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Trigger Finger

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1. Does exercise or splinting in the treatment of trigger finger reduce pain, improve range of movement, grip strength, function and return to work when compared with usual care?

Does exercise or splinting in the treatment of trigger finger reduce pain, improve range of movement, grip strength, function and return to work when compared with usual care? Recently Reviewed and Updated CAT June 2018 Previous CAT Lead: Carol Graham Updated CAT Lead: Carol Graham Date CAT to be reviewed: 2021 Date CAT completed: June 2018 email of CAT Lead: carol.graham@mpft.nhs.uk 1 1 Short Question: Specific Question: Does exercise or splinting in the treatment of trigger finger reduce pain (...) , improve range of movement, grip strength, function and return to work when compared with usual care? Clinical bottom line There is a lack of quality evidence for exercise and splinting in the management of adult trigger finger. However, in the absence of evidence of harm or effectivess of these interventions, they maybe an option for those individuals who wish to avoid invasive procedures. Why is this important? Adults (18+) are referred to therapy departments for exercise and splinting to manage

2018 Public Health England

3. Percutaneous A1 Pulley Release Combined with Finger Splint for Trigger Finger with Proximal Interphalangeal Joint Flexion Contracture. (Abstract)

Percutaneous A1 Pulley Release Combined with Finger Splint for Trigger Finger with Proximal Interphalangeal Joint Flexion Contracture. Background: Long-standing trigger finger can lead to proximal interphalangeal (PIP) joint flexion contracture. In the present study, we present the clinical outcome of percutaneous release with finger splinting for trigger finger with PIP joint flexion contracture prospectively. Methods: We compared outcomes in patients with trigger fingers combined (...) with proximal interphalangeal joint flexion contracture treated by percutaneous release therapy regimen alone (group I) or percutaneous trigger finger release combined with finger splint (group II) during January 2011 and May 2016 with 6 months follow up. Results: Sixty-five patients were randomly allocated to group I (35 patients) or group II (30 patients). Symptoms of locking sensation and pain over the A1 pulley were improved in all patients. The patients in group II showed significantly greater

2019 The journal of hand surgery Asian-Pacific volume Controlled trial quality: uncertain

4. In adults with trigger thumb/finger does splinting improve outcomes for pain and function compared to usual care?

In adults with trigger thumb/finger does splinting improve outcomes for pain and function compared to usual care? Getting Evidence into Clinical Practice: Musculoskeletal Research Facilitation Group (CAT Group) Date: Sept 2016 CAT Lead: Suzanne Sharp Date CAT completed: September 2016 Email: Suzanne.sharp@sath.nhs.uk Review Date: 2018-2020 Specific Question: In adults with trigger thumb/finger does splinting improve outcomes for pain and function compared to usual care? Clinical bottom line (...) Currently there is no evidence to answer this question. It would be reasonable to continue the use of splinting as a therapeutic treatment option for adults with trigger finger/thumb in the absence of evidence to the contrary. There is however a need for clinical audit and research in order to provide further evidence. Why is this important? Splintage for the management of trigger finger and thumb is a relatively new concept in hand therapy and from a clinicians’ perspective it can be beneficial

2017 Public Health England

5. Different Dosages of Triamcinolone Acetonide Injection for the Treatment of Trigger Finger and Thumb: A Randomized Controlled Trial. (Abstract)

Different Dosages of Triamcinolone Acetonide Injection for the Treatment of Trigger Finger and Thumb: A Randomized Controlled Trial. This study was designed to compare the efficacy and complications between 3 different dosages of triamcinolone acetonide for the treatment of trigger finger.Ninety-three patients with a total of 120 trigger digits were included in the study. The involved digits were randomized to 3 groups. Each group received treatment consisting of injection with 5, 10 or 20 mg (...) significant higher success rate when compare to 5 mg at 3 months. There were no differences of success rate between groups at 9 and 12 months. At 12 months, 7 of 40 digits (17.5%) in the 5 mg group, 7 of 40 digits (17.5%) in the 10 mg group, and 9 of 40 digit (22.5%) in the 20 mg group were without triggering (p = 0.806).A dose-response characteristic was demonstrated in the treatment of trigger finger with triamcinolone acetonide. Triamcinolone acetonide 5 mg seems to have the lowest success rate.

2018 The journal of hand surgery Asian-Pacific volume Controlled trial quality: uncertain

6. The 'triad' - carpal tunnel syndrome, trigger Finger and Dupuytren's contracture

The 'triad' - carpal tunnel syndrome, trigger Finger and Dupuytren's contracture The 'triad' - CTS, Trigger Finger and Dupuytren's contracture | Carpal-Tunnel.net The 'triad' - CTS, Trigger Finger and Dupuytren's contracture This group of three conditions are often seen together in the same patient, either at the same time or one after the other, they are: Trigger digit (Stenosing Tenosynovitis) – in this disorder thickening and irregularity of the tendons which connect the forearm muscle (...) to the fingers causes them to get stuck in the pulleys which hold the tendons against the bones at each joint. This can cause pain and locking of the fingers in a flexed position. When they are forcibly straightened with the other hand they ‘click’ straight again – hence the name ‘trigger’ digit. Dupuytren’s Contracture – this condition is caused by thickening of fibrous tissue in the palm called the palmar fascia. As it thickens it contracts and this too can cause the fingers to be pulled into a flexed

2014 Carpal-Tunnel.net

7. [Ultrasound-guided needle-knife for trigger finger]. (Abstract)

[Ultrasound-guided needle-knife for trigger finger]. To explore the efficacy of ultrasound-guided needle-knife with precise three-dimensional stereotactic localization of ashi points for stenosing tenosynovitis of flexor tendon (trigger finger).A total of 74 patients were randomly divided into an observation group and a control group, 37 cases in each group. The patients in the observation group were treated with ultrasound-guided intrathecal injection and releasing method of needle-knife (...) , while the patients in the control group were treated with ultrasound-guided intrathecal injection. The self-made 9-score scale of trigger finger was recorded before treatment, immediately after treatment, 1 month and 3 months after treatment; the curative effect of the two groups was evaluated.The results of self-made 9-score scale in the observation group immediately after treatment, 1 month and 3 months after treatment were lower than that before treatment (all P<0.01); the scores

2019 Zhongguo zhen jiu = Chinese acupuncture & moxibustion Controlled trial quality: uncertain

8. A randomized comparison of ultrasound-guided versus landmark-based corticosteroid injection for trigger finger. (Abstract)

A randomized comparison of ultrasound-guided versus landmark-based corticosteroid injection for trigger finger. One hundred and four patients who had been diagnosed with trigger finger and were to be treated by corticosteroid injection were randomized into two groups; one for landmark-based injection and the other for ultrasound-guided injection. The response to treatment, including objective triggering, the visual analogue scale score for pain and the Quick Disability of the Arm, Shoulder (...) , and Hand (QuickDASH) score were assessed at 12- and 24-weeks follow-up. No significant differences between the two groups were observed in pain or QuickDASH scores at 24 weeks of follow-up. The incidences of adverse events were similar between the two groups. Ultrasound-guided steroid injection provides no benefit in treating trigger finger. Level of evidence: II.

2019 Journal of Hand Surgery - European Controlled trial quality: uncertain

9. A randomized controlled trial of trigger finger release under digital anesthesia with (WALANT) and without adrenaline. Full Text available with Trip Pro

A randomized controlled trial of trigger finger release under digital anesthesia with (WALANT) and without adrenaline. Trigger finger release utilizing wide-awake local anesthesia no tourniquet (WALANT) usage in extremity surgery is not widely used in our setting due to the possibility of necrosis. Usage of a tourniquet is generally acceptable for providing surgical field hemostasis. We evaluate hemostasis score, surgical field visibility, onset and duration of anesthesia, pain score (...) , and the duration of surgery and potential side effects of WALANT.Eighty-six patients scheduled for trigger finger release between July 2016 and December 2017 were randomized into a control group (1% lignocaine and 8.4% sodium bicarbonate with arm tourniquet; given 10 min prior to procedure) and an intervention group (1% lignocaine, 1:100,000 of adrenaline and 8.4% sodium bicarbonate; given 30 min prior to procedure), with a total of 4 ml of solution injected around the A1 pulley. The onset of anesthesia

2019 Journal of orthopaedic surgery (Hong Kong) Controlled trial quality: uncertain

10. A prospective, randomized clinical trial of transverse versus longitudinal incisions for trigger finger release. (Abstract)

A prospective, randomized clinical trial of transverse versus longitudinal incisions for trigger finger release. We investigated whether incision type affects scar quality or outcome following trigger finger release. Our primary and secondary hypotheses were that transverse and longitudinal incision types yield similar scar quality and functional improvement. Digits undergoing trigger finger release at the participating hospitals were randomized to receive transverse or longitudinal incisions (...) . The Patient Scar Assessment Scale, Observer Scar Assessment Scale, and the Disabilities of the Arm, Shoulder and Hand score were collected at 8 and 54 weeks postoperatively. Of 86 randomized patients, 67 patients (71%) had followed-up at 54 weeks postoperatively. We found no significant differences in above three assessments between the incisions at either time-point. Among patients receiving both incision types for multiple simultaneous trigger finger release, there were no significant differences

2019 Journal of Hand Surgery - European Controlled trial quality: uncertain

11. The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger. (Abstract)

The Feasibility and Usability of a Ranking Tool to Elicit Patient Preferences for the Treatment of Trigger Finger. Shared decision making is an approach where physicians and patients collaborate to make decisions based on patient values. This requires eliciting patients' preferences for each treatment attribute before making decisions; a structured process for preference elicitation does not exist in hand surgery. We tested the feasibility and usability of a ranking tool to elicit patient (...) preferences for the treatment of trigger finger. We hypothesized that the tool would be usable and feasible at the point of care.Thirty patients with a trigger finger without prior treatment were recruited from a hand surgery clinic. A preference elicitation tool was created that presented 3 treatment options (surgical release, injection, and therapy and orthosis) and described attributes of each treatment extracted from literature review (eg, success rate, complications). We presented these attributes

2019 Journal of Hand Surgery - American

12. Trigger finger secondary to a neglected flexor tendon rupture. Full Text available with Trip Pro

Trigger finger secondary to a neglected flexor tendon rupture. Secondary trigger finger caused by trauma to the hand, especially associated with partial flexor tendon rupture, is not a common condition. Thus, the clinical manifestations of these patients are not well-known. The aim of this study is to present secondary trigger finger caused by a neglected partial flexor tendon rupture including discussion of the mechanism and treatment.We retrospectively reviewed the records of 6 patients (...) with trigger finger caused by a neglected partial flexor tendon rupture who had been treated with exploration, debridement, and repairing of the ruptured tendon from August 2010 to May 2015. The average patient age was 41 years (range, 23-59). The time from injury to treatment averaged 4.7 months. The average follow-up period was 9 months (range, 4-18). Functional outcome was evaluated from a comparison between the Quick-disabilities of the arm, shoulder, and hand (DASH) score and the visual analogue scale

2019 Medicine

13. Effects of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger: a randomized controlled trial study. Full Text available with Trip Pro

Effects of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger: a randomized controlled trial study. [Purpose] The purpose of this study was to determine the effect of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger. [Participants and Methods] A randomized controlled trial was conducted. Fifty eight patients having trigger finger were randomly assigned as either an experimental group that received (...) in comparison to the control group. [Conclusion] This study results suggest that a single session of Dry Needling (DN) was effective in decreasing pain, DASH score, pulley-tendon thickness and improving pinch grip power in patients with trigger finger.

2019 Journal of physical therapy science Controlled trial quality: uncertain

14. Does Bowstringing Affect Hand Function in Patients Treated With A1 Pulley Release for Trigger Fingers?: Comparison Between Percutaneous Versus Open Technique. (Abstract)

Does Bowstringing Affect Hand Function in Patients Treated With A1 Pulley Release for Trigger Fingers?: Comparison Between Percutaneous Versus Open Technique. We aimed to inspect bowstringing after percutaneous and open release of the A1 pulley for trigger digits and its influence on hand function. Sixty-two patients with a resistant trigger digit were randomized to undergo either open release or percutaneous release of the A1 pulley. We quantified bowstringing of the digit using (...) without showing significant difference between the 2 groups. The clinical outcomes of each cohort improved significantly, with no difference between the groups at final follow-up. No association was found between bowstringing and any clinical outcome measure. Bowstringing occurred by A1 pulley release with either the percutaneous or open technique does not affect clinical hand function in patients with trigger fingers.

2018 Annals of plastic surgery Controlled trial quality: uncertain

15. Intra-sheath versus extra-sheath ultrasound guided corticosteroid injection for trigger finger: a triple blinded randomized clinical trial. (Abstract)

Intra-sheath versus extra-sheath ultrasound guided corticosteroid injection for trigger finger: a triple blinded randomized clinical trial. The aim of this study is to compare clinical results of ultrasound-guided corticosteroid injection, intra-sheath versus extra-sheath of the finger flexor tendon.A total of 166 patients with trigger finger were evaluated in a triple blind randomized clinical trial study. All the patients were injected with 1ml of 40mg/ml methyl prednisolone acetate, under (...) or extra-sheath of the finger flexor tendon under ultrasound guidance in patients with trigger finger are comparably alike. Extra-sheath injection at the level of A1 pulley is as effective as an Intra-sheath administration.

2018 The Physician and sportsmedicine Controlled trial quality: uncertain

16. The Effect of Trigger Finger Injection Site on Injection-Related Pain. Full Text available with Trip Pro

The Effect of Trigger Finger Injection Site on Injection-Related Pain. Stenosing tenosynovitis, or trigger digit, is a common condition for which patients often seek relief. Corticosteroid injections have been shown to provide relief in many cases, and several different approaches for delivering the injection have been described in the literature. We compared patients' perception of pain following each of 3 accepted injection methods, namely, palmar proximal, palmar distal, and webspace (...) approaches.We prospectively followed 38 patients with 39 symptomatic digits in this trial, with varying severities of trigger finger as graded by the Patel and Moradia classification. The patients were divided into 3 groups representing the 3 approaches without randomization, based upon the treating surgeons' preference. Disabilities of the Arm, Shoulder and Hand and visual analog scale (VAS) pain scores were calculated pre-injection and at 4-week and 8-week follow-up visits.No statistically significant

2018 Hand (New York, N.Y.)

17. Effects of simultaneous steroid injection after percutaneous trigger finger release: a randomized controlled trial. (Abstract)

Effects of simultaneous steroid injection after percutaneous trigger finger release: a randomized controlled trial. The purpose of this study was to test the hypothesis that an improved outcome can be achieved by employing simultaneous steroid injection after percutaneous A1 pulley release. One hundred and twelve digits were randomized to either percutaneous A1 pulley release alone or release of the A1 pulley with a steroid injection. The visual analogue scale score for pain, modified patient (...) and improves subjective outcomes during the early postoperative period after percutaneous trigger finger release. Level of evidence: I.

2018 Journal of Hand Surgery - European Controlled trial quality: uncertain

18. Promyelocytic leukemia zinc finger triggers ATP-binding cassette subfamily E member 1-mediated growth inhibition in breast cancer cells Full Text available with Trip Pro

Promyelocytic leukemia zinc finger triggers ATP-binding cassette subfamily E member 1-mediated growth inhibition in breast cancer cells The promyelocytic leukemia zinc finger (PLZF) protein is a transcription factor that is involved in a number of biological processes, including those regulating cellular growth; however, little is known regarding how it achieves its inhibitory effect in different cell and tissue types. It has previously been demonstrated that PLZF expression levels become

2018 Oncology letters

19. Acute Trigger Finger Presenting as an Extensor Lag Full Text available with Trip Pro

Acute Trigger Finger Presenting as an Extensor Lag 29375732 2019 02 26 1937-5719 18 2018 Eplasty Eplasty Acute Trigger Finger Presenting as an Extensor Lag. ic1 Ali Stephen R SR Department of Plastic, Reconstructive and Burns Surgery, North Bristol NHS Trust, Bristol, United Kingdom. Mohamedbahi Hussein H Department of Plastic, Reconstructive and Burns Surgery, North Bristol NHS Trust, Bristol, United Kingdom. eng Case Reports 2018 01 05 United States Eplasty 101316107 1937-5719 extensor lag (...) management stenosing tenosynovitis steroid injection trigger finger 2018 1 30 6 0 2018 1 30 6 0 2018 1 30 6 1 epublish 29375732 PMC5765627 J Hand Surg Am. 1977 Mar;2(2):149-51 845423 J Bone Joint Surg Br. 1948 Aug;30B(3):528-30 18877990 Eplasty. 2014 Sep 01;14:ic31 25328576 J Bone Joint Surg Am. 1973 Jun;55(4):753-7 4283748 J Hand Surg Am. 2006 Jan;31(1):135-46 16443118 J Hand Surg Am. 1994 Jul;19(4):590-4 7963312

2018 Eplasty

20. A medical imaging analysis system for trigger finger using an adaptive texture-based active shape model (ATASM) in ultrasound images. Full Text available with Trip Pro

A medical imaging analysis system for trigger finger using an adaptive texture-based active shape model (ATASM) in ultrasound images. Trigger finger has become a prevalent disease that greatly affects occupational activity and daily life. Ultrasound imaging is commonly used for the clinical diagnosis of trigger finger severity. Due to image property variations, traditional methods cannot effectively segment the finger joint's tendon structure. In this study, an adaptive texture-based active

2017 PLoS ONE

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