The effects of splinting on outcomes for epicondylitis.

OBJECTIVE To evaluate the effects of splinting on outcomes for injured workers with epicondylitis. DESIGN Retrospective cohort study using propensity score methodology to statistically control for all observed pretreatment differences between patients with and without splints. SETTING Nationwide network of 253 occupational medicine clinics. PARTICIPANTS All injured workers (N=4614) receiving primary care for lateral or medical epicondylitis (International Classification of Diseases, 9th Revision, codes 726.31 or 726.32). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Physician-prescribed rates of duty restrictions and lost time, treatment duration, specialist referrals, and medical and physical therapy (PT) visits and charges. RESULTS Overall, patients with splints had higher rates of limited duty ( P <.001), more medical visits and charges ( P <.001), higher total charges (medical and PT, P <.001), and longer treatment durations ( P <.01) than patients without splints. Evaluating differences for patients who did and did not receive PT, significant differences remained for rates of limited duty ( P <.05), medical visits ( P <.01), and medical charges ( P <.01). CONCLUSIONS Splinting patients with epicondylitis may not optimize outcomes, including rates of limited duty, treatment duration, and medical costs.