Effectiveness of interventions of specific complaints of the arm, neck, and/or shoulder: 3 musculoskeletal disorders of the hand. An update.
OBJECTIVE
To provide an evidence-based overview of the effectiveness of conservative and surgical interventions for trigger finger, Dupuytren's, and De Quervain's diseases.


METHODS
The Cochrane Library, PEDro, PubMed, Embase, and CINAHL were searched to identify relevant studies.


METHODS
Two reviewers independently applied the inclusion criteria to select potential relevant studies from the title and abstracts of the references retrieved by the literature search. Relevant (Cochrane) reviews and randomized controlled trials (RCTs) were included.


METHODS
Two reviewers independently extracted the data and performed a methodologic quality assessment.


RESULTS
A best-evidence synthesis was performed to summarize the results of the included trials. One Cochrane review (trigger finger) and 13 RCTs (trigger finger [6], Dupuytren's [4], De Quervain's [3]) were included. The trials reported on physiotherapy (De Quervain's), steroid injections (trigger finger, De Quervain's), surgical treatment (trigger finger, De Quervain's), and a postsurgical treatment (Dupuytren's). For trigger finger, moderate evidence was found for the effectiveness of steroid injections in the short-term (1-4 wk) but not for long-term outcomes. Limited evidence was found for the effectiveness of staples compared with sutures in skin closure and for intermittent compression after surgery to treat Dupuytren's disease. For other interventions, no evidence was found.


CONCLUSIONS
Indications for effectiveness of some interventions for trigger finger, Dupuytren's, and De Quervain's diseases were found. Because only a few RCTs were identified, it is difficult to draw firm conclusions. High-quality RCTs are clearly needed in this field.
Department of General Practice, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands. b.huisstede@erasmusmc.nl
Bionka M
BM
Huisstede
Marienke
M
van Middelkoop
Manon S
MS
Randsdorp
Suzanne
S
Glerum
Bart W
BW
Koes
D053684:De Quervain Disease / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004387:Dupuytren Contracture / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D019637:Orthopedic Procedures; D016896:Treatment Outcome; D052582:Trigger Finger Disorder / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*