Study finds no significant difference between dynamic and turnbuckle methods

Does the method of splinting used to treat elbow stiffness make a difference in outcomes? Not according to a study presented by Anneluuk L.C. Lindenhovious, MSc, at the 6th Biennial AAOS/American Shoulder and Elbow (ASES) Meeting. In comparing preliminary outcomes of dynamic and static progressive (turnbuckle) methods of splinting, her research team found no significant differences in either flexion arc or Disabilities of the Arm, Shoulder and Hand (DASH) scores.

Ms. Lindenhovious, along with Job N. Doornberg, PhD; Jesse B. Jupiter, MD; Chaitanya S. Mudgal, MD; and David C. Ring, MD, PhD, followed 54 patients with posttraumatic elbow stiffness through a progressive, randomized trial.

The static progressive cohort included 31 patients; the dynamic cohort included 23 patients. All patients were evaluated using the Mayo Elbow Performance Index and the DASH questionnaire at enrollment and 3, 6, and 12 months later.

The results presented by Ms. Lindenhovious represented data based on 23 patients in the static progressive group and 16 patients in the dynamic group who had completed at least 6 months follow-up.

During the course of the study, seven patients had surgery (one from the dynamically splinted cohort and six from the statically splinted cohort). Two patients from the dynamic group asked to be switched to static progressive splinting. The researchers’ analysis was conducted based on the intention-to-treat.

Among the patients who had at least 6 months follow-up, researchers found no significant differences in scores at any time (Table 1). Based on those results, Dr. Lindenhovious concluded that the difference between using static progressive and dynamic splint protocols is insignificant, and the option can be left to patients and their physicians.

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Peter Pollack is a staff writer for AAOS Now. He can be contacted at ppollack@aaos.org