Multidisciplinary Consensus Guideline for Managing Trigger Finger: Results From the European HANDGUIDE Study.

• BackgroundTrigger finger is characterized by -sometimes painful- snapping or locking when flexing the finger. Although trigger finger is frequently seen in clinical practice, no standard treatment protocol has been established as 'best practice'.ObjectiveTo achieve consensus on a multidisciplinary treatment guideline for trigger finger.DesignA 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.SettingIn total, 35 experts (hand therapists /hand surgeons selected by the national member associations of their European federations, and Physical Medicine & Rehabilitation (PM&R) physicians) participated in the Delphi consensus strategy.MeasurementsEach Delphi round consisted of a questionnaire, an analysis and a feedback report.ResultsAfter 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. Relevant 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.LimitationsThe results represent a group's opinion at a given point in time. When 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.ConclusionsThis multidisciplinary treatment guideline may help involved therapists and physicians in the treatment of trigger finger, and indicate areas requiring additional research.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

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