Efficacy of Splinting in Managing Adult Trigger Finger: A Systematic Review of Short-Term Outcomes.
Elise S McKenna, Nathaniel Co, Hanna Brancaccio, Blane Soper, Aryan Borole, Yuri Han, David Kirschenbaum, Brian M Katt
Abstract
Open AccessPurpose: Trigger finger is a common hand condition often managed conservatively with splinting, which reduces pain and improves function by immobilizing the affected digit. Splinting is a viable alternative for patients wishing to avoid corticosteroid injections or surgery. Short-term studies suggest it effectively relieves symptoms; however, adherence can be challenging. This systematic review evaluates the short-term efficacy of splinting for trigger finger and aims to identify the most effective splint. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered with the International Prospective Register of Systematic Reviews Registry. Six medical databases were queried, and studies screened using predetermined inclusion criteria. Relevant data were extracted and analyzed. Results: Thirteen studies met criteria, investigating various blocking orthoses worn for 6 to 12 weeks. Splinting consistently reduced pain, stopped triggering, and improved function over the short term (within 1 year), with success rates up to 97%, comparable to corticosteroid injections but without risks like skin atrophy or infection. Regardless of splint type, splinting was most effective when worn 24 hours a day. Although the metacarpophalangeal joint blocking orthoses was the most studied orthotic, the proximal interphalangeal joint blocking orthoses (PIP-BO) outperformed the metacarpophalangeal joint blocking orthoses , providing more effective pain reduction and better functional outcome. Patients found the PIP-BO to be more comfortable and aesthetic, leading to greater wear time. Conclusions: Splinting is an effective short-term conservative treatment for trigger finger, offering symptom relief and functional improvement. Although adherence may be challenging for some patients, splinting remains a valuable option for those seeking noninvasive management. PIP-BOs superior functional outcomes, patient satisfaction, and cost-effectiveness, leads our study to recommend a PIP-BO worn continuously for at least 6 weeks, if splinting is chosen as a first-line treatment. Further research is needed to explore long-term outcomes and standardize splinting approaches for broader clinical application. Type of study/level of evidence: Therapeutic III.