Volume 15, Issue 3 (2023)                   Iran J War Public Health 2023, 15(3): 257-262 | Back to browse issues page

Print XML PDF HTML Full-Text (HTML)


Rights and permissions
1- “Physiotherapy Research Center” and “Department of Occupational Therapy, School of Rehabilitation”, Shahid Beheshti University of Medical Sciences, Tehran, Iran
* Corresponding Author Address: Department of Occupational Therapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Damvand Street, Tehran, Iran. Postal Code: 1616913111 (mn_kalantari@yahoo.com)
Abstract   (346 Views)
Aims: Congenital hand anomalies are abnormal conditions presented at birth regardless of their cause. These abnormalities may lead to structural or functional disorders in children. The treatment of pediatric hand anomalies has been controversial, and the agreement on the gold standard for the treatment of this malformation in children has yet to be ambiguous.
Information & Methods: The aim of the present study was to review studies on splinting in congenital hand anomalies using ProQuest, PubMed, Scopus, and EMBASE databases published from 1990 to 2023.
Findings: A total of 344 articles were found and finally, 13 articles were reviewed, of which six cases were at evidence level I (one randomized controlled trial (RCT) and five reviews), two cases were at evidence level II,  two cases were at evidence level III, one study was at evidence level IV, and two cases were at evidence level V. The methodological quality assessment of the one and five included RCTs and systematic review studies showed the moderate-to-high quality of the studies based on the scores≥5 using the Physiotherapy Evidence Database (PEDro) and Assessment of Multiple Systematic Reviews (AMSTAR) scales.
Conclusion: The use of a splint alone in the function of the upper limbs of children suffering from congenital hand abnormalities cannot be presented as an effective solution.. The use of splints as the first line of congenital hand anomalies in children can be useful if prescribed during infancy and in some congenital anomalies, such as thumb and radial hand. The best treatment process for children with other hand anomalies is surgery and timely prescription of a splint.

1. Netscher DT, Baumholtz MA. Treatment of congenital upper extremity problems. Plast Reconstr Surg. 2007;119(5):101e-29. [Link] [DOI:10.1097/01.prs.0000258535.31613.43]
2. Goldfarb CA. Congenital hand anomalies: A review of the literature, 2009-2012. J Hand Surg Am. 2013;38(9):1854-9. [Link] [DOI:10.1016/j.jhsa.2013.03.023]
3. Pashmdarfard M, Azad A, Amini M, Golabi G. The effect of splinting after Dupuytren's contracture operation: A systematic review. Iran Rehabil J. 2019;17(4):297-304. [Link] [DOI:10.32598/irj.17.4.297]
4. Sletten IN, Winge MI, Hülsemann W, Arner M, Hansen KL, Jokihaara J. Inter-and intra-rater reliability of the Oberg-Manske-Tonkin classification of congenital upper limb anomalies. J Hand Surg Eur Vol. 2022;47(10):1016-24. [Link] [DOI:10.1177/17531934221107264]
5. Goldfarb CA, Ezaki M, Wall LB, Lam WL, Oberg KC. The Oberg-Manske-Tonkin (OMT) classification of congenital upper extremities: Update for 2020. J Hand Surg. 2020;45(6):542-7. [Link] [DOI:10.1016/j.jhsa.2020.01.002]
6. Lowry RB, Bedard T, Kiefer GN, Sass KR. Views on the Oberg-Manske-Tonkin classification system for congenital anomalies of the hand and upper limb. J Hand Surg Am. 2017;42(5):378-81. [Link] [DOI:10.1016/j.jhsa.2017.02.018]
7. Carlsson IK, Dahlin LB, Rosberg HE. Congenital thumb anomalies and the consequences for daily life: Patients' long-term experience after corrective surgery. A qualitative study. Disabil Rehabil. 2018;40(1):69-75. [Link] [DOI:10.1080/09638288.2016.1243159]
8. Clelland AD, Duncan Ó, Lam WL. The importance of embryology for parents of children with congenital hand differences. J Hand Surg Eur Vol. 2022;47(5):475-80. [Link] [DOI:10.1177/17531934211064185]
9. Dahan E, Chaves C, Bachy M, Fitoussi F. Upper limb congenital muscular hypertrophy and aberrant muscle syndrome in children. J Hand Surg Eur Vol. 2018;43(7):751-5. [Link] [DOI:10.1177/1753193418774459]
10. Wade DT, Halligan PW. The biopsychosocial model of illness: A model whose time has come. Clin Rehabil. 2017;31(8):995-1004. [Link] [DOI:10.1177/0269215517709890]
11. Basu AP, Pearse J, Kelly S, Wisher V, Kisler J. Early intervention to improve hand function in hemiplegic cerebral palsy. Front Neurol. 2015;5:281. [Link] [DOI:10.3389/fneur.2014.00281]
12. Amini M, Moosavi S, Shamily A, Kazemi R, Qorbani M, Pashmdarfard M. Impact of extension splint on upper extremity motor components and function in chronic stroke patients. Iran Rehabil J. 2014;12(19):18-21. [Link]
13. Wang AM, Kim M, Ho ES, Davidge KM. Surgery and conservative management of camptodactyly in pediatric patients: A systematic review. Hand. 2020;15(6):761-70. [Link] [DOI:10.1177/1558944719834654]
14. Papadogeorgou EV, Soucacos PN. Treatment alternatives of congenital hand differences with thumb hypoplasia involvement. Microsurgery. 2008;28(2):121-30. [Link] [DOI:10.1002/micr.20463]
15. Jung HJ, Lee JS, Song KS, Yang JJ. Conservative treatment of pediatric trigger thumb: Follow-up for over 4 years. J Hand Surg Eur Vol. 2012;37(3):220-4. [Link] [DOI:10.1177/1753193411422333]
16. Lieberman D, Scheer J. AOTA's evidence-based literature review project: An overview. Am J Occup Ther. 2002;56(3):344-9. [Link] [DOI:10.5014/ajot.56.3.344]
17. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1-9. [Link] [DOI:10.1186/2046-4053-4-1]
18. Rysavy M. Evidence-based medicine: A science of uncertainty and an art of probability. Virtual Mentors. 2013;15(1):4-8. [Link] [DOI:10.1001/virtualmentor.2013.15.1.fred1-1301]
19. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358. [Link] [DOI:10.1136/bmj.j4008]
20. Cashin AG, McAuley JH. Clinimetrics: Physiotherapy Evidence Database (PEDro) Scale. J Physiother. 2019;66(1):59. [Link] [DOI:10.1016/j.jphys.2019.08.005]
21. Sakzewski L, Ziviani J, Boyd R. Systematic review and meta-analysis of therapeutic management of upper-limb dysfunction in children with congenital hemiplegia. Pediatrics. 2009;123(6):e1111-22. [Link] [DOI:10.1542/peds.2008-3335]
22. Lake A. Hand therapy for children with congenital hand differences. Tech Hand Up Extrem Surg. 2010;14(2):78-84. [Link] [DOI:10.1097/BTH.0b013e3181d79f2e]
23. O'Flaherty P. Arthrogryposis multiplex congenita. Neonatal Network. 2001;20(4):13-20. [Link] [DOI:10.1891/0730-0832.20.4.13]
24. Smith DW, Drennan JC. Arthrogryposis wrist deformities: Results of infantile serial casting. J Pediatr Orthopaedics. 2002;22(1):44-7. [Link] [DOI:10.1097/01241398-200201000-00011]
25. Ho ES, Roy T, Stephens D, Clarke HM. Serial casting and splinting of elbow contractures in children with obstetric brachial plexus palsy. J Hand Surg. 2010;35(1):84-91. [Link] [DOI:10.1016/j.jhsa.2009.09.014]
26. Rogers BH, Schmieg SL, Pehnke ME, Shah AS. Evaluation and management of preaxial polydactyly. Curr Rev Musculoskeletal Med. 2020;13:545-51. [Link] [DOI:10.1007/s12178-020-09644-w]
27. Lee ZL, Chang CH, Yang WY, Hung SS, Shih CH. Extension splint for trigger thumb in children. J Pediatr Orthopaedics. 2006;26(6):785-7. [Link] [DOI:10.1097/01.bpo.0000235396.57160.f1]
28. Zucker RM, Cleland HJ, Haswell T. Syndactyly correction of the hand in Apert syndrome. Clin Plast Surg. 1991;18(2):357-64. [Link] [DOI:10.1016/S0094-1298(20)30827-0]
29. Kennedy SM. Neoprene wrist brace for correction of radial club hand in children. J Hand Ther. 1996;9(4):387-90. [Link] [DOI:10.1016/S0894-1130(96)80046-9]
30. Lin N SC, Huang TH, Hsu HY, Lin CJ, Chiu HY. A simple splinting method for correction of supple congenital clasped thumbs in infants. J Hand Surg. 1999;24(5):612-4. [Link] [DOI:10.1054/JHSB.1999.0203]
31. Katić D, Anticević D, Grgurev S, Jukica M, Katić M. Splinting in arthrogryposis multiplex congenita. Lijecnicki Vjesnik. 2002;124(3-4):77-81. [Link]
32. Durlacher KM, Verchere C, Zwicker JG. Parents' experiences of splinting programs for babies with congenital limb anomalies. J Pediatr Rehabil Med. 2015;8(3):207-17. [Link] [DOI:10.3233/PRM-150337]
33. Ho ES, Bradley CS, Borschel GH, Kelley SP. Rehabilitation post-distraction osteogenesis for brachymetacarpia: A case report. Strategies Trauma Limb Reconstruction. 2018:1-5. [Link] [DOI:10.1007/s11751-018-0315-0]
34. Zhou X, Zhang Y, Zhao M, Jian Y, Huang J, Luo X, et al. Surgical management of hand deformities in patients with recessive dystrophic epidermolysis bullosa. J Plast Surg Hand Surg. 2020;54(1):33-9. [Link] [DOI:10.1080/2000656X.2019.1661846]