Discover the transformative power of orthotic interventions in enhancing joint motion for those suffering from hand injuries, as we delve into the latest systematic review and meta-analysis findings.
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Orthotic interventions for restoring proximal interphalangeal joint motion for patients with hand injuries or conditions: A systematic review and meta-analysis.
Yates et al., J Hand Ther 2024
DOI: 10.1016/j.jht.2023.12.018
Summary of Findings:
The study conducted a systematic review to assess the effectiveness of orthotic interventions in improving proximal interphalangeal joint (PIPJ) motion following hand injuries or conditions. The review included twelve trials with a methodological quality score ranging from 4 to 7 out of 10. The key findings are:
- For Dupuytren’s release, orthotic intervention did not show additional benefits over hand therapy alone in terms of:
- Total active extension (mean difference [MD] -2.8°, 95% CI: -9.6° to 4.0°, p = 0.84)
- Total active flexion (MD -5.8°, 95% CI: -12.7° to 1.2°, p = 0.70)
- Disability of the Arm, Shoulder and Hand scores (MD 0.4, 95% CI: -2.7 to 3.6, p = 0.79)
- Patient satisfaction (standardized MD 0.20, 95% CI: -0.49 to 0.09, p = 0.17)
- For traumatic PIPJ fixed flexion deformities, orthotic intervention was more effective than hand therapy alone in improving PIPJ extension (MD -16.7°, 95% CI: -20.1° to -13.3°, p < 0.001).
- No studies evaluated orthotic intervention for improving PIPJ flexion.
Importance: This review highlights that orthotic intervention is beneficial for PIPJ extension in cases of traumatic finger injury or surgery but not for Dupuytren’s contracture when compared to hand therapy alone. It also identifies a gap in the literature regarding the effectiveness of orthotics for PIPJ flexion.
Contribution to Literature: The study provides evidence-based guidance on the use of orthotic intervention for PIPJ motion improvement, which is crucial for hand function, and suggests directions for future research.