If you have arthritis at the base of your thumb, you may need surgery. After surgery, doctors often use splints to help your thumb heal. But which splint works best? Do you need one at all?
A recent study looked at three different ways to treat patients after thumb surgery. The results might surprise you. Here are three key points:
- A short splint that keeps only the base joint still and lets most of the thumb move worked better than a long splint that covers more of the hand.
- Using no splint at all was better than using a long splint.
- All patients got better over time, but the splint type mattered for recovery.
Key Findings at a Glance
- Research shows that a short thumb splint leads to the best recovery 12 weeks after surgery
- Pain scores improved by 5 points in all groups after surgery
- Patients with short or no splints showed the biggest improvement in hand function scores
- Long splints that restrict more movement caused more pain and weaker grip strength
- All patients did therapy for 12 weeks after surgery
In this article:
- What is rhizarthrosis and why does it hurt?
- What kind of surgery did patients have?
- What were the three treatment groups?
- What did the study find?
- Which splint option worked best?
- About this site
- Frequently asked questions
- Conclusion
- Disclaimer
- Scientific source
What is rhizarthrosis and why does it hurt?
Many people with thumb arthritis hurt when they try to open a jar or turn a key. The pain happens because the bones at the base of the thumb rub together. Over time, the smooth covering on the bones wears away.
When other treatments do not help, doctors may suggest surgery. One common surgery is called interposition arthroplasty. That is a big word, but it means the surgeon removes damaged tissue and puts a cushion between the bones to stop rubbing.
What kind of surgery did patients have?
The 42 patients in this study all had the same type of surgery. It is called the Weilby procedure. After the surgery, their thumbs were put in a hard cast for 2 weeks. A cast is a hard shell that keeps your thumb still while it heals.
After the 2 weeks in a cast, the real question began. What should happen next?
You may be wondering why this matters. The way you care for your thumb after surgery can change how well it heals. Some doctors think you should wear a splint to protect the thumb. Other doctors think moving the thumb early is more important.
What were the three treatment groups?
According to this study, patients were split into three groups after their cast came off. Each group wore a different kind of device for 4 weeks. All patients also did hand therapy for 12 weeks.
Here is where it gets interesting. The three groups were:
- Group 1: Wore a long splint that covered a large part of the thumb and hand
- Group 2: Wore a short splint that only kept the base joint of the thumb still but let the rest of the thumb move
- Group 3: Wore no splint at all
The splints were made of thermoplastic. That is a special kind of plastic that can be heated and molded to fit your hand perfectly.
All patients did occupational therapy. That means they worked with a therapist who taught them exercises to help their hand get stronger and move better.
What did the study find?
Researchers checked on the patients at 6 weeks and 12 weeks after surgery. They measured several things:
- How much pain the patients felt
- How well their hand worked in daily life
- How strong their grip and pinch were
- How much their thumb could move
Research shows that all three groups got better over time. Pain went down. Hand function improved. But the groups did not improve in the same way.
Pain scores
Doctors used a pain scale called the VAS. It goes from 0 to 10, where 0 means no pain and 10 means the worst pain you can imagine. All groups saw their pain drop by about 5 points. That is a big improvement.
But here is the important part. Patients who wore the long splint had more pain at 12 weeks compared to the other two groups. Patients who wore no splint did not have more pain. In fact, they did quite well.
Hand function scores
The researchers used a test called the Quick DASH. This test asks questions about how hard it is to do daily tasks like buttoning a shirt or carrying a bag. A lower score means your hand works better.
According to this study, patients with the short splint or no splint saw their Quick DASH scores cut in half. That means their hand function improved a lot. Patients with the long splint did not improve as much.
Grip and pinch strength
Grip strength is how hard you can squeeze something with your whole hand. Pinch strength is how hard you can pinch something between your thumb and finger.
Patients who wore the long splint had weaker grip and pinch strength at 12 weeks. The other two groups did better.
Thumb movement
Doctors measured how much the thumb could move in different directions. The short splint group had the best movement at the base of the thumb joint. They also had the best movement at the tip joint of the thumb.
Which splint option worked best?
Let us look closer. The short splint came out on top. Patients who wore the short splint had:
- Less pain
- Better hand function
- Better thumb movement
- Stronger grip and pinch
The short splint only keeps the operated joint still. It lets the other joints of the thumb move freely. This seems to help the thumb recover better.
The group with no splint came in second. They did better than the long splint group. This tells us that keeping the thumb too stiff for too long is not helpful.
The long splint group had the hardest time. Their pain stayed higher. Their hand function improved less. Their grip stayed weaker. It seems that restricting too much movement slows down recovery.
| Group | Pain improvement | Hand function | Movement |
|---|---|---|---|
| Short splint | Best | Best | Best |
| No splint | Good | Good | Good |
| Long splint | Less improvement | Less improvement | Less improvement |
About this site
We know that thumb pain and arthritis can be confusing. Medical research is often written in complicated language. That is why this site exists. We read the scientific articles for you. Then we explain what they mean in simple words. Every article we write is based only on real published research. We never make things up or guess. Our goal is to help you understand your options so you can talk to your doctor with confidence. Feel free to explore more articles on this site to learn about other studies on thumb arthritis and treatment options.
Frequently asked questions
Do I need to wear a splint after thumb surgery?
According to this study, wearing a short splint that only restricts the operated joint works best. A short splint helps protect the surgery site while letting the rest of your thumb move. This leads to better recovery at 12 weeks. Wearing no splint is better than wearing a long splint that restricts too much movement.
How long should I wear a splint after thumb surgery?
In this study, patients wore their splints for 4 weeks after the cast came off. All patients also did hand therapy for 12 weeks. The short splint group had the best results at the 12 week check.
Will my thumb hurt less after surgery?
Research shows that pain improved by about 5 points on a 10 point scale for all patients in this study. Most people feel much less pain after surgery and therapy. The type of splint you use may affect how much pain you feel during recovery.
What is occupational therapy for the thumb?
Occupational therapy means working with a trained therapist who teaches you exercises and activities to help your thumb heal. The therapist helps you get your strength back and learn how to use your thumb in daily tasks. All patients in this study did occupational therapy for 12 weeks.
Conclusion
If you are facing thumb surgery for arthritis, this research gives you important information. After the surgery and the first 2 weeks in a cast, a short splint works best. It protects the joint that was operated on but lets the rest of your thumb move and heal.
Remember that every person is different. Your surgeon will make the best plan for you based on your surgery and your needs. But this study gives you a starting point for a conversation. You can ask your doctor about using a short splint instead of a long one.
Healing takes time. Be patient with yourself. Work with your therapist. Follow your doctor’s instructions. Most people see big improvements in pain and hand function by 12 weeks after surgery.
Disclaimer
This article is for educational purposes only. It is not medical advice. The information comes from a scientific study and is meant to help you learn about research on thumb surgery recovery. Always talk to your doctor or hand specialist before making any decisions about your treatment. Your doctor knows your specific situation and can give you personalized advice.
Scientific source
Study citation:
Krasny, Christian; Auerbach, Melanie; Radda, Christian; Schallmayer, Daniel; Borchert, Gudrun H.; Frauscher, Barbara; Rampesreiter, Manuela; Albrecht, Christian; Wurnig, Christian (2024). Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb. An observational study. Research Square.
https://doi.org/10.21203/rs.3.rs-4797281/v1