CMC Arthritis - Neoprene Vs. Thermoplast Short Opponens Splinting
| Status: | Archived |
|---|---|
| Conditions: | Arthritis |
| Therapuetic Areas: | Rheumatology |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
Prospective Randomized Comparison: Neoprene Vs. Thermoplast Short Opponens Splinting. Outcomes After a Five-week to Sixteen-week Treatment Trial.
Carpometacarpal Thumb Arthritis is a disease caused by different factors and attacks mainly
woman older than 50 years. The signs and symptoms consist in pain, swelling, joint
instability, deformity and loss of motion. Some evidence has shown that splinting of the
thumb may be of benefit. There are two methods of splinting: The first is Standard
Neoprene wrap-on thumb support (in which the finger is kept in the same position with in a
standard Neoprene thumb splint). The second is Thermoplast Short Opponens splint (This
splint is custom-made and the thumb is use as a template to design the splint). The purpose
of this study is to test and evaluate these two protocols of splinting and assess which one
helps or works better in patients with thumb arthritis.
Osteoarthritis of the thumb carpometacarpal joint is a common condition that affects
approximately 16% to 25% of postmenopausal woman and causes pain, swelling, instability,
deformity and loss of motion. This condition has been staged in 4 periods according to the
degree of severity. Mild stages or stages 1 and 2 are usually treated conservatively by
stabilization of the joint, which can be aggressively achieved by surgical ligament
reconstruction or conservatively with thumb splints. Splinting is a typical treatment for
osteoarthritis of the thumb with the goals of managing pain, stabilizing the CMC joint, and
improving overall thumb function. There are limited studies showing the effectiveness of
splinting for this condition indicating they are successful in decreasing pain and improving
function in activities of daily living as well as radiographically improving joint
stability. What is less clear is, once patients leave the clinic setting, how compliant
they are with their splinting regimen. Patients with chronic illnesses tend to have
compliance issues when it comes to their care. Also, there are limited studies comparing
different modalities of splinting. A recent study compared custom-made short opponens
thermoplastic splint with the metacarpo-phalangeal (MP) joint free to a pre-fabricated short
neoprene splint. They found that patients preferred the neoprene splint but both splints
provided some degree of pain relief, reduction of subluxation of the MP joint and
improvement in function. Our purpose is to objectively quantify the various benefits of
splinting for patients with thumb arthritis using the DASH score and assess if there is a
difference between the pre-fabricated neoprene splint and the custom-made short opponens
thermoplastic splint with the MP included.
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