Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review

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dc.contributor.authorBarrett, Patrick C.en
dc.contributor.authorHackley, Darren T.en
dc.contributor.authorSamuel, Linsen T.en
dc.contributor.authorApel, Peter J.en
dc.date.accessioned2022-10-26T18:37:13Zen
dc.date.available2022-10-26T18:37:13Zen
dc.date.issued2022-09-01en
dc.date.updated2022-10-26T13:41:23Zen
dc.description.abstractPurpose: We provide a systematic review of the current literature regarding best practices in postoperative care following carpometacarpal arthroplasty, and compare these findings to current practices via reported survey data. Methods: The PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Science Direct, and Google Scholar databases were searched for relevant studies. English-language articles were included that assessed any aspect of postoperative care, including the immobilization time or rehabilitation strategy. In addition, studies were included that surveyed surgeons and hand therapists on current practices regarding this topic. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Results: The initial search yielded 3,899 hits. Two systematic reviews were found, along with 5 studies that specifically tested the desired variables of the immobilization duration and type following carpometacarpal arthroplasty. Three relevant surveys were also found. Using the Oxford Centre for Evidence-Based Medicine Level of Evidence guidelines, we found moderate-quality evidence that (1) there is no additional benefit for extended cast immobilization (>6 weeks); and (2) a semirigid orthosis performs as well as a rigid orthosis. We found a lack of evidence regarding formal therapy versus no therapy, and a lack of evidence comparing therapy regimens. When analyzing the survey data, we found wide variation in practices among surgeons and therapists. Conclusions: Longer immobilization times (>6 weeks) and rigid orthotic devices provide no additional benefit over earlier immobilization and semirigid orthotic devices. There is a lack of evidence for the use of formal hand therapy or any specific rehabilitation protocol. Current practices in these areas vary widely among hand surgeons. Clinical relevance: Practices following carpometacarpal arthroplasty are widely variable, and guidance has previously been lacking. This review compiles the most recent data, as well as identifies gaps in the literature for future studies.en
dc.description.versionPublished versionen
dc.format.extentPages 255-262en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1016/j.jhsg.2022.05.011en
dc.identifier.eissn2589-5141en
dc.identifier.issn2589-5141en
dc.identifier.issue5en
dc.identifier.orcidApel, Peter [0000-0002-5428-2125]en
dc.identifier.otherPMC9492801en
dc.identifier.otherS2589-5141(22)00069-X (PII)en
dc.identifier.pmid36157304en
dc.identifier.urihttp://hdl.handle.net/10919/112286en
dc.identifier.volume4en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/36157304en
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectCMC arthroplastyen
dc.subjectCarpometacarpal jointen
dc.subjectHand therapyen
dc.subjectImmobilization timeframeen
dc.subjectSystematic reviewen
dc.subjectRehabilitationen
dc.titleImmobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Reviewen
dc.title.serialJournal of Hand Surgery Global Onlineen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherJournal Articleen
dcterms.dateAccepted2022-05-25en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Orthopedicen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Orthopedic/Hand and Upper Extremityen

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