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

Carpal Tunnel Syndrome: How does traditional hand therapy compare with neurodynamic therapy?

November 20, 2021

Hamzeh, H., Mohammad, M., Alghwiri, A., & Hawamdeh, Z. (2021). The long-term effect of neurodynamics vs. exercise therapy on pain and function in people with carpal tunnel syndrome: A randomized parallel-group clinical trial.  Journal of Hand Therapy, 34, 521-530.  The Skinny:  Carpal tunnel is the most common peripheral nerve compression problem.  There is now some…

Read More

Volkmann’s Contracture

December 13, 2020

Written by Melissa Miller Introduction Volkmann’s contracture is a rare condition that occurs after injury to the elbow and upper arm, typically from a crush injury. This condition can occur when acute compartment syndrome is left untreated. If unrecognized, Volkmann’s contracture can lead to a permanent deformity in the hand and forearm. Hand therapists are…

Read More

Effectiveness of Conservative Therapy and Splinting for 1st CMC OA

June 13, 2021

Tsehaie, J., Sprekraijse, K., Wouters, R., Slijper, H., Feitz, R., Hovious, S., & Selles, R. (2018). Outcome of a Hand Orthosis and Hand Therapy for Carpometacarpal Osteoarthritis in Daily Practice: A Prospective Cohort Study. American Society for Surgery of the Hand, 1-11. The skinny: Non-surgical approaches (hand therapy & orthotics) are typically the go-to for…

Read More

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.