Comparison of Custom-made Versus Prefabricated Thumb Splinting for Carpometacarpal Arthrosis: A Systematic Review and Meta-analysis



1 Department of Orthopaedic Surgery, Montréal General Hospital, McGill University, Canada

2 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Department of Hand and Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, USA

4 Department of Hand and Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, USA


Background: The goal of this study was to compare the two types of orthoses, prefabricated soft splints versus short
thermoplastic custom-made splints, that are the most commonly used for the management of first carpometacarpal
(CMC) osteoarthritis (OA).
Methods: We conducted a meta-analysis and systematic review in the literature based on the Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We extracted the outcomes of disability
scores, pain scores, grip and pinch strength and gathered the unified data accordingly.
Results: We included five randomized clinical trials with 230 patients with the mean age of 61 years and the mean
follow-up of 8.1 weeks. The results of the pooled data demonstrated only a statistically significant difference in disability
scores among splints in favor of the prefabricated splints. The rest of the outcome measures consisting of pain, grip
strength, and pinch strength were not statistically different.
Conclusion: According to our systematic review and meta-analysis, both thumb-based splints improved pain and
function in the first CMC OA in a short-term follow-up, nevertheless the efficacy of prefabricated splints in abatement of
disability scores was significantly higher than custom-made splints. In contrast, the other outcome measures including
pain, grip and pinch strength were improved identically after wearing either of the splints.
Level of evidence: II


Main Subjects

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Volume 6, Issue 6
November 2018
Pages 478-485
  • Receive Date: 07 September 2018
  • Revise Date: 11 October 2018
  • Accept Date: 14 October 2018
  • First Publish Date: 01 November 2018