NEW YORK (Reuters Health) Aug 14 - Silver ring splints and commercial prefabricated thermoplastic splints are effective in treating "swan neck" finger deformities in patients with rheumatoid arthritis, according to research supported by The Dutch Arthritis Association.
"Both splints can improve outcomes in patients with these deformities," Dr. F. J. van der Giesen from Leiden University Medical Center, The Netherlands told Reuters Health. "Since no splint had the absolute preference of the patients, it is important to individualize the choice made for a particular type of splint."
Dr. van der Giesen and colleagues compared the effectiveness, patient satisfaction, and patient preferences of these 2 types of splints in a crossover study of 50 patients with rheumatoid arthritis and swan neck deformities.
Sequential Occupational Dexterity Assessment (SODA) scores at 4 weeks improved to a similar extent with the use of both splints, the authors report in the August 15th Arthritis Care & Research.
After 4 weeks with each treatment, 24 patients preferred the silver ring splint, 21 preferred the prefabricated thermoplastic splint, and 2 had no preference.
Groups that continued for an additional 22 weeks with their preferred splint showed no difference in SODA scores or any of the clinical outcome measures, the researchers say.
Patient satisfaction was generally higher with the silver ring splint, the investigators note, but few scores on the questionnaire differed significantly.
"The results of our study suggest that the provision of a prefabricated thermoplastic splint (PTS) is worth considering for patients with a mobile swan neck deformity," the authors conclude. "This is especially the case since PTS are less expensive than silver ring splints, with similar time needed for the hand therapist to measure and adjust the splint to obtain the optimal fit and allowed extension."
"It was not an objective of our study, but one can hypothesize that patients wearing a splint of their choice will display more adherence to the treatment in contrast to patient who have to wear splints they don't like," Dr. van der Giesen said.
Arthritis Rheum (Arthritis Care Res) 2009;61:1025-1031.