RESEARCH - Effectiveness of two finger splints for swan neck deformity in patients with RA

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Arthritis Rheum. 2009 Jul 30;61(8):1025-1031.

Effectiveness of two finger splints for swan neck deformity in

patients with rheumatoid arthritis: A randomized, crossover trial.

van der Giesen FJ, van Lankveld WJ, Kremers-Selten C, Peeters AJ,

Stern EB, Le Cessie S, Nelissen RG, Vliet Vlieland TP.

Leiden University Medical Center, Leiden, The Netherlands.

OBJECTIVE: To compare the effectiveness and acceptability of silver

ring splints (SRS) and commercial prefabricated thermoplastic splints

(PTS) in treating swan neck deformities in patients with rheumatoid

arthritis (RA).

METHODS: Consecutive patients with RA and a mobile swan neck deformity

were included in a randomized, crossover trial. In 2 different

sequences, patients used both splints for 4 weeks, with a washout

period of 2 weeks. Afterward, patients used the preferred splint for

another 12 weeks. The primary outcome measure was dexterity measured

with the Sequential Occupational Dexterity Assessment (SODA).

Secondary outcome measures included other measures of hand function,

satisfaction with the splints, and splint preference.

RESULTS: Fifty patients were included, and 47 (94%) of those completed

the study. Eighteen patients (36%) had 1 swan neck deformity, whereas

the other patients had 2 or more. The improvement of the total SODA

score with the SRS (11.2; 95% confidence interval [95% CI] 8.1, 14.3)

and PTS (10.8; 95% CI 7.5, 14.1) was similar (difference -0.5; 95% CI

-2.2, 1.2). In addition, there were no significant differences in

change scores regarding the other clinical outcome measures, or

satisfaction. Twenty-four patients preferred the SRS, 21 preferred the

PTS, and 2 patients chose neither. A comparison in the 12-week

followup period yielded similar clinical outcomes, with the exception

of a significantly higher score in 3 items of satisfaction in the SRS

group.

CONCLUSION: For patients with RA and a mobile swan neck deformity, SRS

and PTS are equally effective and acceptable.

PMID: 19644897

http://www.ncbi.nlm.nih.gov/pubmed/19644897

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