Effect of custom made splint in first carpo-metacarpal joint Osteoarthritis: A Quincy Experiments
Abstract
Custom- made splints are in use of treatment of osteoarthritis but there are very few studies in this regards i.e. effectiveness of use of these custom-made splints. So this present Quincy experiment interventional study was conducted to evaluate the effectiveness of custom-made splints (short dynamic splint) on pain, function, grip strength and key pinch in patients with first carpometacarpal (CMC) joint OA (grade 2nd and 3rd) in comparison to conventional treatment. Sixty patients with CMC joint osteoarthritis were randomly assigned to the splint (group A) or non splint group B) treatment. So 30 CMC joint osteoarthritis patients (grade 2nd and 3rd)were given custom-made splints (short dynamic splint)and 30 CMC joint OA (grade 2nd and 3rd)were given conventional treatment. Both groups were comparable statistically in both the groups (P>0.05) as per age, sex etc. In follow up assessment at 4th & 8th week, the Splint group shows significant improvement in all the outcomes (pain, grip and pinch strength) measures at all follow up except DASH score improvement at 2nd follow up in comparison to non splint group. So it can be concluded that the splint group shows significant improvement in all the outcomes (pain, grip and pinch strength) measures at all follow up except DASH score improvement at 2 nd follow up in comparison to non splint group. Result of present study supports that rehabilitation intervention (Short Custom-Made splint) can significantly benefits to individuals with early osteoarthritis and by it we can delay the need for surgical intervention.
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Introduction
Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in joints. It can occur in any joint, but it usually affects hand, knee, hip and spine. Hand OA particularly affects the base of the thumb: the carpometacarpal (CMC) joint. the thumb CMC joint is a frequently involved site in patients with OA. The base of the thumb, primarily the trapeziometacarpal (TMC) joint, is the second most common site affected by primary idiopathic arthritis in the hand behind only the distal joints of the fingers.1
Symptomatic arthritis in this area can cause a much more significant functional disability due to the broad range of activities that become impaired. Major risk factors for Hand OA are Age over 40 years, Female gender, Positive family history, Occupational usage, Obesity and Joint injury.2
Patients with arthritis of the basal joint will typically complain of pain at the base of the thumb particularly with pinch grasp activities such as opening jars or bottles and turning keys. . On physical examination, palpation directly over the thumb base or TMC joint will cause pain. With advanced arthritis, motion of this joint will often elicit crepitance.3
Conclusion
When analyzing for treatment order effect, THE SPLINT GROUP shows significant improvement in all the outcomes (pain, grip and pinch strength) measures at all follow up except DASH score improvement at 2nd follow up in comparison to NON SPLINT GROUP.
The result of present study supports that rehabilitation intervention (Short Custom-Made splint) can significantly benefits to individuals with early osteoarthritis and by it we can delay the need for surgical intervention.