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

BackhroundsThe goal of this study is to compare two types of orthoses, prefabricated soft splintsand short thermoplastic custom-made splints, that are the most common and currentlyprescribed for management of the first carpometacarpal (CMC) osteoarthritis (OA).MethodsWe conducted a meta-analysis and systematic review on the literature based on PreferredReporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Weextracted the outcomes of disability scores, pain scores, grip and pinch strength andgathered the unified data accordingly.ResultsWe included fives randomized clinical trials with 230 patients with the mean age of 61 yearsand the mean follow-up was 8.1 weeks. The results of the meta-analysis of the pooled datademonstrated a statistically significant difference in disability scores among splints in favorof prefabricated splints. The rest of the outcome measures consisting of pain, grip strength, and pinch strength were not statistically different.ConclusionsAccording to our systematic review and meta-analysis both thumb-based splints improvepain and function in first CMC OA in a short-term follow-up, nevertheless the efficacy ofprefabricated splints in abatement of disability scores was significantly higher than custommadesplints. In contrast, the other outcome measures including pain, grip and pinchstrength were improved identically wearing each splint.