One hundred eight patients (122 fingers) with Green severity grade 1-3 trigger finger were randomized to receive a custom-fit nighttime extension orthosis, a cortisone injection, or a combination of both treatments. Outcome of interest included symptom relief, patient-reported wrist and hand evaluation (PRWHE) scores and incidence of triggering. Outcomes were assessed at 6 weeks, and at 3, 6, and 12 months. Overall, the results of the study revealed no significant difference in symptom relief or PRWHE scores between treatment groups for Green grade 1 and 2 trigger fingers. However, for grade 3 trigger fingers, patients receiving orthosis alone experienced lower rates of symptom relief and higher PRWHE scores compared to other groups. The findings suggest orthosis alone is effective in about half of patients, with no added benefit from combining it with cortisone injections.