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

Background: The goal of this study was to compare the two types of orthoses, prefabricated soft splints versus shortthermoplastic 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 ReportingItems for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We extracted the outcomes of disabilityscores, 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 meanfollow-up of 8.1 weeks. The results of the pooled data demonstrated only a statistically significant difference in disabilityscores among splints in favor of the prefabricated splints. The rest of the outcome measures consisting of pain, gripstrength, and pinch strength were not statistically different.Conclusion: According to our systematic review and meta-analysis, both thumb-based splints improved pain andfunction in the first CMC OA in a short-term follow-up, nevertheless the efficacy of prefabricated splints in abatement ofdisability scores was significantly higher than custom-made splints. In contrast, the other outcome measures includingpain, grip and pinch strength were improved identically after wearing either of the splints.Level of evidence: II