Comparison of Custom-made Versus Prefabricated Thumb Splinting for Carpometacarpal Arthrosis: A Systematic Review and Meta-analysis

Baradaran, A., Baradaran, A., Ebrahimzadeh, M. H., Kachooei, A. R., Rivlin, M., & Beredjiklian, P. (2018). Comparison of Custom-made Versus Prefabricated Splint for Carpometacarpal Arthrosis: A Systematic Review and Meta-analysis. The archives of bone and joint surgery, 6(6), 478–485.

Article Review By: Dalton Busch

The Skinny – A systematic review and meta-analysis were composed to compare the effectiveness of prefabricated orthoses versus a custom-made thermoplastic splint. The splints were created to manage carpometacarpal (CMC) osteoarthritis (OA). A total of five randomized clinical trials with a total of 230 patients were analyzed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 

prefabricated splint

In the weeds – Within the five randomized controlled trials, the researchers analyzed patients’ disability scores, pain scores, grip, and pinch strength, and integrated the data properly. All of the trials assessed were comparing results of the CMC OA orthoses as a non-surgical alternative. The primary outcome measure included was the Disabilities of the Arm Shoulder and Hand (DASH). Secondary measures that were extracted by the researchers included pain ratings, grip strength, and pinch strength. Further, the researchers looked into overall demographics, sample size, study design, and the type of splint utilized on the affected thumb. 

Bringing it home – Overall findings from the systematic review pointed towards a statistical difference in the overall disability scores of patients who wore the prefabricated versus the custom, showing preference to the prefabricated.   The secondary data relating to pain and grip/pinch strength both showed overall improvement wearing either the prefabricated or custom-made orthotic.  

Rating (0-5) – 4: This systematic review and meta-analysis were done across five clinical trials with a large sample size of 230 patients. The review shows the effectiveness of both custom and prefabricated orthoses but shows lessened disability scores for prefabricated. The mean follow-up testing was 8.1 weeks which is a short-term retest as CMC OA orthoses could become a lifelong solution for patients who fall within this category. Improved research may look into long-term follow-up for more accurate data. 

1 Comments

  1. Alex on May 9, 2022 at 10:02 am

    This doesn’t surprise me as I think there is a high variability between therapist custom splint designs which may outweigh the potential benefit of having the splint custom fabricated.

Leave a Comment






More To Read

Orthotic Intervention Incorporating Dart- Throwers Motion for Scapholunate Injury

February 16, 2020

Anderson, H. & Hoy, G. (2016). Orthotic intervention incorporating the dart-thrower’s motion as part of conservative management guidelines for treatment of scapholunate injury. Journal of Hand Therapy, 29, 199-204. By Brittany Carrie The Skinny Ligaments that overlay the carpal bones are imperative for wrist motion; however, are highly susceptible to instability. Injury to the scapholunate…

Read More

Surgery & Hand Therapy Highlights for Dupuytren’s Disease 

October 24, 2021

Dupuytren’s disease affects the fascia of the hand (Dupuytren’s fasciectomy hand).  It is relatively common to encounter patients with Dupuytren’s condition, even if that is not the primary reason you are treating the patient.  Patients often present with a nodule(s) in the palm of the hand, or they may even have a thickened cord running…

Read More

Surgical vs. Conservative Treatment for Pediatric Trigger Finger

July 30, 2023

Jia, L., King, J. D., Goubeaux, C., Belardo, Z. E., Little, K. J., Samora, J. B., Marks, J., &Shah, A. S. (2023). Presentation and management of the pediatric trigger finger: Amulticenter retrospective cohort study. The Journal of Hand Surgery, 48(7), 665–672.https://doi.org/10.1016/j.jhsa.2023.03.015 Article Review: Kelsy Melton The Skinny: The goal of this study conducted by King…

Read More
Envelope_1

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.