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Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review

PURPOSE: We provide a systematic review of the current literature regarding best practices in postoperative care following carpometacarpal arthroplasty, and compare these findings to current practices via reported survey data. METHODS: The PubMed, Cochrane, Cumulative Index to Nursing and Allied Hea...

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Autores principales: Barrett, Patrick C., Hackley, Darren T., Samuel, Linsen T., Apel, Peter J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492801/
https://www.ncbi.nlm.nih.gov/pubmed/36157304
http://dx.doi.org/10.1016/j.jhsg.2022.05.011
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author Barrett, Patrick C.
Hackley, Darren T.
Samuel, Linsen T.
Apel, Peter J.
author_facet Barrett, Patrick C.
Hackley, Darren T.
Samuel, Linsen T.
Apel, Peter J.
author_sort Barrett, Patrick C.
collection PubMed
description PURPOSE: We provide a systematic review of the current literature regarding best practices in postoperative care following carpometacarpal arthroplasty, and compare these findings to current practices via reported survey data. METHODS: The PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Science Direct, and Google Scholar databases were searched for relevant studies. English-language articles were included that assessed any aspect of postoperative care, including the immobilization time or rehabilitation strategy. In addition, studies were included that surveyed surgeons and hand therapists on current practices regarding this topic. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. RESULTS: The initial search yielded 3,899 hits. Two systematic reviews were found, along with 5 studies that specifically tested the desired variables of the immobilization duration and type following carpometacarpal arthroplasty. Three relevant surveys were also found. Using the Oxford Centre for Evidence-Based Medicine Level of Evidence guidelines, we found moderate-quality evidence that (1) there is no additional benefit for extended cast immobilization (>6 weeks); and (2) a semirigid orthosis performs as well as a rigid orthosis. We found a lack of evidence regarding formal therapy versus no therapy, and a lack of evidence comparing therapy regimens. When analyzing the survey data, we found wide variation in practices among surgeons and therapists. CONCLUSIONS: Longer immobilization times (>6 weeks) and rigid orthotic devices provide no additional benefit over earlier immobilization and semirigid orthotic devices. There is a lack of evidence for the use of formal hand therapy or any specific rehabilitation protocol. Current practices in these areas vary widely among hand surgeons. CLINICAL RELEVANCE: Practices following carpometacarpal arthroplasty are widely variable, and guidance has previously been lacking. This review compiles the most recent data, as well as identifies gaps in the literature for future studies.
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spelling pubmed-94928012022-09-23 Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review Barrett, Patrick C. Hackley, Darren T. Samuel, Linsen T. Apel, Peter J. J Hand Surg Glob Online Original Research PURPOSE: We provide a systematic review of the current literature regarding best practices in postoperative care following carpometacarpal arthroplasty, and compare these findings to current practices via reported survey data. METHODS: The PubMed, Cochrane, Cumulative Index to Nursing and Allied Health Literature, Science Direct, and Google Scholar databases were searched for relevant studies. English-language articles were included that assessed any aspect of postoperative care, including the immobilization time or rehabilitation strategy. In addition, studies were included that surveyed surgeons and hand therapists on current practices regarding this topic. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. RESULTS: The initial search yielded 3,899 hits. Two systematic reviews were found, along with 5 studies that specifically tested the desired variables of the immobilization duration and type following carpometacarpal arthroplasty. Three relevant surveys were also found. Using the Oxford Centre for Evidence-Based Medicine Level of Evidence guidelines, we found moderate-quality evidence that (1) there is no additional benefit for extended cast immobilization (>6 weeks); and (2) a semirigid orthosis performs as well as a rigid orthosis. We found a lack of evidence regarding formal therapy versus no therapy, and a lack of evidence comparing therapy regimens. When analyzing the survey data, we found wide variation in practices among surgeons and therapists. CONCLUSIONS: Longer immobilization times (>6 weeks) and rigid orthotic devices provide no additional benefit over earlier immobilization and semirigid orthotic devices. There is a lack of evidence for the use of formal hand therapy or any specific rehabilitation protocol. Current practices in these areas vary widely among hand surgeons. CLINICAL RELEVANCE: Practices following carpometacarpal arthroplasty are widely variable, and guidance has previously been lacking. This review compiles the most recent data, as well as identifies gaps in the literature for future studies. Elsevier 2022-07-07 /pmc/articles/PMC9492801/ /pubmed/36157304 http://dx.doi.org/10.1016/j.jhsg.2022.05.011 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Barrett, Patrick C.
Hackley, Darren T.
Samuel, Linsen T.
Apel, Peter J.
Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review
title Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review
title_full Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review
title_fullStr Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review
title_full_unstemmed Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review
title_short Immobilization and Hand Therapy After Carpometacarpal Arthroplasty: A Systematic Review
title_sort immobilization and hand therapy after carpometacarpal arthroplasty: a systematic review
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9492801/
https://www.ncbi.nlm.nih.gov/pubmed/36157304
http://dx.doi.org/10.1016/j.jhsg.2022.05.011
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