The effects of adding splint use to corticosteroid injection for the treatment of trigger finger: A randomized controlled trial

Musculoskeletal Care. 2022 Dec;20(4):908-916. doi: 10.1002/msc.1647. Epub 2022 May 18.

Abstract

Background: Trigger finger is the most common flexor tendinopathy affecting the general population. We evaluated the effects of adding a static metacarpophalangeal joint splint to corticosteroid injection for the management of trigger finger in the short term.

Methods: We carried out a randomized controlled trial with two parallel arms in Department of Physical Medicine and Rehabilitation at a university hospital. We randomly allocated 60 participants (34 women) with trigger fingers other than the thumb to two groups (both n = 30). The mean (SD) age was 41.5 (7.6) years. All participants received a single injection of 40 mg methylprednisolone plus 0.5 ml of lidocaine at the A1 pulley. Patients in the splint group wore a full time static splint for blocking the metacarpophalangeal joint for 3 months. The primary outcome was the Numerical Pain Rating Scale and the secondary outcomes were Boston questionnaire scores for symptom severity and functional status, grip strength, and the stages of stenosing tenosynovitis. We measured the outcomes at baseline, and in 1 and 3 months post-intervention.

Results: Both interventions were effective; however, the splint group showed more reductions in pain (p = 0.013) and symptom severity (p = 0.047) and a larger decrease in the stages of tenosynovitis (p = 0.004) after 3 months. There was no significant difference in decreasing functional scores between the groups (p = 0.162). The splint group had a better (but not statistically significant) restoring grip strength (p = 0.056).

Conclusion: Wearing of a static metacarpophalangeal joint splint for 3 months following a single injection of corticosteroid increases and stabilises the benefits of the treatment for trigger finger.

Keywords: corticosteroid; metacarpophalangeal; orthotic; pain; splint; trigger finger.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adrenal Cortex Hormones* / therapeutic use
  • Adult
  • Female
  • Humans
  • Trigger Finger Disorder* / drug therapy

Substances

  • Adrenal Cortex Hormones