Trigger Finger Webinar

Date: Wednesday 21st February
Time: 1900-2100 GMT (London)
Location: Zoom webinar service
Registration: https://zoom.us/webinar/register/WN_jtzOaUCBRKSX4QPK0uDbpQ

There are 500 places available in the webinar. If this is exceeded it will be possible to watch the session via the YouTube feed.

Who should attend?

  • Clinicians who treat trigger finger and would like to find out about the current evidence.
  • Clinicians interested in designing a randomised controlled trial relating to the treatment of trigger finger.

Learning objectives

Programme – Starts 1900 GMT (London time)

1900 Welcome and introduction to the webinar
1910 Trigger fingers: how do you treat them? Emmi Friedman MD EPOBRAS, Jeroen Bosch Hospital, Den Bosch, The Netherlands
1920 Trigger fingers: areas of clinical uncertainty. Prof. Tim Davis MD PhD FRCS(Ortho), University of Nottingham, UK
1930 Discussion
1940 BEST Guidelines for trigger finger. Jeremy Rodrigues MD PhD, University of Oxford, UK
1955 Discussion
2010 Research collaboratives: the UK experience. Matt Gardiner MD PhD FRCS(Plast), Oxford, UK
2020 Introducing the TRIGGER Trial. Anita Dijksterhuis MD, UMC Utrecht, The Netherlands
2030 Discussion and brainstorming RCT
2100 Close

Certificates of attendance will be emailed to those at the close of the meeting.

 

TRIGGER Trial

 

Trigger finger is one of the most common conditions seen by hand surgeons. Different non-operative treatments (e.g. physiotherapy, splinting and NSAIDs) have been described with little evidence to support the usage. The mainstay of non-operative treatment remains intermediate-acting steroid injection with or without a local anesthetic added. Operative management is by release of the A1 pulley, either percutaneously or with open surgery.

A recent systematic review showed moderate evidence that steroid injections are an effective initial treatment for trigger fingers. However, this evidence is based on two small studies of poor quality with a short follow-up of just four months. There is high quality evidence that trigger digits can be managed safely by open or percutaneous surgical release, but there are only 3 RCTs with several shortcomings comparing steroid injection with surgery.

We propose a large, international, multicenter, randomized controlled trial to compare steroid injection and surgery in treating trigger fingers with follow-up of one year. At the end of this study we should be able to make an evidence-based recommendation on how to treat a patient with a trigger finger.

Population: Adults with ≥ 1 trigger fingers

Intervention: Surgical release using surgeon’s preferred technique (open or percutaneous)

Control: ≥ 1 injections with steroid injection (steroid of choice, with or without local anesthetic added)

Outcome:

  • Primary outcome: resolution of triggering
  • Secondary outcome: level of pain, hand function (PROM), costs and complications
  • Subgroup analysis: type of surgery, type of injection, thumb vs long digits, diabetes, rheumatoid arthritis
  • Follow-up: 6 and 12 months

Register your interest

The project will use similar methodology to the WIRE Study. Collaborators will submit a ‘denominator’ list of all eligible hand surgeons and therapists and be expected to get a high response rate. This will lead to Pubmed citation as a collaborator.

The survey is currently being finalised. Please register below to express your interest in being a collaborator.





  • Clinician survey
  • University ethics approval
  • Data collection
  • Data analysis
  • Manuscript submission
  • Publication
Anita Dijksterhuis
Plastic Surgery Trainee
Jeroen Bosch Hospital
The Netherlands

Brigitte van der Heijden
Consultant Hand Surgeon
Jeroen Bosch Hospital
The Netherlands

Jan Debeij
The Netherlands

Henk Coert
The Netherlands

Richard Pinder
Consultant Hand Surgeon
Hull, UK

Jeremy Rodrigues
NIHR Academic Clinical Fellow in Plastic Surgery
NDORMS
University of Oxford, UK

Matthew D. Gardiner
Kennedy Institute of Rheumatology
University of Oxford, UK

Zaf Naqui
Manchester, UK

Abhilash Jain
NDORMS
University of Oxford, UK

Collaborators will be listed here in due course.
SITU, NDORMS, University of Oxford
£20K BAPRAS Pump Priming Award for Clinical Trials
No downloads available.