Multidisciplinary Consensus Guideline for Managing Trigger Finger

The characteristics of trigger finger are -sometimes painful- snapping or locking when flexing the finger. While trigger finger is frequently seen in clinical practice, there isn’t any standard treatment protocol that is established as ‘best practice’. This study aimed to achieve consensus on a multidisciplinary treatment guideline for trigger finger. A European Delphi consensus strategy was initiated. Systematic reviews reporting on the effectiveness of surgical and non-surgical interventions were conducted and used as an evidence-based starting point for this study. In total, 35 experts (hand therapists /hand surgeons selected by the national member associations of their European federations, and Physical Medicine & Rehabilitation (PM&R) physicians) took part in the Delphi consensus strategy. Each Delphi round was composed of a questionnaire, an analysis and a feedback report. After four Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of trigger finger. The experts agreed that splinting, corticosteroid injections, corticosteroid injections plus splinting, and surgery are suitable treatment options. Applicable details for the use of splinting, corticosteroid injections, and surgery were described. Main factors for selecting one of these treatment options were identified as severity and duration of the disease, and previous treatments received. A relation between the severity/duration and choice of therapy was indicated by the experts and reported on in the guideline. As the evidence for the effectiveness of interventions increases, experts’ opinions will change and the guideline should be re-evaluated and adjusted in view of these new insights.

This multidisciplinary treatment guideline could help involved therapists and physicians in the treatment of trigger finger, and indicate areas requiring additional research.