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Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

Authors Malliaropoulos N, Jury R, Pyne D, Padhiar N, Turner J, Korakakis V, Meke M, Lohrer H

Received 10 March 2016

Accepted for publication 9 June 2016

Published 31 October 2016 Volume 2016:7 Pages 143—151

DOI https://doi.org/10.2147/OAJSM.S108126

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Andreas Imhoff


Nikos Malliaropoulos,1–5 Rosanna Jury,1,2,5 Debasish Pyne,3–5 Nat Padhiar,3,5 Jennifer Turner,6 Vasileios Korakakis,3,7 Maria Meke,1 Heinz Lohrer3,8

1Sports and Exercise Medicine, Thessaloniki Musculoskeletal Clinic, 2Thessaloniki National Track and Field Centre, Sports Medicine Clinic of S.E.G.A.S., Thessaloniki, Greece; 3European Sports Care, 4Department of Rheumatology, Sports Clinic, Barts Health NHS Trust, 5Centre for Sports & Exercise Medicine, Queen Mary University of London, London, UK; 6Healthcare Group Guernsey, Guernsey; 7Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar; 8European SportsCare Network (ESN), Zentrum für Sportorthopädie, Wiesbaden-Nordenstadt, Germany


Introduction: Stenosing tenosynovitis that is characterized by the inability to flex the digit smoothly, usually leads to prolonged rehabilitation or surgery.
Study design: This case series is a retrospective cohort study.
Purpose: The aim of this case series was to evaluate the effectiveness of radial extracorporeal shockwave therapy (rESWT) for the treatment of stenosing tenosynovitis of the digital flexor tendon (trigger digit).
Methods: A retrospective analysis of 44 patients (49 fingers) treated with an individually adapted rESWT protocol was conducted. Trigger digit pain and function were evaluated at baseline and 1-, 3-, and 12-months posttreatment. Recurrence and pretreatment symptom duration were analyzed.
Results: Significant reductions in pain scores and functional improvement were found between baseline and all follow-up assessments (P<0.001). Pretreatment symptom duration was significantly correlated with the number of rESWT sessions required (r=0.776, P<0.001) and 1-year posttreatment pain score (r=0.335, P=0.019).
Conclusion: This study provides initial evidence that rESWT is an effective treatment for trigger digit, but randomised controlled trials are required to provide further evidence of this effect.

Keywords: trigger finger, trigger thumb, tendon, shockwave therapy, non-surgical therapy, conservative treatment, physiotherapy

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