Influence of Custom Orthosis Post Carpometacarpal (CMC) Arthroplasty

Not Applicable

Completed

Brief Summary: This study aims to compare post-surgical outcomes of individuals who receive either a custom orthosis or prefabricated splint after carpometacarpal arthroplasty.

Detailed Description: This research study will randomly assign subjects post CMC arthroplasty to Intervention A (prefabricated splint) or Intervention B (custom orthosis). The orthosis and splint being used in this study are both considered standard practice. Subjects will be provided the splint or orthosis at the first post-operative appointment. Subjects who are assigned to Intervention A will be provided a pre-fabricated splint by a member of the surgical team. Subjects who are assigned to Invention B will be evaluated by an occupational therapist and a custom orthosis will be fabricated. Outcome measures include: QuickDASH, Pain Visual Analogue Scale, active range of motion measurements, the Applied Dexterity portion of the Arthritis Hand Function Test except for the putty cutting task, edema, Sandy Grading Score and the Orthotics and Prosthetics User's Survey (OPUS) Satisfaction with Device and Services. Data will be collected at the first, second, and third post-operative appointment.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

if the surgeon identifies risk factors that would preclude random assignment to the control or experimental group
if subject requests a prefabricated or custom orthosis.

Arm && Interventions

Group	Intervention	Description
Intervention B - custom orthosis	Custom Orthosis	a custom orthosis (wrist splint with thumb spica) is fabricated by an occupational therapist
Intervention A - prefabricated splint	Prefabricated splint	A prefabricated splint is provided to the client

Primary Outcome Measures

Name	Time	Method
Change in Pain Post-operatively Using the Visual Analog Scale (Pain VAS)	11-12 weeks after surgery	The Pain Visual Analog Scale is a self-report measure of pain with a range of 0= no pain - 10 = worst pain. Subjects report pain while using hand.
Change in Wound Dehiscence Post-operatively as Measured by Sandy Grading System	11-12 weeks after surgery	Sandy Grading System is a scale used to measure wound dehiscence. Scale contains 6 grades (I, Ia, II, Ia, III, IIIa). A grade of I indicates no clinical signs of microbiological confirmation of infection and IIIa indicates presence of clinical signs and confirmed microbiological confirmation of infection. The higher number indicates increased presence of infection.

Secondary Outcome Measures

Name	Time	Method
Change in the Amount of Thumb CMC Active Range of Motion Post-operatively	11-12 weeks after surgery	Goniometric measurements for active radial and palmar abduction will determine the amount of active movement. More range indicates better movement (0-50 = radial abduction norms) (0-70 = palmar abduction norms)
Change in Client's Self-report of Hand Function Post-operatively as Measured by the QuickDash Disabilities of Arm, Shoulder, and Hand (QuickDASH)	11-12 weeks after surgery	The QuickDash is a questionnaire about symptoms and ability to perform certain activities. Scores range from 0 (no disability) to 100 (severe disability).
Change in the Degree of Dexterity Post-operatively as Measured by the Applied Dexterity Portion of the Arthritis Hand Function Test	11-12 weeks after surgery	Four of Five items (fasten and unfasten buttons, lace a shoe and tie a bow, pin and unpin two safety pins in a cloth, pick up and manipulate four coins into a slot) will be completed. Each task will be timed. A shorter amount of time indicates better dexterity.