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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Related Experiment Video

Updated: May 10, 2026

C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
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Can we avoid casting for suspected scaphoid fractures? A multicenter randomized controlled trial.

Abigael Cohen1, Max Reijman2, Gerald A Kraan3

  • 1Department of Orthopaedics and Sport Medicine, Erasmus MC University Medical Center, PO box 2040, 3000 CA, Rotterdam, The Netherlands. a.cohen.1@erasmusmc.nl.

Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
|March 5, 2025
PubMed
Summary
This summary is machine-generated.

Bandaging is a suitable alternative to casting for suspected scaphoid fractures with normal initial X-rays. This approach avoids overtreatment and yields comparable functional outcomes at three months.

Keywords:
AdultsBoneFracturesPatient-reported outcome measuresScaphoid boneWrist injuries

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Area of Science:

  • Orthopedic surgery
  • Traumatology
  • Evidence-based medicine

Background:

  • Suspected scaphoid fractures with normal radiographs often lead to overtreatment with casting.
  • Only 10% of patients with these symptoms actually have a scaphoid fracture.
  • Evaluating non-operative alternatives like bandaging can reduce unnecessary casting.

Purpose of the Study:

  • To compare functional outcomes of bandaging versus casting for suspected scaphoid fractures with normal initial radiographs.
  • To determine if bandaging is noninferior to casting in terms of functional recovery.

Main Methods:

  • A multicenter randomized controlled trial included adults with suspected scaphoid fractures and normal initial radiographs.
  • Patients were randomized to receive either 3-day bandaging or 2-week casting.
  • Functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) score at 3 months, alongside other patient-reported outcomes and physical examinations.

Main Results:

  • Bandaging was found to be noninferior to casting for functional outcomes at 3 months (adjusted estimated difference QDASH score 0.30).
  • No significant differences were observed in most patient-reported function and pain scores between the two groups.
  • The bandaging group showed better range of motion at 2 weeks and higher patient satisfaction.

Conclusions:

  • Casting can be avoided in cases of suspected scaphoid fractures with normal initial radiographs.
  • Bandaging is a viable alternative treatment option, particularly when patients are reassessed after two weeks.
  • This approach helps reduce overtreatment and improve patient satisfaction.