Beneficial Effects of Nonsurgical Treatment for Symptomatic Thumb Carpometacarpal Instability in Clinical Practice: A Cohort Study

Beneficial Effects of Nonsurgical Treatment for Symptomatic Thumb Carpometacarpal Instability in Clinical Practice: A Cohort Study

To describe outcomes of nonsurgical treatment for symptomatic thumb carpometacarpal joint (CMC-1) instability. Secondary, to evaluate the conversion rate to surgical treatment. Prospective cohort study. A total of 20 outpatient clinics for hand surgery and hand therapy in the Netherlands. A consecut...

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Veröffentlicht in:Archives of physical medicine and rehabilitation 2020-03, Vol.101 (3), p.434-441
Hauptverfasser: Wouters, Robbert M., Slijper, Harm P., Esteban Lopez, Lisa, Hovius, Steven E.R., Selles, Ruud W., Blomme, R.A.M., Sluijter, B.J.R., van der Avoort, D.J.J.C., Kroeze, A., Smit, J., Debeij, J., Walbeehm, E.T., van Couwelaar, G.M., Vermeulen, G.M., de Schipper, J.P., Temming, J.F.M., van Uchelen, J.H., de Boer, H.L., de Haas, K.P., Zöphel, O.T., Feitz, R., Souer, J.S., Hovius, S.E.R., Moojen, T.M., Smit, X., van Huis, R., Pennehouat, P.Y., Schoneveld, K., van Kooij, Y.E., Wouters, R.M., Zagt, P., van Ewijk, F.J., Moussault, F., Veltkamp, J.J., Fink, A., de Ridder, W.A., Slijper, H.P., Selles, R.W., Porsius, J.T., Spekreijse, K.R., Zhou, C., Tsehaie, J., Poelstra, R., Janssen, M.C., van der Oest, M.J.W., Evers, S., Sun, P.O., Schrier, V.J.M.M., Dekker, J., Jansen-Landheer, M., ter Stege, M.
Format: Artikel
Sprache:eng
Schlagworte:
Carpometacarpal joints
Ehlers-Danlos Syndrome
Exercise therapy
Joint instability
Orthotic devices
Physical therapy modalities
Rehabilitation
Thumb
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Zusammenfassung:To describe outcomes of nonsurgical treatment for symptomatic thumb carpometacarpal joint (CMC-1) instability. Secondary, to evaluate the conversion rate to surgical treatment. Prospective cohort study. A total of 20 outpatient clinics for hand surgery and hand therapy in the Netherlands. A consecutive sample of patients with symptomatic CMC-1 instability (N=431). Nonsurgical treatment including exercise therapy and an orthosis. Pain (visual analog scale [VAS], 0-100) and hand function (Michigan Hand Outcomes Questionnaire [MHQ], 0-100) at baseline, 6 weeks, and 3 months. Conversion to surgery was recorded for all patients with a median follow-up of 2.8 years (range, 0.8-6.7y). VAS scores for pain during the last week, at rest, and during physical load improved with a mean difference at 3 months of 17 (97.5% CI, 9-25), 13 (97.5% CI, 9-18), and 19 (97.5% CI, 12-27), respectively (P
ISSN:0003-9993
1532-821X
DOI:10.1016/j.apmr.2019.08.485