Article

OBJECTIVE: To investigate which orthosis results in (1) fewer complications; (2)
the least extensor lag; and (3) the highest rates of treatment success according
to the Abouna and Brown criteria for soft tissue mallet injury in adults. DATA SOURCES: Electronic databases AMED, CINAHL, Embase, MEDLINE, PubMed, OTseeker,
and PEDro were searched from the earliest available date until September 16, 2014.
STUDY SELECTION: Controlled trials evaluating orthosis type in the conservative management of mallet injury were included. Database searching
yielded 1024 potential studies, of which 7 met inclusion criteria with a total of
491 participants. DATA EXTRACTION: Data were extracted using an author-designed
extraction form by one reviewer, and accuracy was assessed by a second reviewer.
The PEDro scale was used to assess methodological quality. DATA SYNTHESIS:
Results were pooled using a random-effects model with inverse variance methods.
Dichotomous outcomes are expressed as risk ratios (RRs) and 95% confidence
intervals (CIs) and continuous outcomes as standardized mean differences and 95%
CIs. There is moderate quality evidence that prefabricated orthoses had 3 times
the risk of developing skin complications as compared with all other orthoses
(RR, 3.17; 95% CI, 1.19-8.43; I(2)=47%) and nearly 7 times the risk of developing
skin complications as compared with custom-made thermoplastic orthoses (RR, 6.72;
95% CI, 1.59-28.46; I(2)=0%). Treatment outcomes were found to be similar for
treatment success when prefabricated orthoses were compared with custom-made
orthoses (RR, .99; 95% CI, 0.80-1.22; I(2)=39%; very low quality evidence), as
well as for extensor lag when custom-made thermoplastic orthoses were compared
with other orthoses (standardized mean difference, .03; 95% CI, -.29 to .36;
I(2)=0%; moderate quality evidence). CONCLUSIONS: Prefabricated orthoses were
found to increase the risk of developing skin complications as compared with
custom-made orthoses, but there were no differences in treatment success,
failure, or extensor lag.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS