"Our findings support nonsurgical treatment as the first treatment choice and suggest that treatment effects are sustainable" in patients with problems in the thumb carpometacarpal joint, said study author Lisa Esteban Lopez, of University Medical Center Rotterdam in the Netherlands.therapy. Surgery can be considered if these don't work, but it costs a lot, requires lengthy rehabilitation and outcomes vary.
Nonsurgical treatment focused on the use of orthotics, physical therapy sessions focused on exercises, achieving more stable thumb opposition and daily homeIn an initial analysis of 134 patients who did not have surgery, most improvements happened in the first three months. But from 12 months to over five years, there was "clinically relevant" improvement in standardized scores, as well as in scores for overall hand function and workability.
About 16% of patients rated the outcomes of nonsurgical treatment as excellent, 39% said they were good, 26% answered fair and 14% said moderate. Only 5% reported poor outcomes. About 71% of patients said they would be willing to undergo the same treatment again under similar circumstances. The authors also evaluated rates of subsequent surgery in a larger sample of 217 patients. At a median follow-up of seven years, 22% decided to get surgical treatment.The findings, published online Oct. 30 insupport current recommendations for initial nonsurgical treatment.or limitations in ADL after 12 months in patients undergoing nonsurgical treatment," the researchers said in a journal news release.
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