Original CommunicationsSplinting in the treatment of arthritis of the first carpometacarpal joint*,**,*,**
Section snippets
Materials and methods
Between December 1990 and December 1993, 125 patients (141 thumbs) were seen at our hand center for pain and disability resulting from first carpometacarpal (CMC) joint disease. Of this group, 130 thumbs in 114 patients were treated initially with a protocol of thumb splinting. Eleven of the 141 thumbs (8%) had reconstruction of the volar ligament of the first CMC joint (with or without resurfacing of the trapeziometacarpal and/or the scaphotrapezial joints) without prior splinting. The reasons
Results
Seventy-four patients with 85 involved thumbs (67%) responded to the questionnaire. Six patients with 6 involved thumbs (5%) were lost to follow-up due to death or mental incapacity. Fourteen other patients (16 thumbs; 13%) could not be located. The remaining 16 patients (19 thumbs; 15%) failed to respond to 2 postal questionnaires and multiple telephone reminders. Only patients who answered the questionnaire are considered in the following results.
Discussion
To our knowledge there are no studies that directly evaluate splinting as a conservative treatment for first CMC joint arthritis. Anecdotal mention of its use in the literature on surgical treatment lists poor patient compliance and limitation of hand function as its main disadvantages. 4, 5, 6, 7 At the time of initial consultation, however, most patients are reticent to commit to surgery because of concern about postoperative pain and fairly prolonged immobilization and therapy. The patient
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Cited by (0)
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Reprint requests: Carrie R. Swigart, MD, Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, Sports Medicine Center, One Long Wharf, 6th Floor, New Haven, CT 06511.
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J Hand Surg 1999;24A:86–91
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0363-5023/99/24A01-0013$3.00/0