Five studies (524 symptomatic wrists from 494 patients) were included in the review: three prospective trials, one retrospective study and one case study.
The overall quality of the trials was poor, with four studies scoring only 3 out of a maximum of 10 points, and one study scoring just 2 points. Only one study used randomised methods of allocation; none of the studies stated whether they used concealed allocation methods; one used an intention-to-treat analysis; none of the studies blinded the participants, assessors or treatment providers; two studies failed to use comparable study populations and valid or reliable outcome measures. All but one study failed to state inclusion and exclusion criteria, but only one failed to use appropriate follow-up.
Two out of three studies comparing splinting with steroid injection found that steroid injections led to a greater improvement in symptoms compared with splinting alone, but failed to find any statistically significant differences in pain relief. Both studies of splinting combined with NSAIDs found the intervention to be effective in terms of symptom relief or improvement, but one study found the intervention to be less effective in patients with more severe symptoms. One study comparing splinting and steroid injection with splinting alone and steroid injection alone found that statistically higher rates of success were associated with steroid injection alone. One study of splinting plus NSAIDs with no control group found that 62% of patients had satisfactory results with the combined intervention.