The Effect of Custom-molded Splint on Pain Severity of Patients with Carpometacarpal Joint Osteoarthritis

Background: Pain at the base of the thumb due to arthritis of the carpometacarpal joint (CMCJ) is a common problem, especially for women in the fifth to seventh decades of life. They report pain, a reduction in pinch and grip strength and hand function. Splinting and exercise are the most common types of conservative treatment for patients with moderate to severe first carpometacarpal joint (CMCJ) osteoarthritis (According to the literature, custom-made splints are able to reduce pain in patients with CMCJ OA of grade 1 and 2. The aim of this research is to evaluate the effect of a custom-molded splint on pain of patients with moderate to severe CMCJ OA.Methods: This was a quasi-experimental study of 24 patients with CMCJ OA. Recruited patients divided in two groups according to the degree of OA. 12 patients had a OA grade 3 and 12 patients had grade 4. A hand-based custom-molded splint was constructed for each subject using 3.2 mm thick low-temperature moldable thermoplastic material (Aquafit NS Stiff—3.2 mm (1/8″), Orfit Company, Inc., Belgium). All participants were asked to use the splint during activities of daily living or whenever they felt pain during the day. A 100- mm visual analogue scale was used to measure pain at the baseline and after 6 weeks using the splint.Results: In both groups, the pain severity was significantly reduced after 6 weeks using of the splint (p=0.02). After 6 weeks wearing of splint, there was no statistically significant difference on pain severity between the patients with grade 3 and grade 4 (p=0.30)).Conclusion: For patients with grade 3 and 4 first CMCJ OA, a custom-molded splint may be considered as a treatment option to decrease pain and assist in proper joint positioning to increase function.

Keywords:

Orthosis , Splint , Carpometacarpal joint , Osteoarthritis , Pain