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The effects of splinting on outcomes for epicondylitis
V Jane Derebery1, Jenny N Devenport, Geneva M Giang
1Concentra Inc., 5080 Spectrum Drive, Suite 400, West Tower, Addison, TX 75001, USA.
Objective:
To evaluate the effects of splinting on outcomes for injured workers with epicondylitis.
Design:
Retrospective cohort study using propensity score methodology to statistically control for all observed pretreatment differences between patients with and without splints.
Setting:
Nationwide network of 253 occupational medicine clinics.
Participants:
All injured workers (N=4614) receiving primary care for lateral or medical epicondylitis (International Classification of Diseases, 9th Revision, codes 726.31 or 726.32).
Interventions:
Not applicable.
Main Outcome Measures:
Physician-prescribed rates of duty restrictions and lost time, treatment duration, specialist referrals, and medical and physical therapy (PT) visits and charges.
Results:
Overall, patients with splints had higher rates of limited duty ( P <.001), more medical visits and charges ( P <.001), higher total charges (medical and PT, P <.001), and longer treatment durations ( P <.01) than patients without splints. Evaluating differences for patients who did and did not receive PT, significant differences remained for rates of limited duty ( P <.05), medical visits ( P <.01), and medical charges ( P <.01).
Conclusions:
Splinting patients with epicondylitis may not optimize outcomes, including rates of limited duty, treatment duration, and medical costs.