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| Name | Class |
|---|---|
| University of Massachusetts, Worcester | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Surgery | Patients who underwent surgical release of A1 pulley |
| |
| corticosteroid injections only | Patients who underwent local corticosteroid injections only, and no other treatment |
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| hand therapy only occupational/physical | 1 visit: orthosis fabrication, range of motion, nodule and ice massage. |
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| Injection and Hand therapy | This group of participants received a combination of corticosteroid injection in the affected finger and one visit of hand therapy. |
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| Modality Hand Therapy | Ongoing hand therapy treatment, which included the above plus modalities such as ultrasound or iontophoresis. |
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| Injection and Modality Hand Therapy | Ccombination of local cortiscosteroid injection to the affected digit and ongoing hand therapy with modalities. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| surgery | Procedure | A1 pulley release of finger |
| |
| corticosteroid injections |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Functional use using Quick DASH 6 weeks | Change from baseline to 6 weeks Quick DASH | Day 1, 6 weeks |
| Change in Functional use using Quick DASH 3 months | Change from baseline to 3 months Quick DASH | Day 1, 3 months |
| Change in Functional use using Quick DASH 6 months | Change from baseline to 6 months Quick DASH | Day 1, 6 months |
| Change in Edema 6 weeks | Baseline to 6 weeks Circumferential measurement in centimeters of the proximal phalanx | day 1, 6 weeks |
| Change in Edema 3 months | Baseline to 3 months weeks Circumferential measurement in centimeters of the proximal phalanx | day 1, 3 months |
| Change in Edema 6 months | Baseline to 6 months weeks Circumferential measurement in centimeters of the proximal phalanx | day 1, 6 months |
| Change in Pain on a likert scale 6 weeks | Baseline to 6 weeks pain on a 0-10 scale | 1 day, 6 weeks |
| Change in Pain on a likert scale 3 months | Baseline to 3 months pain on a 0-10 scale |
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Inclusion Criteria:
Exclusion Criteria:
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patients undergoing medical treatment or hand therapy for trigger finger in digits #2-5 at the hand clinic. Patients were dropped from the study if they had changed to a different treatment.
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| Name | Affiliation | Role |
|---|---|---|
| Erika S. Lewis, Ed.D | Associate Professor, University of Massachusetts Lowell | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20825126 | Background | Lewis E, Fors L, Tharion WJ. Interrater and intrarater reliability of finger goniometric measurements. Am J Occup Ther. 2010 Jul-Aug;64(4):555-61. doi: 10.5014/ajot.2010.09028. |
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There are no plans for sharing the IPD
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| ID | Term |
|---|---|
| D052582 | Trigger Finger Disorder |
| D053682 | Tendon Entrapment |
| ID | Term |
|---|---|
| D052256 | Tendinopathy |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D013514 | Surgical Procedures, Operative |
| D026741 | Physical Therapy Modalities |
| D009788 | Occupational Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
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|
| Procedure |
corticosteroid injection to A1 pulley |
|
| Hand Therapy | Other | orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, |
|
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| Modality Hand Therapy | Other | orthosis fabrication, therapeutic exercise for range of motion to digits, ice massage, nodule massage, patient education, plus modalities such as ultrasound, iontophoresis |
|
| 1 day, 3 months |
| Change in Pain on a likert scale 6 months | Baseline to 6 months pain on a 0-10 scale | 1 day, 6 months |
| Change in Range of motion 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. | 1 day, 6 weeks |
| Change in Range of motion 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. | 1 day, 3 months |
| Change in Range of motion 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. | 1 day, 6 months |
| Change in Severity or Grade of triggering 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 | 1 day, 6 weeks |
| Change in Severity or Grade of triggering 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 | 1 day, 3 months |
| Change in Severity or Grade of triggering 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 | 1 day, 6 months |
| D005791 |
| Patient Care |