Clinical Study of the Conservative Treatment for Thumb Carpometacarpal Joint Osteoarthritis

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  • 母指CM関節症の保存的治療
  • ボシ CM カンセツショウ ノ ホゾンテキ チリョウ

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<p>Objective: Patients with osteoarthritis of the thumb carpometacarpal (CM) joint should initially be treated conservatively such as with splinting, non-steroidal anti-inflammatory drugs, intra-articular injection of steroids, and modification of patient activities. The purpose of this paper was to investigate the results of those conservative treatments.</p><p>Methods: One hundred and thirty six joints of 127 patients were divided into three groups-an injection group (75 joints), a splinting group (short opponens type; 28 joints), and a combined injection/splinting group (33 joints). The patient records were examined retrospectively at the mean follow-up period of 3 years and 7 months. The results were evaluated due to the degree of pain and functional disturbance in activities of daily living.</p><p>Results: In the injection group, 52% reported “excellent” and 22% reported “good”. Thirty-nine percent of the splinting group and 24% of the combined injection/splinting group reported “excellent” whereas 14% and 18% of the respective groups reported “good”.</p><p>According to the statistical analysis, the injection group obtained better results than the combined injection/splinting group; the older group (above 61 years old) did better than the younger group (below 60 years old). In cases of Eaton stage 1, the injection group showed better results than the other groups. There was no significant difference among the three treatment groups in stage 2 and stage 3. Splinting did not show significant effectiveness because the splint was hard and uncomfortable to wear. Other factors such as occupation, the number of injections and the period of wearing the splint did not statistically affect the clinical results.</p><p>Conclusion: Corticoteroid injection is useful in the early stages of arthritis. Splinting is also effective, but comfort and the ease of use for patients is important, and may be limited by the use of such a device.</p>

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