Evaluating Patient Compliance With Woodcast and Thermoplast Splints After Thumb Carpometacarpal Arthroplasty: A Randomized Controlled Trial

BACKGROUND: This study evaluated the efficacy of woodcast (WC) versus thermoplastic (TP) splints for postoperative immobilization following carpometacarpal (CMC) joint suspensionplasty. The hypothesis was that WC splints would provide improved efficacy and compliance compared with TP splints, while also reducing waste generation. METHODS: A prospective, randomized controlled trial enrolled 26 patients, all older than 18 years old, undergoing CMC joint suspensionplasty. Participants were randomized to receive postoperative splinting with either a WC or TP splint. Exclusion criteria included additional procedures on the same arm or surgeon-determined unsuitability. Outcomes assessed included patient comfort, compliance, satisfaction, complication rates, and quantity of waste material generated by each splint type. RESULTS: The TP group demonstrated higher splint compliance and fewer splint-related complications than the WC group. Both groups reported similar satisfaction concerning their splints and overall treatment. However, the WC group generated significantly less waste (3.14 ± 1.38 g) compared with the TP group (20.88 ± 9.64 g), an 85% reduction. Functional outcome scores (Quick Disabilities of Arm, Shoulder, and Hand, Patient-Rated Wrist Evaluation, visual analog scale) were similar between groups at all time points. CONCLUSIONS: Thermoplastic splinting resulted in greater compliance and fewer complications but generated substantially more waste than WC splinting. As both splint types yielded comparable functional outcomes, the choice of splinting material should account for therapist expertise and health care waste considerations. The findings support exploring alternative biodegradable splint materials that support waste management without compromising patient care.Randomized Controlled Trial: ClinicalTrials.gov ID: NCT06876350.