Effectiveness of Non-surgical Interventions for the Trigger Finger: a Randomized Clinical Trial

Beatriz Sernajoto Cristiani Pedro

Status

Unknown

Conditions

Trigger Finger

Treatments

Procedure: Therapeutic modalities: LLLT (Group 2)

Procedure: Therapeutic modalities: Paraffin (Group 3)

Procedure: Corticosteroid injection (Group 4)

Procedure: Therapeutic modalities: Orthotic (Group 1)

Study type

Interventional

Funder types

Other

Identifiers

NCT02972879

BSCPedro

Details and patient eligibility

About

The aim of this study is to assess the effectiveness of therapeutic modalities (paraffin, ultrasound and orthotics) versus corticosteroid injection for trigger finger.

Full description

There are several forms of nonsurgical treatment for trigger finger, the most used are:

Oral nonsteroidal and steroidal antiinflammatory's drugs use to resolve the inflammatory process
Corticosteroids local injection: that proposes to control the inflammation, these injections have shown good effectiveness for trigger finger treatment.
Orthotic: with the aim of to immobilize the affected joint until the resolution of the inflammatory process.
Electrotherapeutic modalities:
Paraffin that increases cellular metabolism and promotes peripheral vasodilatation, favoring the transduction tissue fluid, lymph flow, hyperemia and consequent absorption of exsudato.
LASER -Lower Level Laser Therapy (LLLT): the absorption of light through the skin's photoreceptors stimulates mitochondrial chain reactions, promoting adenosine triphosphate (ATP) synthesis, acting on gene expression, which raises the level of growth factors and Tissue repair

Although the non-surgical treatment is often used there is no evidence in the literature of which is the most effective conservative treatment for trigger finger. Thus, it is necessary use appropriate methodology to define the benefits and harms of each treatment modality and assess the effectiveness of these nonsurgical treatments, and may define which one has a higher resolution and lower rates of trigger finger recurrences in short, medium and long term.

Enrollment

132 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

2-3 grade of trigger finger (Quinnell´s classification)
Signing the Terms of Consent.

Exclusion criteria

Presence of finger trigger in children
Presence of traumatic finger trigger
Secondary causes (patients with tumor of the tendon sheath,

synovitis tuberculosis, etc ...)

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

132 participants in 2 patient groups

Therapeutic Modalities

Active Comparator group

Description:

* Group 1: Metal orthotic, keeping 0º of the extension of the proximal interphalangeal joint, during all day, for 5 weeks, stopping the use only for bathing * Group 2: 10 LLLT sessions applications on the A1 pulley and lump formed on the flexor tendon of the the affected finger; Two sessions per week, five weeks of treatment. * Group 3: Paraffin bath 2 times a week for 20 minutes (total of 10 sessions).

Treatment: