A modified spica-splint in postoperative early-motion management of skier’s thumb lesion

Rupture of ulnar collateral ligament of the thumb (UCL) represents a common injury of the hand. Surgical repair is thought to be the gold standard but postoperative immobilization causes partial stiffness in a percentage of cases. This paper’s objective was to assess the effectiveness of a postoperative functional hand-based splint for the thumb which allows immediate postoperative motion. A randomized prospective clinical trial was carried out at the Orthopedics and Hand Surgery Unit of The Catholic University School of Medicine, Rome, Italy. Thirty consecutive patients, with a diagnosis of acute complete tear of the UCL, were chosen to be treated surgically (predominantly men, mean age 39). Cases presenting associated injuries weren’t included. Patients were randomized postoperatively into 2 groups of 15 (one using the new splint and the other using a standard spica splint). Following four weeks of splinting, clinical outpatient evaluations were carried on (at one, two, six, twelve months) on both groups to evaluate: joint stability; pain; pinch strength; range of motion; time lost from work; sessions of physiotherapy. Results: Immediate postoperative motion of the operated joint produced faster and better functional results. No cases of recurrence were recorded.

The study found that surgical repair, administered with active metacarpophalangeal motion allowed by the new functional splint, was effective, safe and well tolerated. The treatment improved the patients’ function and reduced the time of functional recovery, the reported treatment presents possible advantages in the management of this frequent acute hand injury.

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