American Association for Hand Surgery

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Patient Satisfaction for Post-Operative Carpometacarpal Arthroplasty: Woodcasting Versus Thermoplastic Splint
Tantien Nguyen, BS1, Victor T. Hung, M.D.2, Joshua U Hancock, BS1, Daniel Bailey, M.D.3, Tien Nguyen, BS1, Alfred Vincent Hess, MD4; Michael C Doarn, MD5
(1)Foundation For Orthopaedic Research and Education, Tampa, FL, (2)Foundation for Orthopaedic Research and Education, Tampa, FL, (3)University of South Florida Health Morsani College of Medicine, Tampa, FL, (4)Orthopedic Surgery/ Hand and Wrist, Florida Orthopaedic Institute, Tampa, FL, (5)Hand and Upper Extremity Surgery, Florida Orthopaedic Insititue, Tampa, FL

  • Introduction: State the problem and the purpose of the study.
    • Orthopaedic care, especially in hand and upper extremity clinics, generates considerable waste, with standard post-carpometacarpal (CMC) joint arthroplasty treatment often utilizing non-recyclable thermoplastic splints. With growing environmental concerns, this study evaluates whether removable, recyclable woodcasting orthoses can improve patient comfort and compliance while reducing waste and environmental impact. The study investigates and compares woodcasting (WC) versus thermoplast (TP) splinting in regard to patient preference and amount of waste produced in patients that underwent CMC joint arthroplasty.
  • Methods: Describe what was actually done.
    • This is a prospective, non-blinded clinical study involving patients undergoing CMC arthroplasty surgeons (AH, MD) at a single institution between 2024 and 2025. Prior to surgery, all participants completed the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire to establish a baseline for comparison throughout the study. Patients returned for follow-up at two weeks postoperatively to receive their assigned type of immobilizer (woodcast or thermoplast). During the six-week follow-up, they completed patient satisfaction and compliance surveys and were invited to provide additional comments regarding their splint. The satisfaction survey comprised three questions, each scored from 1 (no satisfaction at all) to 5 (extremely satisfied), for a maximum total score of 15. The compliance survey included four questions, also scored from 1 (not at all) to 5 (all the time), for a maximum total score of 20.
  • Results: Report the findings of the study.
    • The woodcast group and the thermoplast group had equivalence in splint satisfaction, treatment satisfaction, splint compliance, and QuickDASH scores. The woodcast group produced significantly less waste when compared to the thermoplast group (p=0.0001).
  • Conclusion: Woodcasting significantly reduced waste during orthosis fabrication, with patient preference and compliance similar to thermoplastic splints. Clinics with thermoplastic-trained therapists can use either option, while woodcasts are a practical, insurance-covered alternative for settings without such expertise, offering secure immobilization, less waste, and comparable patient outcomes.



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