An alternative splinting and rehabilitation protocol for metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis

Abstract

This prospective study was completed to establish results obtained using a static splinting regimen as an alternative to the dynamic extension splint. Fifteen patients with rheumatoid arthritis, who had undergone metacarpophalangeal (MCP) joint arthroplasties and a postoperative rehabilitation program of alternating MCP joint flexion and extension static splints, were assessed pre-operatively and reviewed postoperatively. Total active arc of MCP joint motion and ulnar deviation were measured, and an activities-of-daily-living questionnaire was completed by each patient at 19 months (mean) postoperatively. Mean total active arc of MCP joint motion showed statistical improvement from 21.6° (range, 5°-60°) pre-operatively to 47.2° (range, 15°-84°) postoperatively. The little finger gained the most improvement, with a 50.2° arc, showing that this regimen does not compromise flexion gains at this joint. Ulnar deviation improved from a mean of 30.4° (range, 5°-65°) pre-operatively to 9.7° (range, 0°-30°) postoperatively. These initial results reinforce the clinical impression that this alternating static splint regimen can be used as an effective alternative to the dynamic extension splint. J HAND THER. 2002;15:41-47.