title: An alternative splinting and rehabilitation protocol for metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis.
abstract: This prospective study was completed to establish results obtained using a static splinting regimen as an alternative to the dynamic extension splint. Fifteen patients with rheumatoid arthritis, who had undergone metacarpophalangeal (MCP) joint arthroplasties and a postoperative rehabilitation program of alternating MCP joint flexion and extension static splints, were assessed pre-operatively and reviewed postoperatively. Total active arc of MCP joint motion and ulnar deviation were measured, and an activities-of-daily-living questionnaire was completed by each patient at 19 months (mean) postoperatively. Mean total active arc of MCP joint motion showed statistical improvement from 21.6 degrees (range, 5 degrees-60 degrees) pre-operatively to 47.2 degrees (range, 15 degrees-84 degrees) postoperatively. The little finger gained the most improvement, with a 50.2 degree arc, showing that this regimen does not compromise flexion gains at this joint. Ulnar deviation improved from a mean of 30.4 degrees (range, 5 degrees-65 degrees) pre-operatively to 9.7 degrees (range, 0 degrees-30 degrees) postoperatively. These initial results reinforce the clinical impression that this alternating static splint regimen can be used as an effective alternative to the dynamic extension splint.
authors.affiliation: Hand Therapy Unit, Mount Vernon Hospital, Northwood Middlesex, United Kingdom.
authors.forename: N
authors.initials: N
authors.lastname: Burr
authors.forename: A L
authors.initials: AL
authors.lastname: Pratt
authors.forename: P J
authors.initials: PJ
authors.lastname: Smith
mesh_terms: D000203:Activities of Daily Living; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D001178:Arthroplasty / Q000534:rehabilitation*; D005081:Exercise Therapy; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013165:Splints; D016896:Treatment Outcome