Weiss Susan, Lastayo Paul, Mills Amy, Bramlet Dale
Exploring Hand Therapy, Inc., St. Petersburg, FL, USA.
J Hand Ther. 2004 Oct-Dec;17(4):401-6.
The purpose of this study was to compare the objective, subjective, and radiographic responses of patients with carpometacarpal joint osteoarthritis (CMCJ-OA) wearing a prefabricated neoprene splint (PFN), which crosses the CMCJ and metacarpophalangeal joint, with those of patients wearing a custom-made thermoplastic short opponens splint (CMT), which crosses only the CMCJ. Patients ( N = 25) with first CMCJ stage I and II osteoarthritis were assigned randomly to wear either the PFN splint or the CMT splint for one week. After one week, the subjects rated their function in the splint and their satisfaction and pain levels on visual analogue scales. Pinch measurements were performed and x-rays were taken to assess carpometacarpal subluxation. The second splint was then applied for one week and all measures were repeated. The subjects rated the PFN splint significantly higher, and most reported that they would choose the PFN splint over the CMT splint for daily and long-term use. Both pain and function were improved with splinting, but the effect was amplified with the PFN splint compared with the CMT splint. Both splints reduced subluxation at the first carpometacarpal joint, but the CMT effect was greater. This study further supports current evidence that subjects with stage I and II first CMCJ-OA will have pain relief with thumb splinting. In addition, the PFN splint will provide greater relief when compared with the CMT splint. Furthermore, this study reveals that patients prefer the PFN splint to the CMT splint.
本研究的目的是比较掌指关节骨关节炎（CMCJ - OA）患者佩戴预制氯丁橡胶夹板（PFN，跨越CMCJ和掌指关节）与佩戴定制热塑性短对掌夹板（CMT，仅跨越CMCJ）的客观、主观和影像学反应。将25例处于CMCJ I期和II期骨关节炎的患者随机分配，分别佩戴PFN夹板或CMT夹板一周。一周后，受试者在视觉模拟量表上对他们在夹板中的功能、满意度和疼痛程度进行评分。进行捏力测量并拍摄X线片以评估掌指关节半脱位情况。然后再佩戴另一种夹板一周，并重复所有测量。受试者对PFN夹板的评分明显更高，大多数人表示在日常和长期使用中，他们会选择PFN夹板而非CMT夹板。夹板固定后疼痛和功能均有所改善，但与CMT夹板相比，PFN夹板的效果更明显。两种夹板均能减少第一掌指关节的半脱位，但CMT夹板的效果更显著。本研究进一步支持了现有证据，即I期和II期CMCJ - OA患者通过拇指夹板固定可缓解疼痛。此外，与CMT夹板相比，PFN夹板能提供更大程度的缓解。此外，本研究还表明患者更喜欢PFN夹板而非CMT夹板。
