Authors (including presenting author) :
Lam YC, Lui WY, Wong MF, Hui N
Affiliation :
Occupational Therapy Dept., United Christian Hospital
Introduction :
Ulnar wrist pain is a common problem encountered by many patients. It can affect an individual in all aspects of life. Patients may suffer from an aggravated pain in various daily activities, for instance, pushing themselves up from chairs, wringing towels for grooming, pushing a heavy door, heavy pushing or lifting at work. Different designs of static splints were used in treating this group of patients. Yet, patients often had poor compliance to these rigid splints at work due to discomfort.
To improve the clinical outcomes and patient satisfaction, the DRUJ wrist band was developed. It is a newly designed soft working splint made up of neoprene, velcro hooks and metal D-rings. It stabilizes the distal radioulnar joint (DRUJ) in wrists and provides support to patients during daily activities and at work.
Objectives :
To evaluate the effectiveness of the DRUJ wrist band by comparing the clinical outcomes before and after the splint prescription.
Methodology :
Retrospective review of 20 patients with DRUJ wrist bands prescribed were conducted from 1/2/2023 to 1/10/2024. Their diagnoses are mainly ulnar wrist pain, DRUJ instability and TFCC degeneration. Patients were given a DRUJ wrist band during initial assessment and instructed to apply it during daytime at work. Grip strength and weight bearing test were measured with and without a DRUJ wrist band. While grip strength assesses the maximum force exerted by hand using a dynamometer, weight bearing test measures the amount of loads one can place on a table-top weighing scale through an arm within pain tolerance. Patients were assessed upon initial assessment and final evaluation at around 6-8 weeks. A pair sample T-test or Mann-Whitney U test were used for statistical analysis depending on the data distribution.
Result & Outcome :
During initial assessment, the weight bearing test results were significantly better with a DRUJ wrist band, compared to not applying the wrist band. During final evaluation, both grip strength and weight bearing test results were significantly better with the DRUJ wrist band. Even without a wrist band, their weight bearing tolerance was significantly higher upon final evaluation. This may contribute to the increased DRUJ stability after applying the wrist band during the intervention period.
Patients showed good compliance and adherence to the DRUJ wrist band. With its effectiveness and comfortable design, patients were highly satisfied. After the use of wrist band, their ADL and work performance improved with reduced pain and struggles. It provides a better treatment option to patients and improves the quality of patient care.
The newly designed DRUJ wrist band was effective in improving the grip strength and pain tolerance of patients with ulnar wrist pain. This result correlates with the findings of previous researchers (Shin et al., 2022; Khuyabaatar et al., 2019). By reducing the dorsal-volar translation of radius and ulna, the DRUJ will be more stabilized. With the new design, patients showed better compliance and satisfaction towards the treatment with improved functional performance. In future, further study with a larger sample size, a specific timeframe and more outcome measures will be needed to validate the results.
