Effectiveness of two finger splints for swan neck deformity in patients with rheumatoid arthritis: A randomized, crossover trial†
Article first published online: 30 JUL 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis Care & Research
Volume 61, Issue 8, pages 1025–1031, 15 August 2009
How to Cite
van der Giesen, F. J., van Lankveld, W. J., Kremers-Selten, C., Peeters, A. J., Stern, E. B., Le Cessie, S., Nelissen, R. G. H. H. and Vliet Vlieland, T. P. M. (2009), Effectiveness of two finger splints for swan neck deformity in patients with rheumatoid arthritis: A randomized, crossover trial. Arthritis & Rheumatism, 61: 1025–1031. doi: 10.1002/art.24866
- Issue published online: 30 JUL 2009
- Article first published online: 30 JUL 2009
- Manuscript Accepted: 13 APR 2009
- Manuscript Received: 17 APR 2008
- The Dutch Arthritis Association. Grant Number: 04-2-01
To compare the effectiveness and acceptability of silver ring splints (SRS) and commercial prefabricated thermoplastic splints (PTS) in treating swan neck deformities in patients with rheumatoid arthritis (RA).
Consecutive patients with RA and a mobile swan neck deformity were included in a randomized, crossover trial. In 2 different sequences, patients used both splints for 4 weeks, with a washout period of 2 weeks. Afterward, patients used the preferred splint for another 12 weeks. The primary outcome measure was dexterity measured with the Sequential Occupational Dexterity Assessment (SODA). Secondary outcome measures included other measures of hand function, satisfaction with the splints, and splint preference.
Fifty patients were included, and 47 (94%) of those completed the study. Eighteen patients (36%) had 1 swan neck deformity, whereas the other patients had 2 or more. The improvement of the total SODA score with the SRS (11.2; 95% confidence interval [95% CI] 8.1, 14.3) and PTS (10.8; 95% CI 7.5, 14.1) was similar (difference −0.5; 95% CI −2.2, 1.2). In addition, there were no significant differences in change scores regarding the other clinical outcome measures, or satisfaction. Twenty-four patients preferred the SRS, 21 preferred the PTS, and 2 patients chose neither. A comparison in the 12-week followup period yielded similar clinical outcomes, with the exception of a significantly higher score in 3 items of satisfaction in the SRS group.
For patients with RA and a mobile swan neck deformity, SRS and PTS are equally effective and acceptable.