Effectiveness of conservative surgical, & post-surgical interventions for Trigger finger, Dupuytren’s, & De Quervain’s

The objective of this study was to provide an evidence-based overview of the effectiveness of conservative and (post)-surgical interventions for trigger finger, Dupuytren’s -, and De Quervain’s disease. The Cochrane Library, PEDro, PubMed, Embase and CINAHL were searched to identify relevant systematic reviews and RCTs.

Two reviews (trigger finger, Quervain’s) and 37 RCTs (trigger finger(8), Dupuytren’s(14), Quervain’s (15)) were included. The trials reported on oral medication (Dupuytren’s), physiotherapy (Quervain’s) injections and surgical treatment (trigger finger, Dupuytren’s, Quervain’s), other conservative (Quervain’s), and postsurgical treatment (Dupuytren’s). Moderate evidence was found for the effect of corticosteroid injection on the very short-term for trigger finger, De Quervain’s disease, and for injections with Collagenase on the very short-term (30 days) when looking at all joints, no evidence was found when looking at the PIP joint for Dupuytren’s disease. A thumb-splint as additive to a corticosteroid injections seem to be effective (moderate evidence) for De Quervain’s diseae (short-, midterm). For Dupuytren’s disease use of a corticosteroid injection within a Percutaneous Needle Aponeurotomy in midterm, and Tamoxifen versus a placebo before/after a fasciectomy seems to promising (moderate evidence). The authors also found moderate evidence for splinting after Dupuytren’s surgery in short-term.

In recent years more and more RCTs have been conducted to study treatment of the above-mentioned hand disorders. However, more high-quality RCTs are still needed in order to further stimulate evidence-based practice for patients with trigger finger, Dupuytren’s disease, and De Quervain’s disease.