title: Is an intervention with a custom-made splint and an educational program useful on pain in patients with trapeziometacarpal joint osteoarthritis in a daily clinical setting?
abstract: OBJECTIVE
  Custom-made splints may be useful in the conservative treatment of osteoarthritis (OA) of trapeziometacarpal (TMC) joint OA. Our aim was to evaluate usefulness of a custom-made splint and educational program in patients with symptomatic TMC joint OA in daily clinical practice.
  
  
  METHODS
  Fifty patients with symptomatic TMC joint OA, not treated with surgery, were enrolled in a open prospective study in a clinical day setting and treated with a 'butterfly' custom-made thermoplastic short opponens splint to be worn 16 h/day for 30 days and then when needed, for 12 months. Patients were evaluated at enrolment (T0), at the first month (T1) and at the 12th month (T2) since splint application for pain (main outcome measure) by numeric rating scale 0-10. At T0 and T1, a Jamar dynamometer (kg) was used to assess hand strength, a pinch gauge to evaluate pinch strength (kg) and Dreiser test to assess hand disability (secondary outcome measures).
  
  
  RESULTS
  The comparison between T0 and T1 showed a significant improvement in all the outcome measures (P < 0.0001 for pain, muscle and pinch strength; P = 0.001 for Dreiser test). Moreover, at the end of 12 months follow-up, patients maintained the reduction of pain (T2 vs. T1, P = NS) and showed a reduced consumption of analgesics (P < 0.05).
  
  
  CONCLUSIONS
  A custom-made thermoplastic short opponens splint for 30 consecutively days for at least 16 h/day, followed by occasional use on pain outbreak is an useful conservative treatment in symptomatic TMC joint OA.
authors.affiliation: Division of Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Maddali-Bongi
authors.affiliation: Division of Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Del Rosso
authors.affiliation: Division of Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Galluccio
authors.affiliation: Associazione Multidisciplinare Riabilitazione Reumatologica (AMuRR), Florence, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sigismondi
authors.affiliation: Division of Medicine, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D001696:Biomechanical Phenomena; D052737:Carpometacarpal Joints / Q000503:physiopathology*; D004185:Disability Evaluation; D004867:Equipment Design; D005260:Female; D018737:Hand Strength; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D010353:Patient Education as Topic; D011446:Prospective Studies; D013165:Splints; D013997:Time Factors; D051223:Trapezoid Bone / Q000503:physiopathology*; D016896:Treatment Outcome
keywords: conservative therapy; osteoarthritis; pain; splint; trapeziometacarpal joint