The Use of Splinting in the Non-Surgical Treatment of De Quervain's Disease: A Review of the Literature

Abstract

Background The application of splinting in the treatment of de Quervain's disease is widespread. However, given its cost and the potential limitation to daily activities, clinicians must be confident of splinting's efficacy before utilising it. Objectives To determine whether there is any clinical evidence to support the use of splinting in the non-surgical treatment of de Quervain's disease. Search Strategy: A search was conducted using the Cochrane clinical trials register (November 2004 of The Cochrane Library), Medline, CINAHL and EMBASE databases. Selection Criteria Due to the paucity of available literature, all studies investigating the use of splinting for de Quervain's disease were included in this review (both randomized and non-randomized). This included studies comparing the use of splinting with other treatments such as corticosteroid injections. Data collection and analysis All trials judged as fitting the selection criteria by the reviewer, were assessed for methodological quality. The trials were grouped into four categories that related to the type of treatment. Main results In all, there were five studies, involving a total of 524 symptomatic wrists from 494 patients that all met the inclusion criteria. Comprehensive details of the individual studies are presented in the review and in tabular form. Reviewer's conclusions There are many treatment options available to treat de Quervain's disease, including splintage for various lengths of time and in different positions; steroid injections with or without splintage; local electrotherapy and massage and non-steroidal anti-inflammatory drugs (NSAIDs). In this review, splinting has performed poorly in comparison to steroid injections, especially in those patients with more severe symptoms.