Custom-Made Splint Treatment for Osteoarthritis of the Distal Interphalangeal Joints

Purpose

We investigated the usefulness of a custom-made splint for treatment of painful osteoarthritis of the distal interphalangeal (DIP) joints. The splint was designed to be easily detachable so as not to diminish finger pad sensation or interfere with proximal interphalangeal joint motion.

Methods

We enrolled 25 patients (24 women and one man, mean age 58 y) with painful osteoarthritis of the DIP joints of the fingers and thumbs in this cohort study. Nineteen patients had multiple affected digits in one or both hands. Splints were applied to protect and immobilize the DIP joints. We assessed the outcome of this treatment using the visual analog scale pain score and the Quick Disabilities of the Arm, Shoulder, and Hand score for subjective assessment of symptoms. The mean follow-up period after wearing the splint until assessment was 6 months. Subjects were assessed 6 months after they started wearing the splint.

Results

Pain decreased from 100% at pretreatment to 34% at final follow up. So, the average improvement ratio was 66%. The Quick Disabilities of the Arm, Shoulder, and Hand disability/symptom score changes were not statistically significant (28 points pretreatment and 17 points at final follow-up).

Conclusions

This splint reduced pain from DIP osteoarthritis according to the visual analog scale; however, this does not enable the patient to obtain completely satisfactory function of the upper extremities.

Type of study/level of evidence

Therapeutic IV.

Key words: Conservative treatment, DIP joint, Heberden's node, osteoarthritis, splint