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 Comment

  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

INTEROSSEOUS MUSCLE TIGHTNESS TESTING

June 11, 2022

May 2012 No. 19 INTEROSSEOUS MUSCLE TIGHTNESS TESTING Judy Colditz, OT/L, CHT, FAOTA INTEROSSEOUS MUSCLE TIGHTNESS TESTING – ARE YOU DOING IT CORRECTLY? The common term “Intrinsic Tightness Testing” is a misnomer as it describes a maneuver specifically designed to test tightness of the interosseous muscles. The interosseous muscles are small, short-fibered muscles contained within…

Read More

Stretching Alone Can Change P1 Bone Shape in Patients with Camptodactyly

May 20, 2019

Woo Hong, S. Kim, J., Sang Kwon, O., Ho Lee, M., Sik Gong, H., Hyun Baek, G., (2019). Radiographic Remodeling of the Proximal Phalangeal Head Using a Stretching Exercise in Patients With Camptodactyly. J Hand Surg Am, 1.e1-1.e10 The Skinny – Camptodactyly is a congenital, nontraumatic flexion contracture of the PIP in fingers other than…

Read More

Changes in ROM of the MCP after Trapeziometacarpal Arthrodesis 

December 19, 2021

Rapid Review: Changes in ROM of the MCP after Trapeziometacarpal Arthrodesis Hayashi, M., Kato, H., Komatsu, M., Yamazaki, H., Uchiyama, S., & Takahashi, J. (2021). Changes in the Functional Range of Motion of the Thumb Metacarpophalangeal Joint After Trapeziometacarpal Arthrodesis for Patients With Advanced Trapeziometacarpal Osteoarthritis. The Journal of hand surgery, S0363-5023(21)00613-4. Advance online publication. https://doi.org/10.1016/j.jhsa.2021.09.018. The Skinny: Several published…

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.