Splinting the degenerative basal joint: custom-made or prefabricated neoprene?

Area of Science:

• Orthopedics
• Rheumatology
• Hand Therapy

Background:

• Carpometacarpal joint osteoarthritis (CMCJ-OA) is a common condition affecting hand function.
• Thumb splinting is a recognized conservative treatment for CMCJ-OA.
• Different splint designs may offer varying degrees of efficacy and patient preference.

Purpose of the Study:

• To compare the objective, subjective, and radiographic outcomes of prefabricated neoprene (PFN) and custom-made thermoplastic (CMT) splints in patients with early-stage CMCJ-OA.
• To evaluate patient preference and satisfaction between the two splint types.

Main Methods:

• A randomized crossover study involving 25 patients with stage I and II first CMCJ-OA.
• Patients wore each splint (PFN and CMT) for one week, with outcomes assessed after each period.
• Outcome measures included visual analogue scales for function, satisfaction, and pain, pinch strength measurements, and radiographic assessment of carpometacarpal subluxation.

Main Results:

• Patients rated the PFN splint significantly higher than the CMT splint.
• Both splints improved pain and function, with greater improvements observed with the PFN splint.
• While both splints reduced subluxation, the CMT splint demonstrated a greater effect on subluxation reduction.

Conclusions:

• Thumb splinting provides pain relief for patients with stage I and II CMCJ-OA.
• The prefabricated neoprene (PFN) splint is preferred by patients and offers greater pain relief and functional improvement compared to the custom-made thermoplastic (CMT) splint.
• Both splint types are effective in managing CMCJ-OA, but patient preference leans towards the PFN splint for daily use.