The effect of thumb splinting on thenar muscles atrophy, pain, and function in subjects with thumb carpometacarpal joint osteoarthritis

Abstract

A large and significant effect on perceived pain in patients with first carpometacarpal joint osteoarthritis was observed after 4 weeks of splint use. Differences in treatment effects were found with regard to muscle cross-sectional areas, but these were not significant. Clinical relevance Custom-made splints may be recommended for the treatment of first carpometacarpal joint osteoarthritis. Moderate to large but non-significant treatment effects were found with regard to muscle cross-sectional areas.

Procedimientos quirúrgicos de los miembros de la Sociedad Española de Cirugía de la Mano (SECMA) para la artrosis trapecio-metacarpiana: Un examen de las tendencias de la práctica clínica actual

“…Esto es importante, ya que los objetivos finales de la cirugía de la artrosis TMC es restaurar la función del pulgar. 8,9 Es llamativo sin embargo, que pese a que existe una relación entre la funcionalidad y la intensidad de dolor, 6 solo el 36% valora la intensidad del dolor tras la cirugía cuando la mayor parte de ellos, concretamente el 94%, toman como referencia la intensidad de dolor referida por el paciente antes de tomar una decisión quirúrgica. Eso impide que se puedan valorar los resultados de forma concreta entre las diferentes técnicas quirúrgicas ya que no existe una concordancia entre las medidas de resultados tomadas como referencia antes de la cirugía y después de la misma.…”

Effectiveness of splinting for pain and function in people with thumb carpometacarpal osteoarthritis: a systematic review with meta-analysis

“…Interventions comprised a range of splint designs and materials (Table I). Rationales proposed for splint interventions included: to stabilise the CMC joint 34,37e43 ; to prevent adjacent metacarpophalangeal (MCP) joint hyperextension 14,15,34,39 ; to leave adjacent joints free for unhindered function 34,39,40,42,43 ; to maintain length of the first web space 14,15 ; to reduce CMC joint synovitis/inflammation 36,39,41 ; to reduce local muscle spasm 41 ; for patient preference 36 . One study reported telephone follow-up at 1-week 41 .…”

“…Of the four cross-over design trials, two used paired-t tests to assess the effect of splint wearing 41,42 and two used repeated-measures analysis of variance (ANOVA) 37,38 . Funding was not received in three studies 39,40,43 ; four studies received institutional or national health organisation grants 14,15,36,38 ; two studies received complimentary splint materials from the manufacturer 34,41 (one stated specifically no influence on the study design, conduct or outcome 41 ); and in three studies funding sources were not stated 37,42 or unclear 35 .…”

“…One of four studies comparing splint with no splint 43 and five of eight studies comparing different types of splints 34,37e40 were judged to be at high or unclear risk of selection bias. All outcomes reported in this review were judged to be at high risk of detection bias primarily due to PROs being completed by unblinded participants.…”

“…All outcomes reported in this review were judged to be at high risk of detection bias primarily due to PROs being completed by unblinded participants. Risk of selective outcome reporting was judged unclear or high for seven studies as study protocols were neither registered a priori nor published 34,37,38,40,43 , stated outcomes or time points were not reported 14,36 , or splint materials were provided by industry with unclear risk of influence 34 .…”