A Study Comparing Use and Effects of Custom-Made versus Prefabricated Splints for Swan Neck Deformity in Patients with Rheumatoid Arthritis

This study investigates the use of custom-made and prefabricated splints for swan neck deformities in rheumatoid arthritis. The splints were compared on the variables cosmesis, comfort, functional use and wearing time per 24 hours. Effects on stability, grip strength and mobility were also recorded. 18 patients, divided into two groups of nine patients each, were involved. During a three-month period one group used custom-made splints while the other group used prefabricated splints. Then the first group changed to prefabricated splints for another three-month period and the second group changed to custom-made splints. The outcome of this study indicates that using a splint increases finger stability significantly (p< 0.014) and passive extension of the distal interphalangeal (DIP) joint (mean ± SD 3.33° ± 6.41; p= 0.042). The flexed position of the DIP joint was found to decrease significantly (mean ± SD 4.72° ± 6.96; p=0.010). These results were not dependent on the type of splint. The prefabricated splint was worn during longer periods of time and scored higher for cosmesis (p<0 .0001). Used as a first splint the prefabricated splint scored higher for comfort (p <0 .011). The overall conclusion from this study is that the prefabricated splints are tolerated better and more acceptable in terms of wear then the custom-made splints.