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

Abstract

Background: The goal of this study was to compare the two types of orthoses, prefabricated soft splints versus short<br />thermoplastic custom-made splints, that are the most commonly used for the management of first carpometacarpal<br />(CMC) osteoarthritis (OA).<br />Methods: We conducted a meta-analysis and systematic review in the literature based on the Preferred Reporting<br />Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We extracted the outcomes of disability<br />scores, pain scores, grip and pinch strength and gathered the unified data accordingly.<br />Results: We included five randomized clinical trials with 230 patients with the mean age of 61 years and the mean<br />follow-up of 8.1 weeks. The results of the pooled data demonstrated only a statistically significant difference in disability<br />scores among splints in favor of the prefabricated splints. The rest of the outcome measures consisting of pain, grip<br />strength, and pinch strength were not statistically different.<br />Conclusion: According to our systematic review and meta-analysis, both thumb-based splints improved pain and<br />function in the first CMC OA in a short-term follow-up, nevertheless the efficacy of prefabricated splints in abatement of<br />disability scores was significantly higher than custom-made splints. In contrast, the other outcome measures including<br />pain, grip and pinch strength were improved identically after wearing either of the splints.<br />Level of evidence: II