Journal of hand surgery global online · 2026
Effectiveness of Proximal Interphalangeal Joint Orthosis and Therapeutic Exercise in the Management of Trigger Finger: A Prospective Case Series.
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To Cuong Dinh, Vu Thanh Xuan, Do Hung Phuoc, Nguyen Khoa Anh, Nguyen Phi Duong
Аннотация
PURPOSE: Trigger finger, or stenosing tenosynovitis, is a common musculoskeletal disorder characterized by pain, stiffness, and locking of the affected digit. This prospective case series evaluated the outcomes of a commercially available proximal interphalangeal (PIP) joint orthosis combined with therapeutic exercise in patients with Green grades I-III trigger finger. Thumbs were excluded.
METHODS: Patients aged ≥18 years with trigger finger (Green grades I-III) were treated with a PIP joint orthosis worn during sleep and as needed during the day, together with a structured exercise program including flexor tendon gliding and stretching exercises for 6 weeks. Pain intensity (Numeric Pain Rating Scale [NPRS]), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores, and Green's grades were assessed at baseline and after 6 weeks. Treatment success was defined based on initial Green grade.
RESULTS: Seventy-nine patients (107 affected digits) were enrolled, with a mean age of 51.8 ± 9.8 years and a women-to-men ratio of 3.4:1. After 6 weeks of intervention, median NPRS pain scores significantly decreased from 6 to 1 during movement, and QuickDASH scores improved from 25 to 10. The proportion of digits with Green grade III decreased from 8.0% to 2.3%, whereas grade I increased to 71.3%. The overall treatment success rate was 55.2%.
CONCLUSIONS: In this prospective case series, the combination of PIP joint orthosis and therapeutic exercise was associated with reduced pain, improved hand function, and decreased triggering severity in patients with Green grades I-III trigger finger. Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
METHODS: Patients aged ≥18 years with trigger finger (Green grades I-III) were treated with a PIP joint orthosis worn during sleep and as needed during the day, together with a structured exercise program including flexor tendon gliding and stretching exercises for 6 weeks. Pain intensity (Numeric Pain Rating Scale [NPRS]), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores, and Green's grades were assessed at baseline and after 6 weeks. Treatment success was defined based on initial Green grade.
RESULTS: Seventy-nine patients (107 affected digits) were enrolled, with a mean age of 51.8 ± 9.8 years and a women-to-men ratio of 3.4:1. After 6 weeks of intervention, median NPRS pain scores significantly decreased from 6 to 1 during movement, and QuickDASH scores improved from 25 to 10. The proportion of digits with Green grade III decreased from 8.0% to 2.3%, whereas grade I increased to 71.3%. The overall treatment success rate was 55.2%.
CONCLUSIONS: In this prospective case series, the combination of PIP joint orthosis and therapeutic exercise was associated with reduced pain, improved hand function, and decreased triggering severity in patients with Green grades I-III trigger finger. Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.