Methodology: 4/5
Usefulness: 3/5
Cohen A, et al. J Orthop Traumatol. 2025 Mar 5;26(1):14. doi: 10.1186/s10195-025-00822-5.
Question and Methods: Authors tested if bandaging was noninferior to casting for suspected scaphoid fractures by conducting a multicenter RCT with 180 adult patients.
Findings: Bandaging was noninferior to casting for QDASH at 3 months: 8.7 vs 6.5 (adjusted estimated difference QDASH score 0.30 (95% CI: -0.02 to 0.62). No scaphoid nonunions. Patient satisfaction and ROM better with bandaging.
Limitations: Unblinded patients and assessors, study was underpowered to detect scaphoid nonunions when comparing bandaging to casting, and no data on return to work or cost-effectiveness.
Interpretation: For low-risk patients with suspected scaphoid fractures, initial bandaging with reassessment at 2 weeks is safe, effective, and avoids unnecessary casting. However, further consensus among surgeons is needed before bandaging becomes standard of care given concerns of medicolegal risk.
JC Supervisor: Dr. Jeff Perry
