Thumb carpometacarpal joint immobilization orthosis

Background: A new design of thumb carpometacarpal joint immobilization orthosis for positioning and improving hand function. This orthosis stabilizes the thumb in the desired position when thenar muscles are weakened, first carpometacarpal joint pain, deformities, or other thumb problems. This orthosis frees the dorsum of the hand, covers the palm, curves and conforms to the thenar web space, and holds the thumb in opposition. Objective: To study compliance and acceptance of patients with the new design thumb carpometacarpal joint immobilization orthosis that is easy to fabricate and reduces cost. Materials and methods: This pilot study was set at the Occupational Therapy Unit, Department of Rehabilitation Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University. All twelve patients, including seven of first carpometacarpal joint arthritis, two Syringomyelia, two median nerve injuries, and one cerebral palsy, were asked to fill out a questionnaire designed for hand function and activities of daily living. In contrast, the thumb carpometacarpal joint immobilization orthosis was fabricated. After the patient had worn the new design orthosis for two weeks, they were asked to complete two questionnaires. One was hand function and activities of daily living, and the other was five items of patients’ satisfaction with thumb carpometacarpal joint immobilization orthosis that was found out from the factors related to compliance with hand orthosis. Results: After two weeks, all patients who applied a thumb carpometacarpal joint immobilization orthosis could improve the quality of writing, open doors, and pick up small coins. They all accepted thumb carpometacarpal joint immobilization orthosis to take turns applying with thumb spica because free space at the dorsum of the hand permitted them to move more flexibly with excellent support at the first carpometacarpal joint, letting them tolerate long-term activities. Conclusion: The new thumb carpometacarpal joint immobilization orthosis focuses on thumb opposition and allows free movement of the wrist and metacarpophalangeal joints, especially in the case of carpometacarpal joint arthritis who do not have a weak thumb. It can be substituted for another thumb opposition orthosis because of easy fabrication and reduced cost.