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Functional Assessment of Thumb Spica Cast Immobilization versus Short Arm Cast Immobilization
Lyubov Tsytsikova, MD2; Raghuveer Muppavarapu, MD1, Michael Gottschalk, MD1, Charles Cassidy, MD2; John T. Capo, MD1
1NYU Hospital for Joint Diseases, New York, NY; 2Tufts Medical Center, Boston, MA

Purpose: The purpose of this study is to compare the functional outcome differences between patients with a short arm cast immobilization (SAC) versus forearm based thumb spica short arm cast immobilization (TSC).

Methods: 50 healthy volunteers completed a baseline and post casting typing assessment and a PROMIS short form upper extremity functional scoring assessment. The volunteers were randomly assigned to one of two groups. Participants in group 1 were initially assigned to a TSC of their dominant hand followed by a SAC, while participants in group 2 were initially assigned to a TSC of their non-dominant hand followed by a SAC. The casts were each maintained for 24 hours.

Results: A total of 50 participants were enrolled in the study with 25 in group 1 and 25 in group 2. Clinical characteristics and demographics for each study group were comparable. There was a significant difference between the average PROMIS score and typing speed of participants with SAC compared to participants with TSC (Tables 1 & 2). Table 3 shows that there were differences in the PROMIS scores and typing test results when comparing participants who had undergone casting of dominant hand versus non-dominant hand.

Conclusion: There is a significant difference in functionality of a thumb spica cast immobilization versus a short arm cast immobilization according to the PROMIS functional outcome score. When possible, short arm cast immobilization should be used given the functional deficits associated with thumb spica casting.

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