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Meta-Analysis
. 2024 Feb 21;25(1):163.
doi: 10.1186/s12891-024-07230-6.

Are there any benefits for post-operative splinting after carpal tunnel release? A systematic review and meta-analysis

Uchenna I Peter-Okaka  1 , Samira Shiri  2 , Oluwafemi Owodunni  3 , Seyed Reza Bagheri  4 , Amir Jalilian  5 , Cynthia Uzoukwu  6 , Sonia Eden  7 , Ehsan Alimohammadi  8
Affiliations
Meta-Analysis

Are there any benefits for post-operative splinting after carpal tunnel release? A systematic review and meta-analysis

Uchenna I Peter-Okaka et al. BMC Musculoskelet Disord. .

Abstract

Background: There is a controversy on the effectiveness of post-operating splinting in patients with carpal tunnel release (CTR) surgery. This study aimed to systematically evaluate various outcomes regarding the effectiveness of post-operating splinting in CTR surgery.

Methods: Multiple databases, including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane, were searched for terms related to carpal tunnel syndrome. A total of eight studies involving 596 patients were included in this meta-analysis. The quality of studies was evaluated, and their risk of bias was calculated using the methodological index for non-randomized studies (MINORS) and Cochrane's collaboration tool for assessing the risk of bias in randomized controlled trials. Data including the visual analogue scale (VAS), pinch strength, grip strength, two-point discrimination, symptom severity score (SSS), and functional status scale (FSS) were extracted.

Results: Our analysis showed no significant differences between the splinted and non-splinted groups based on the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. The calculated values of the standardized mean difference (SMD) or the weighted mean difference (WMD) and a 95% confidence interval (CI) for different variables were as follows: VAS [SMD = 0.004, 95% CI (-0.214, 0.222)], pinch strength [WMD = 1.061, 95% CI (-0.559, 2.681)], grip strength [SMD = 0.178, 95% CI (-0.014, 0.369)], SSS [WMD = 0.026, 95% CI (- 0.191, 0.242)], FSS [SMD = 0.089, 95% CI (-0.092, 0.269)], and the two-point discrimination [SMD = 0.557, 95% CI (-0.140, 1.253)].

Conclusions: Our findings revealed no statistically significant differences between the splinted and non-splinted groups in terms of the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. These results indicate that there is no substantial evidence supporting a significant advantage of post-operative splinting after CTR.

Keywords: Carpal tunnel release; Functional status scale; Postoperative care; Splinting; Symptom severity score.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow-diagram showing summary of literature review
Fig. 2
Fig. 2
Forest plot of standardized mean difference (SMD) of the four included studies investigating VAS between the splinted and the non-splinted groups
Fig. 3
Fig. 3
Forest plot of weighted mean difference (WMD) of the three included studies investigating pinch strength between the splinted and the non-splinted groups
Fig. 4
Fig. 4
Forest plot of standardized mean difference (SMD) of the four included studies investigating grip strength between the splinted and the non-splinted groups
Fig. 5
Fig. 5
Forest plot of weighted mean difference (WMD) of the three included studies investigating SSS between the splinted and the non-splinted groups
Fig. 6
Fig. 6
Forest plot of standardized mean difference (SMD) of the three included studies investigating FSS between the splinted and the non-splinted groups
Fig. 7
Fig. 7
Forest plot of weighted mean difference (WMD) of the three included studies investigating two-points discrimination between the splinted and the non-splinted groups
See this image and copyright information in PMC

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