Trigger Finger Treatment

Sponsor

University of Massachusetts, Lowell (Other)

Overall Status

Completed

CT.gov ID

NCT03847935

Collaborator

University of Massachusetts, Worcester (Other)

Enrollment

Actual Duration (Months)

Study Details

Study Description

Brief Summary

Trigger finger is a common disorder of the hand which causes pain at the A1 pulley, inflammation, stiffness and/or snapping during movement. This observational study compared all of the possible treatments and combinations of treatments for trigger finger at the A1 pulley, including surgery, cortisone injections and hand therapy.

Condition or Disease	Intervention/Treatment	Phase
Trigger Finger Trigger Digit Stenosing Tenosynovitis	Procedure: surgery Procedure: corticosteroid injections Other: Hand Therapy Other: Modality Hand Therapy

Detailed Description

Trigger finger is a common disorder of the hand which causes pain at the A1 pulley, inflammation, stiffness or snapping during movement. This can be very debilitating. Current treatment includes local steroid injection, oral NSAIDS, resting orthoses, physical or occupational therapy and surgical intervention. The aim of this prospective study with an observational design was to determine the outcome between surgical, hand therapy rehabilitation, and corticosteroid injection interventions for trigger finger. There were 6 treatment groups: surgery, corticosteroid injection, 1 visit of hand therapy for orthosis fabrication and therapeutic exercise, hand therapy in combination with cortisone injection, Modality hand therapy alone (ongoing visits) or with corticosteroid injections.

Study Design

Study Type:

Observational

Actual Enrollment :

86 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

Trigger Finger Treatment - An Outcomes Study. Comparing 6 Traditional Treatment Techniques

Actual Study Start Date :

Dec 10, 2007

Actual Primary Completion Date :

Dec 8, 2012

Actual Study Completion Date :

Dec 8, 2012

Arms and Interventions

Arm	Intervention/Treatment
Surgery Patients who underwent surgical release of A1 pulley	Procedure: surgery A1 pulley release of finger
corticosteroid injections only Patients who underwent local corticosteroid injections only, and no other treatment	Procedure: corticosteroid injections corticosteroid injection to A1 pulley
hand therapy only occupational/physical 1 visit: orthosis fabrication, range of motion, nodule and ice massage.	Other: Hand Therapy orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, Other Names: physical therapy occupational therapy
Injection and Hand therapy This group of participants received a combination of corticosteroid injection in the affected finger and one visit of hand therapy.	Procedure: corticosteroid injections corticosteroid injection to A1 pulley Other: Hand Therapy orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, Other Names: physical therapy occupational therapy
Modality Hand Therapy Ongoing hand therapy treatment, which included the above plus modalities such as ultrasound or iontophoresis.	Other: Modality Hand Therapy orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, plus modalities such as ultrasound, iontophoresis
Injection and Modality Hand Therapy Ccombination of local cortiscosteroid injection to the affected digit and ongoing hand therapy with modalities.	Procedure: corticosteroid injections corticosteroid injection to A1 pulley Other: Modality Hand Therapy orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, plus modalities such as ultrasound, iontophoresis

Outcome Measures

Primary Outcome Measures

Change in Functional use using Quick DASH 6 weeks [Day 1, 6 weeks]
Change from baseline to 6 weeks Quick DASH
Change in Functional use using Quick DASH 3 months [Day 1, 3 months]
Change from baseline to 3 months Quick DASH
Change in Functional use using Quick DASH 6 months [Day 1, 6 months]
Change from baseline to 6 months Quick DASH
Change in Edema 6 weeks [day 1, 6 weeks]
Baseline to 6 weeks Circumferential measurement in centimeters of the proximal phalanx
Change in Edema 3 months [day 1, 3 months]
Baseline to 3 months weeks Circumferential measurement in centimeters of the proximal phalanx
Change in Edema 6 months [day 1, 6 months]
Baseline to 6 months weeks Circumferential measurement in centimeters of the proximal phalanx
Change in Pain on a likert scale 6 weeks [1 day, 6 weeks]
Baseline to 6 weeks pain on a 0-10 scale
Change in Pain on a likert scale 3 months [1 day, 3 months]
Baseline to 3 months pain on a 0-10 scale
Change in Pain on a likert scale 6 months [1 day, 6 months]
Baseline to 6 months pain on a 0-10 scale
Change in Range of motion 6 weeks [1 day, 6 weeks]
Baseline to 6 weeks flexion and extension range of motion at metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) using a finger goniometer.
Change in Range of motion 3 months [1 day, 3 months]
Baseline to 3 months flexion and extension range of motion at metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) using a finger goniometer.
Change in Range of motion 6 months [1 day, 6 months]
Baseline to 6 months flexion and extension range of motion at metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) using a finger goniometer.
Change in Severity or Grade of triggering 6 weeks [1 day, 6 weeks]
Baseline to 6 weeks Using the scale by Patel and Bassini to measure the amount of triggering 1=normal joint, 6=locked in flexion
Change in Severity or Grade of triggering 3 months [1 day, 3 months]
Baseline to 3 months Using the scale by Patel and Bassini to measure the amount of triggering 1=normal joint, 6=locked in flexion
Change in Severity or Grade of triggering 6 months [1 day, 6 months]
Baseline to 6 months Using the scale by Patel and Bassini to measure the amount of triggering 1=normal joint, 6=locked in flexion