After comparison of five treatments in this meta-analysis, the results recommend an initial treatment using a long rigid orthosis and later, short rigid orthosis. The SUCRA score revealed that the long rigid splint is the best choice for pain relief, while the stiff short splint is the best option for decreasing disability.

This meta-analysis focused on finding out the most suitable option among orthoses in patients with osteoarthritis (OA) of the thumb.

Database search included exploring the Embase, Cochrane, Cochrane, ClinicalTrials.gov and PubMed. The randomized controlled trials involving thumb OA concerning any orthosis from the beginning were included. Independent reviewers extracted the data and examined for accuracy and completeness. Pain and function were regarded as the outcomes. Random-effects model was useful for the direct pair-wise associations.

A total of 619 patients in 11 RCT’s were considered. Five groups were assessed for 4 diverse orthoses, namely:

• Short neoprene carpometacarpal splint (Soft CMC, n=1)
• Long neoprene carpometacarpal-metacarpophalangeal splint (Soft CMC-MCP, n=5)
• Short thermoplastic carpometacarpal splint (Rigid CMC, n=5)
• Long thermoplastic carpometacarpal-metacarpophalangeal splint (Rigid CMC-MCP, n=7), and
• Controls (n=5)

As per the results, all splints were found to be superior to placebo in terms of easing pain intensity and the top-ranked intervention was the Rigid CMC-MCP with a SUCRA (surface under the cumulative ranking curve analysis) score of 65.4. A SUCRA score of 71.6 was reported based on the function assessment.

Long thermoplastic splint was a found to be the preeminent choice for pain relief and the short thermoplastic carpometacarpal splint can be regarded as the most appropriate treatment to increase function.