint was immobilized by the orthosis, blocking either the metacarpophalangeal joint or the proximal or distal interphalangeal joint. All studies reported positive results with statistically significant improvements and medium to large effect size to almost every outcome measure, including the Number of Triggering Events in Ten Active Fist 1.37, Frequency of Triggering from 2.07 to 2.54, Quick Disabilities of the Arm, Shoulder and Hand Outcome Measure from 0.46 to 1.88, Visual Analogue Pain Scale from 0.92 to 2.00, and Numeric Rating Pain Scale from 0.49 to 1.31. Severity tools and patient-rated outcome measures were used with the validity and reliability of some unknown.

CONCLUSIONS: Orthoses are effective for non-surgical management of pediatric and adult trigger finger using various orthotic options. Although used in practice, evidence for the use of relative motion orthosis is absent. High-quality studies based on sound research questions and design using reliable and valid outcome measures are needed.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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