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J Hand Surg Eur Vol. 2017 Jun;42(5):473-480. doi: 10.1177/1753193416682917. Epub 2016 Dec 21.

Evidence-based management of adult trigger digits.

Author information

1
1 Trauma and Orthopaedics, Bristol Royal Infirmary, Bristol, UK.
2
2 Upper Limb Unit, Wrightington Hospital, Wigan, UK.
3
3 Plastics and Reconstructive Surgery, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UK.
4
4 Trauma and Orthopaedics, Queen's Medical Centre, Nottingham, UK.
5
5 Hand Unit, Queen's Medical Centre, Nottingham, UK.

Abstract

The aim of this systematic review was to develop an evidence-based guideline to assist clinicians in the treatment of adult trigger digits. There is moderate evidence to suggest that local corticosteroid injection is a safe and effective short-term treatment and it may, therefore, be recommended as an initial treatment for this condition. However, when compared with surgery, there is strong evidence that corticosteroid injection is associated with increased rates of ongoing or recurrent symptoms at 6 months after intervention. There is strong evidence suggesting that trigger digit can be managed safely by surgical release. There is weak evidence to support the use of splinting or other non-operative modalities. Hence a single corticosteroid injection may be offered as the first line in treatment of adult trigger digits, but percutaneous release is a safe alternative. Surgery should be the next line if the injection fails, symptoms recur or the patient chooses.

LEVEL OF EVIDENCE:

I.

KEYWORDS:

Trigger finger; injection; open surgery; percutaneous release; treatment; trigger thumb

PMID:
28488453
DOI:
10.1177/1753193416682917
[Indexed for MEDLINE]

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