Evidence-based management of adult trigger digits

• Published in: The Journal of hand surgery, European volume Vol. 42; no. 5; pp. 473 - 480
• Main Authors: Amirfeyz, R., McNinch, R., Watts, A., Rodrigues, J., Davis, T. R. C., Glassey, N., Bullock, J.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-06-2017
• Subjects: Adrenal Cortex Hormones - therapeutic use; Adult; Female; Humans; Male; Orthopedic Procedures; Splints; Trigger Finger Disorder - therapy; treatment; open surgery; Trigger finger; injection; trigger thumb; percutaneous release
• ISSN: 1753-1934; 2043-6289
• DOI: 10.1177/1753193416682917

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