Abstract
Objectives
To provide an evidence-based overview of the effectiveness of conservative and (post)surgical
interventions for trigger finger, Dupuytren disease, and De Quervain disease.
Data Sources
Cochrane Library, Physiotherapy Evidence Database, PubMed, Embase, and CINAHL were
searched to identify relevant systematic reviews and randomized controlled trials
(RCTs).
Data Selection
Two reviewers independently applied the inclusion criteria to select potential studies.
Data Extraction
Two reviewers independently extracted the data and assessed the methodologic quality.
Data Synthesis
A best-evidence synthesis was performed to summarize the results. Two reviews (trigger
finger and De Quervain disease) and 37 randomized controlled trials (RCTs) (trigger
finger: n=8; Dupuytren disease: n=14, and De Quervain disease: n=15) were included.
The trials reported on oral medication (Dupuytren disease), physiotherapy (De Quervain
disease), injections and surgical treatment (trigger finger, Dupuytren disease, and
De Quervain disease), and other conservative (De Qervain disease) and postsurgical
treatment (Dupuytren disease). Moderate evidence was found for the effect of corticosteroid
injection on the very short term for trigger finger, De Quervain disease, and for
injections with collagenase (30d) when looking at all joints, and no evidence was
found when looking at the PIP joint for Dupuytren disease. A thumb splint as additive
to a corticosteroid injection seems to be effective (moderate evidence) for De Quervain
disease (short term and midterm). For Dupuytren disease, use of a corticosteroid injection
within a percutaneous needle aponeurotomy in the midterm and tamoxifen versus a placebo
before or after a fasciectomy seems to promising (moderate evidence). We also found
moderate evidence for splinting after Dupuytren surgery in the short term.
Conclusions
In recent years, more and more RCTs have been conducted to study treatment of the
aforementioned hand disorders. However, more high-quality RCTs are still needed to
further stimulate evidence-based practice for patients with trigger finger, Dupuytren
disease, and De Quervain disease.
Keywords
List of abbreviations:
CANS (complaints of the arm, neck, and/or shoulder), CI (confidence interval), DASH-Q (Disability of the Arm, Shoulder and Hand Questionnaire), MCP (metacarpophalangeal), PEDro (Physiotherapy Evidence Database), PIP (proximal interphalangeal), PNA (percutaneous needle aponeurotomy), RCT (randomized controlled trial), TA (triamcinolone acetonide), VAS (visual analog scale)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 28, 2017
Footnotes
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
