Comparison of Splinting Versus Nonsplinting in the Treatment of Pediatric Trigger Finger

• Published in: The Journal of hand surgery (American ed.) Vol. 37; no. 6; pp. 1211 - 1216
• Main Authors: Shiozawa, Ritsu, MD, Uchiyama, Shigeharu, MD, Sugimoto, Yoshihiro, MD, Ikegami, Shota, MD, Iwasaki, Norimasa, MD, Kato, Hiroyuki, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2012
• Subjects: Child; Child, Preschool; Children; Humans; Infant; Orthopedics; Retrospective Studies; Splints; static splint; Treatment Outcome; trigger finger; Trigger Finger Disorder - therapy; trigger finger; static splint; Children
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1016/j.jhsa.2012.03.032

Purpose Because pediatric trigger finger is much less common than pediatric trigger thumb, there is no consensus on the efficacy of splinting, owing to both the rarity of the condition and a lack of natural history and comparative therapeutic data. We performed the present retrospective study on 47 fingers to compare pediatric trigger finger treatment by splinting and nonsplinting. Methods We included 24 children with a total of 47 trigger fingers. Affected fingers included 4 index, 28 middle, 11 ring, and 4 little fingers. Patient age at initial examination ranged from 1 month to 9 years (mean, 2 y). We observed 24 fingers treated with a static splint and 23 fingers treated without it. The time from initial examination to follow-up ranged from 2 to 18 years. Results In the splinting group, 16 fingers (67%) resolved, 4 fingers (17%) improved, and 4 fingers (17%) remained unchanged. Seven fingers (29%) ultimately required surgery. In the nonsplinting group, 7 fingers (30%) resolved spontaneously, 1 (4%) improved, and 15 (65%) remained unchanged. Fifteen fingers (65%) later underwent surgical release. The rate of resolution in the splinting group was significantly higher than that in the nonsplinting group. The proportion of fingers needing surgical treatment in the splinting group was significantly lower than that in the nonsplinting group. Conclusions For treatment of pediatric trigger finger, it is advisable to fit a static splint at the first visit. Type of study/level of evidence Therapeutic IV.