E-poster considering successful early mobilization following surgery of the base of the thumb, presented at the IFSSH & IFSHT Triennal Congress 2016 at Buenos Aires.

1. Standarised hand therapy
following surgery of the base of
the thumb: a case-serie
K. van Pelt – Dieleman MSc / OT / CHT-NL
T. Zaadnoordijk PT / HT
Noordwest Ziekenhuisgroep & Fysio-Langedijk
The Netherlands

2. Objective
To investigate functional outcomes of
standarized hand therapy after
carpometacarpal (CMC-I) arthroplasty
(Burton-Pellegrini procedure)
K. van Pelt-Dieleman

3. Methods
 Retrospective study of 30 patients treated with a standarized
hand therapy protocol after CMC-I arthroplasty
 Primary outcome measures: pain (VAS 0-10), functional use
of the hand (DASH-DLV/VAS 0-10) and patient’s level of
independence (VAS 0-10)
 Secondary outcome measures: active and passive ROM of
palmar/radial abduction CMC-I, flexion/extension MCP-I,
flexion/extension IP, Kapandji score, grip strength, pinch
strength
K. van Pelt-Dieleman

4. Methods
Protocol:
 Pre-operative screening 4 weeks before surgery
 Post-operative immobilization for 2 weeks with removable thumb
spica cast (without IPjoint)
 Post-operative hand therapy:
 2 – 4 weeks: gentle pinch exercises
4 – 6 weeks: splint withdrawal, resistive exercises, mobilisations
6 – 12 weeks: strenghtening exercises to enable activities
 Data collection: pre-operative (T0), 6 weeks (T1) and 12 weeks (T2)
K. van Pelt-Dieleman

5. Results
K. van Pelt-Dieleman

6. Limitations
K. van Pelt-Dieleman
• Retrospective study design
• Small sample size (N=30)
• Missing data (35%)
• Complete cases 33% (N=10)

7. Summary
All complete cases showed an increase of
functionality and independance without increasing
pain
Standarized hand therapy with early mobilisation
might be a better protocol compared to an
immobilization period of 4 to 6 weeks
K. van Pelt-Dieleman

8. References
K. van Pelt-Dieleman
• Burton RI, Pellegrini VD Jr. (1986) Surgical management of basal
joint arthritis of the thumb. Part II. Ligament reconstruction with
tendon interposition arthroplasty, Journal of Hand Surgery, 11A,
pp. 324 –332
• van Pelt-Dieleman, K (2014) Postoperative treatment protocol
after CMC-I arthroplasty. Rehabilitation Department, Noordwest
Ziekenhuisgroep,The Netherlands
• Wajon A, Carr E, Edmunds I, Ada L (2009) Surgery for thumb
(trapeziometacarpal joint) osteoarthritis (Review), The Cochrane
Collaboration. Published by John Wiley & Sons, Ltd.