Órteses, talas e suportes Folheto

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que é

Órteses, talas e suportes são dispositivos que mantêm uma articulação ou um membro imóvel enquanto ele cicatriza. Alguns são rígidos, como um gesso. Outros podem ser retirados para o banho, os exercícios ou o sono. São usados para muitos problemas: ossos quebrados, como fraturas do punho, ligamentos rompidos, como o LCA (ligamento cruzado anterior) do joelho, problemas de tendão, como o dedo em gatilho, e após algumas cirurgias.

Eles não servem apenas para um tipo de paciente. Crianças com fratura do tornozelo podem usar uma bandagem de suporte, uma tala removível ou uma bota gessada para caminhar [1]. Adultos com certas fraturas do punho podem precisar de cerca de quatro semanas de gesso [2]. Algumas lesões dos ligamentos do joelho podem ser tratadas sem cirurgia com um protocolo de uso de órtese [3]. Pessoas com canelite podem usar bandagem funcional (taping) junto com a terapia por exercícios [4].

A ideia é simples: o tecido lesionado precisa de alguma proteção para se reconstituir, mas imobilidade demais pode deixar a articulação rígida e fraca. Encontrar o equilíbrio certo entre movimento e repouso é um dos desafios centrais da reabilitação, e isso tem um impacto decisivo na qualidade da cicatrização do tecido e da sua recuperação [5]. É por isso que o seu médico escolhe o tipo de suporte, e por quanto tempo você deve usá-lo, com base na sua lesão específica.

As pesquisas continuam a aprimorar essas escolhas. Estudos que compararam tipoia e órtese após o reparo de tendão do ombro constataram que ambas funcionaram de forma semelhante [6]. Estudos sobre talas removíveis para algumas fraturas do punho constataram que elas pouparam tempo aos pacientes e idas extras ao hospital [7]. Opções mais novas, como suportes feitos por impressão 3D, estão sendo estudadas, mas ainda não fazem parte da prática padrão [8].

Funciona mesmo?

Para muitas lesões, sim, mas a resposta honesta depende da finalidade do suporte. Alguns usos foram bem testados. Outros se baseiam em pesquisas iniciais ou limitadas, e vamos avisar quando for esse o caso.

Algumas conclusões são claras. Para um punho quebrado, uma tala removível pode funcionar tão bem quanto um gesso, especialmente nos tipos de fratura estáveis [9]. Para o dedo em gatilho, dois tipos diferentes de tala para o dedo tiveram desempenho igual quanto à dor, à função da mão e ao conforto durante o uso [10]. Para a dor no ombro, acrescentar exercícios para a parte superior das costas ou bandagem funcional aos exercícios padrão para o ombro melhorou a dor e a incapacidade relacionadas às atividades em uma medida que as pessoas percebem no dia a dia [11]. Para pessoas com luxação recorrente do ombro, a bandagem funcional combinada com a reabilitação padrão melhorou o movimento e a função do ombro mais do que a reabilitação isolada [12].

Outras áreas estão menos definidas. Para crianças com fraturas do tornozelo de baixo risco, bandagens, talas removíveis e botas gessadas para caminhar foram todas bem toleradas, com taxas de complicação semelhantes, e as pesquisas ainda não definiram qual opção é a melhor [1]. Para gessos à prova d'água em crianças, os estudos até agora foram pequenos e variados, por isso ainda são necessários estudos mais sólidos [13]. Algumas abordagens mais novas parecem promissoras, mas precisam de mais testes. Exercícios com um manguito especial e uma órtese após uma ruptura completa do LCA podem encurtar a recuperação ou ajudar algumas pessoas a evitar a cirurgia [14]. A estimulação elétrica muscular durante o período de repouso após o reparo de tendão do ombro ajudou a prevenir a perda muscular e acelerou a recuperação inicial da força [15].

Alguns pontos merecem uma linguagem simples. Um estudo sobre os pequenos ossos do punho constatou que algumas fraturas consolidaram sozinhas ao longo de um a cinco anos, sem nenhuma intervenção [16]. E a cirurgia com um suporte interno semelhante a uma órtese para certos reparos de ligamento mostrou bons resultados iniciais de retorno ao esporte [17], embora ainda sejam necessárias pesquisas de prazo mais longo.

Onde as evidências são escassas, vamos dizer isso e explicar o que sabemos.

Quais são os riscos?

A maioria dos problemas com órteses, talas e suportes vem do próprio dispositivo, e não de uma cirurgia. O principal desafio é encontrar o equilíbrio certo entre manter a lesão imóvel e movimentá-la o suficiente. Imobilidade demais pode deixar a articulação rígida e fraca, enquanto movimento demais pode impedir que o tecido cicatrize adequadamente [5]. O seu médico pondera esse equilíbrio ao escolher o que você vai usar e por quanto tempo.

Alguns efeitos têm a ver com conforto e ajuste. Um suporte que pressiona a pele pode causar irritação, e um gesso rígido não pode ser retirado para o banho. Opções removíveis, como talas e órteses, podem ser tiradas, o que muitas pessoas acham mais fácil no dia a dia [9]. Para crianças com fraturas do tornozelo de baixo risco, bandagens, talas removíveis e botas gessadas para caminhar foram todas bem toleradas, com taxas de complicação semelhantes entre as três [1]. Os gessos à prova d'água para crianças foram estudados de forma menos completa, por isso as evidências nessa área ainda são escassas [13].

Alguns pontos específicos valem a pena conhecer. Após o reparo de tendão do ombro, o músculo que levanta o braço pode atrofiar enquanto o braço fica imóvel. A estimulação elétrica muscular durante esse período de repouso ajudou a prevenir essa perda muscular e acelerou a recuperação inicial da força [15]. Para lesões do punho, um estudo constatou que algumas fraturas de ossos pequenos consolidaram sozinhas ao longo de um a cinco anos, sem nenhum tratamento [16], e é por isso que o seu médico pode acompanhar a consolidação em vez de operar de imediato.

Os suportes mais novos trazem as suas próprias incertezas. Os suportes feitos por impressão 3D ainda estão sendo estudados, e os pesquisadores levantaram dúvidas sobre a sua durabilidade e sobre a qualidade da sua avaliação [8]. Para o dedo em gatilho, uma abordagem com tala e exercícios mostrou melhora a curto prazo, mas o estudo não tinha grupo de comparação, por isso não consegue mostrar se ela funciona melhor do que outros tratamentos [18].

Se você notar alterações na pele, dormência, dor crescente ou problemas no ajuste do seu suporte, avise a sua equipe de saúde. Ela pode ajustá-lo ou substituí-lo.

É a opção certa para você?

Uma órtese, tala ou suporte pode ser adequado para você se a sua lesão puder cicatrizar com a articulação imóvel, ou se você estiver se recuperando de uma cirurgia que precise de proteção depois. Também pode ser uma opção quando a cirurgia pode ser totalmente evitada. Algumas lesões dos ligamentos do joelho, por exemplo, podem ser tratadas com um programa de uso de órtese em vez de uma cirurgia [3]. Para certas fraturas pequenas do punho, o seu médico pode simplesmente acompanhar a consolidação do osso ao longo de um a cinco anos em vez de operar de imediato [16].

Pode não ser adequado se a sua lesão precisar de cirurgia para cicatrizar adequadamente, ou se o suporte fosse manter a articulação imóvel por tanto tempo que surgissem rigidez e fraqueza. O seu médico pondera esse equilíbrio ao escolher o que você vai usar e por quanto tempo.

Geralmente há escolhas a fazer. Após o reparo de tendão do ombro, uma tipoia e uma órtese funcionaram de forma semelhante nos estudos [6]. Para algumas fraturas do punho, uma tala removível pode funcionar tão bem quanto um gesso [9]. Para crianças com fraturas do tornozelo de baixo risco, bandagens, talas removíveis e botas gessadas para caminhar foram todas bem toleradas [1]. A opção certa depende da sua lesão, do seu dia a dia e do que você consegue manejar em casa.

Esta deve ser uma decisão compartilhada com o seu médico. Pergunte para que serve o suporte, por quanto tempo você vai usá-lo e como ele se compara com as outras opções. A seção de riscos acima explica a que prestar atenção, e a sua equipe de saúde pode ajustar ou substituir um suporte que não se encaixe bem.

Conclusão

Órteses, talas e suportes valem a pena ser considerados para muitas lesões e, em alguns casos, podem substituir totalmente a cirurgia. As evidências por trás deles variam: alguns usos foram bem testados, outros se baseiam em estudos pequenos ou iniciais. O mais importante a saber é que o equilíbrio entre manter a lesão imóvel e movimentá-la o suficiente influencia a qualidade da sua cicatrização; por isso, siga o plano que o seu médico lhe der e avise se o ajuste ou o conforto não estiverem adequados.

Referências

[1] Supportive bandage, removable splint, or walking casts for low-risk ankle fractures in children: a feasibility randomized controlled trial. The Bone & Joint Journal. 2025. DOI: 10.1302/0301-620x.107b1.bjj-2024-0354.r1

[2] Adequately Reduced Distal Radial Fractures in Elderly Patients: How Long Should We Immobilize?. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.25.00333

[3] Short-term Outcomes of the Cross Brace Protocol for ACL Rupture Management: A Prospective Cohort Study. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967126s00013

[4] PS2 The effect of kinesiotaping with exercise therapy for the treatment of shin splints: a case report. Injury. 2013. DOI: 10.1016/s0020-1383(13)70151-7

[5] Achieving a balance between mobilization and immobilization after surgical or conservative treatment of the hand. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934251413908

[6] Regarding “Sling Is Not Inferior to Brace Immobilization After Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial”. Arthroscopy. 2026. DOI: 10.1002/arj.70326

[7] Do patients with minimally displaced distal radial fractures need a plaster cast?. The Bone & Joint Journal. 2025. DOI: 10.1302/0301-620x.107b1.bjj-2024-0634.r1

[8] The current state of 3D-printed orthoses clinical outcomes: a systematic review. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09070-4

[9] Outcome analysis of conservative treatment of a distal radius fracture with OPTIVOhand orthosis versus plaster cast: a randomized controlled trial. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09585-4

[10] A randomized comparative trial: Relative motion vs metacarpophalangeal joint blocking orthoses for trigger finger management. Journal of Hand Therapy. 2026. DOI: 10.1016/j.jht.2025.05.018

[11] Effects of adding thoracic extension exercises or thoracic kinesio taping to shoulder exercises on pain and function in adults with subacromial pain syndrome: a randomized controlled trial. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.02.001

[12] A retrospective analysis of the promoting effect of kinesio taping on the rehabilitation of military personnel with recurrent shoulder dislocation caused by training injury. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09753-6

[13] Waterproof casts for the management of upper limb fractures in children. The Bone & Joint Journal. 2025. DOI: 10.1302/0301-620x.107b6.bjj-2025-0011

[14] Conservative treatment using blood flow restriction and brace in individuals with complete anterior cruciate ligament rupture: protocol for a randomised clinical trial. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06285-y

[15] Mid‐frequency electrical muscle stimulation during immobilization may prevent early deltoid muscle atrophy and promote early strength recovery after arthroscopic rotator cuff repair. Knee Surgery, Sports Traumatology, Arthroscopy. 2026. DOI: 10.1002/ksa.70303

[16] Radiological outcome of early surgical fixation versus cast immobilization for adults with a scaphoid waist fracture: five-year follow-up of the Scaphoid Waist Internal Fixation for Fractures Trial. The Bone & Joint Journal. 2026. DOI: 10.1302/0301-620x.108b1.bjj-2025-0125.r1

[17] Outcomes of Revision UCL Repair With Internal Brace for Failure of Primary UCL Reconstruction in Professional and Collegiate Baseball Pitchers: A First Look. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/23259671261422231

[18] Effectiveness of Proximal Interphalangeal Joint Orthosis and Therapeutic Exercise in the Management of Trigger Finger: A Prospective Case Series. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101038


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Sling immobilization is not inferior to brace immobilization after arthroscopic rotator cuff repair [1].
  • The conclusion that sling immobilization is not inferior to brace immobilization cannot be attributed solely to the type of immobilization [1].
  • Removable splints for minimally displaced distal radial fractures save patients time and inconvenience regarding additional hospital visits [2].
  • Removable splints for minimally displaced distal radial fractures save the healthcare system money [2].
  • The Cross Brace Protocol provides an additional non-operative option for ACL injuries [3].
  • The Cross Brace Protocol may be associated with satisfactory anatomical and functional healing for certain patient groups with ACL injuries [3].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement in the management of trigger finger [4].
  • Findings on proximal interphalangeal joint orthosis and therapeutic exercise for trigger finger cannot establish superiority over other conservative treatments due to the absence of a control group [4].
  • Four weeks of cast immobilization is sufficient for most distal radial fractures in elderly patients [5].
  • Splinting is an effective short-term conservative treatment for trigger finger [6].
  • Splinting offers symptom relief and functional improvement comparable to corticosteroid injections for trigger finger [6].
  • Maintaining an appropriate balance between mobilization and immobilization is a central challenge in hand rehabilitation [7].
  • The balance between mobilization and immobilization has a decisive impact on tissue healing, functional recovery, and patient outcomes in hand rehabilitation [7].
  • Orthoses offer a good alternative to plaster casts for stable fracture types [8].
  • Limitations of 3D-printed orthoses include small sample sizes, lack of standardized assessment methods, and durability concerns [9].
  • Kinesiotaping can be considered an alternative supplementary treatment together with exercise therapy for shin splints [10].
  • Pain and functional outcomes are comparable between no immobilization and a 3-week immobilization period in primary reverse total shoulder arthroplasty [11].
  • Union consolidated in patients with greater than 20% bridging without intervention between one and five years after randomization for scaphoid waist fractures [12].
  • Symptom severity, pain, hand function, and orthosis wearability outcomes support interchangeable use of relative motion and metacarpophalangeal joint blocking orthoses for managing trigger finger [13].
  • Supportive bandage, removable splint, and walking casts are all well tolerated with similar complication rates for low-risk ankle fractures in children [14].
  • Equipoise remains regarding the best treatment for low-risk ankle fractures in children among supportive bandage, removable splint, and walking casts [14].
  • Pooling of studies on waterproof casts for upper limb fractures in children was limited by heterogeneity and small study sizes [15].
  • Definitive randomized controlled trials are required to confirm efficacy and investigate cost-effectiveness of waterproof casts for upper limb fractures in children [15].
  • Adult patients with a scaphoid waist fracture displaced by 2 mm or less should be treated initially with immobilization in a cast, followed by early fixation of a nonunion [16].
  • Use of a codesigned patient decision aid in practice for total knee arthroplasty was feasible [17].
  • Initial cast immobilization with fixation for nonunion is the optimal form of treatment for adults with a scaphoid waist fracture [18].
  • Small quality-adjusted life year gains for those who underwent initial surgery for scaphoid waist fractures were not sufficient to justify the higher costs compared to initial cast immobilization [18].
  • Athletes who underwent ulnar collateral ligament repair with internal brace reported excellent midterm patient-reported outcomes statistically similar to those after ulnar collateral ligament reconstruction [19].
  • The proportion of athletes successfully returning to preinjury sport was statistically similar between ulnar collateral ligament repair with internal brace and ulnar collateral ligament reconstruction [19].

How It Works

  • Sling immobilization is not inferior to brace immobilization after arthroscopic rotator cuff repair, though this conclusion cannot be attributed solely to the type of immobilization [1].
  • Removable splints for minimally displaced distal radial fractures save patients time and inconvenience regarding additional hospital visits and save the healthcare system money [2].
  • The Cross Brace Protocol provides an additional non-operative option for ACL injuries and may be associated with satisfactory anatomical and functional healing for certain patient groups [3].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement in trigger finger management, but cannot establish superiority over other conservative treatments due to the absence of a control group [4].
  • Splinting is an effective short-term conservative treatment for trigger finger, offering symptom relief and functional improvement comparable to corticosteroid injections [6].
  • Maintaining an appropriate balance between mobilization and immobilization is a central challenge in hand rehabilitation with a decisive impact on tissue healing, functional recovery, and patient outcomes [7].
  • Orthoses offer a good alternative to plaster casts, especially for stable fracture types [8].
  • 3D-printed orthoses face limitations including small sample sizes, lack of standardized assessment methods, and durability concerns that must be addressed through further research [9].
  • Pain and functional outcomes after primary reverse total shoulder arthroplasty are comparable to those obtained with a 3-week immobilization period when no immobilization is used [11].
  • Union consolidated in patients with scaphoid waist fractures who had > 20% bridging without intervention between one and five years after randomization [12].
  • Pooling of studies on waterproof casts for upper limb fractures in children was limited by heterogeneity and small study sizes, requiring definitive RCTs to confirm efficacy and investigate cost-effectiveness [15].
  • Adult patients with a scaphoid waist fracture displaced by ≤ 2 mm should be treated initially with immobilization in a cast, followed by early fixation of a nonunion [16].
  • Initial cast immobilization with fixation for nonunion is the optimal form of treatment for adults with a scaphoid waist fracture, as small quality-adjusted life year gains from initial surgery were not sufficient to justify higher costs [18].
  • Athletes who underwent ulnar collateral ligament repair with internal brace reported excellent midterm patient-reported outcomes statistically similar to those after ulnar collateral ligament reconstruction, including the proportion successfully returning to preinjury sport [19].
  • Mid-frequency electrical muscle stimulation during the immobilization period after arthroscopic rotator cuff repair effectively prevented early post-operative deltoid muscle atrophy and accelerated early recovery of shoulder muscle strength [20].
  • Shoelace repair with internal brace may be a viable surgical option for ulnar collateral ligament injuries with chronic avulsion bone fragments in carefully selected young athletes with minimal ligament degeneration and good tissue quality, particularly when early return to play is prioritized [21].
  • The embrace technique yielded equivalent outcomes compared with suture button fixation for managing syndesmotic injuries [22].
  • The level of supporting force did not significantly influence architectural or activation outcomes during partial bodyweight-supported squats [25].
  • Anthropometric studies can aid in discerning fundamental ratios for orthoses design, allowing for custom-fitted designs and manufacturing with ease and efficiency [26].
  • Two claws form a useful addition to Charnley's clamp and have proved effective and easy to use [27].

What the Evidence Shows

Upper Extremity

  • Maintaining an appropriate balance between mobilization and immobilization is a central challenge in hand rehabilitation and has a decisive impact on tissue healing, functional recovery, and patient outcomes [7].
  • Relative motion and metacarpophalangeal joint blocking orthoses can be used interchangeably for managing trigger finger, as symptom severity, pain, hand function, and orthosis wearability outcomes support this equivalence [13].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger but cannot establish superiority over other conservative treatments due to the absence of a control group [4].
  • Pain and functional outcomes are comparable between no immobilization and a 3-week immobilization period after primary reverse total shoulder arthroplasty [11].
  • Mid-frequency electrical muscle stimulation during the immobilization period after arthroscopic rotator cuff repair effectively prevents early post-operative deltoid muscle atrophy and accelerates early recovery of shoulder muscle strength [20].
  • The recommendation that adult patients with a scaphoid waist fracture displaced by ≤ 2 mm should be treated initially with immobilization in a cast, followed by early fixation of a nonunion, is corroborated by five-year follow-up findings [16].
  • Union consolidated in patients with > 20% bridging without intervention between one and five years after randomization for scaphoid waist fractures [12].
  • Waterproof casts for upper limb fractures in children require definitive RCTs to confirm efficacy and investigate cost-effectiveness, as pooling of studies was limited by heterogeneity and small study sizes [15].

Lower Extremity

  • Exercise under blood flow restriction in combination with a brace could serve as an alternative treatment for participants with acute or subacute complete ACL tears, potentially reducing recovery time or avoiding surgery [31].
  • Supportive bandage, removable splint, and walking casts are all well tolerated with similar complication rates for low-risk ankle fractures in children, with equipoise remaining regarding the best treatment [14].
  • The combined intervention of kinesio taping and conventional rehabilitation led to more significant improvements in shoulder range of motion and functional scores compared to conventional rehabilitation alone for military personnel with recurrent shoulder dislocation [30].
  • Adding thoracic extension exercises or thoracic kinesio taping to shoulder exercises resulted in significant improvements in activity-related pain and self-reported disability exceeding previously reported MCID values for adults with subacromial pain syndrome [29].

Surgical Augmentation and Internal Braces

  • Athletes who underwent UCL repair with internal brace reported excellent midterm patient-reported outcomes statistically similar to those after UCL reconstruction, including the proportion successfully returning to preinjury sport [19].
  • Shoelace repair with internal brace may be a viable surgical option for UCL injuries with chronic avulsion bone fragments in carefully selected young athletes with minimal ligament degeneration and good tissue quality, particularly when early return to play is prioritized [21].
  • UCL repair with internal brace for high-level pitchers with recurrent UCL injury after UCL reconstruction shows promising short-term results with excellent return-to-sport and patient-reported outcomes [33].
  • Meniscotibial repair with suture anchors with internal brace augmentation for the MCL repair can provide a strong final construct and a safe and fast recovery [34].
  • Modified anatomical reconstruction of the medial collateral ligament with tibial sling bone tunnels and double-bundle semitendinosus tendon aims to restore knee stability more isometrically to improve long-term efficacy and help prevent complications such as osteoarthritis and functional limitations [32].

Technology and General

  • 3D-printed orthoses face limitations such as small sample sizes, lack of standardized assessment methods, and durability concerns that must be addressed through further research [9].

Practical Considerations

Upper Extremity and Shoulder

  • The conclusion that sling immobilization is not inferior to brace immobilization after arthroscopic rotator cuff repair cannot be attributed solely to the type of immobilization [1].
  • Pain and functional outcomes after primary reverse total shoulder arthroplasty are comparable between no immobilization and a 3-week immobilization period [11].
  • Mid-frequency electrical muscle stimulation applied during the immobilization period after arthroscopic rotator cuff repair effectively prevents early post-operative deltoid muscle atrophy and accelerates early recovery of shoulder muscle strength [20].

Wrist and Hand

  • For adult patients with a scaphoid waist fracture displaced by ≤ 2 mm, initial treatment with immobilization in a cast followed by early fixation of a nonunion is corroborated by five-year follow-up findings [16].
  • In patients with a scaphoid waist fracture and > 20% bridging, union consolidated without intervention between one and five years after randomization [12].
  • Orthoses offer a good alternative to plaster casts for the conservative treatment of distal radius fractures, especially for stable fracture types [8].
  • If patients with minimally displaced distal radial fractures can be treated safely using a removable splint, this saves them time and inconvenience regarding additional hospital visits and saves the healthcare system money [2].
  • Findings from a prospective case series on proximal interphalangeal joint orthosis and therapeutic exercise for trigger finger demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments due to the absence of a control group [4].
  • Maintaining an appropriate balance between mobilization and immobilization is a central challenge in hand rehabilitation that has a decisive impact on tissue healing, functional recovery, and patient outcomes [7].

Lower Extremity and General

  • For low-risk ankle fractures in children, supportive bandage, removable splint, and walking casts all appear well tolerated with similar complication rates, leaving equipoise regarding the best treatment [14].
  • Kinesiotaping can be considered an alternative choice of supplementary treatment together with exercise therapy for shin splints [10].
  • Limitations of 3D-printed orthoses, including small sample sizes, lack of standardized assessment methods, and durability concerns, must be addressed through further research [9].
  • Pooling of studies on waterproof casts for upper limb fractures in children was limited by heterogeneity and small study sizes, and definitive RCTs are required to confirm efficacy and investigate cost-effectiveness [15].

Key Evidence

  • [L5] They argue that the conclusion that sling immobilization is 'not inferior' to brace immobilization cannot be attributed solely to the type of immobilization. [1] (10.1002/arj.70326)
  • [L2] If patients can be treated safely using a removable splint, this will save them time and inconvenience in terms of additional visits to the hospital, and save the healthcare system money. [2] (10.1302/0301-620x.107b1.bjj-2024-0634.r1)
  • [L2] The Cross Brace Protocol provides an additional non-operative option for ACL injuries and may be associated with satisfactory anatomical and functional healing for certain patient groups. [3] (10.1177/2325967126s00013)
  • [L4] Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments. [4] (10.1016/j.jhsg.2026.101038)
  • [L5] The authors should be commended for a well-designed, well-executed randomized controlled trial that makes a compelling case that 4 weeks of cast immobilization is sufficient for most distal radial fractures in elderly patients. [5] (10.2106/jbjs.25.00333)
  • [L2] Splinting is an effective short-term conservative treatment for trigger finger, offering symptom relief and functional improvement comparable to corticosteroid injections. [6] (10.1016/j.jhsg.2025.100881)
  • [L5] The review highlights that maintaining an appropriate balance between mobilization and immobilization is a central challenge in hand rehabilitation and has a decisive impact on tissue healing, functional recovery and patient outcomes. [7] (10.1177/17531934251413908)
  • [L1] Hence, orthoses offer a good alternative to plaster casts, especially for stable fracture types. [8] (10.1186/s12891-026-09585-4)
  • [L1] However, limitations such as small sample sizes, lack of standardized assessment methods, and durability concerns must be addressed through further research. [9] (10.1186/s12891-025-09070-4)
  • [L5] Shin Splints is a rare antity and when diagnosed; kinesiotaping can be thought as an alternative choice of supplementary treatment together with exercise therapy. [10] (10.1016/s0020-1383(13)70151-7)
  • [L1] The pain and functional outcomes are comparable to those obtained with a 3-week immobilization period. [11] (10.1016/j.jse.2025.02.015)
  • [L1] Between one and five years after randomization, union consolidated in those with > 20% bridging without intervention. [12] (10.1302/0301-620x.108b1.bjj-2025-0125.r1)
  • [L1] Symptom severity, pain, hand function, and orthosis wearability outcomes support interchangeable use of relative motion and metacarpophalangeal joint blocking orthoses for managing trigger finger. [13] (10.1016/j.jht.2025.05.018)
  • [L2] There remains equipoise regarding the best treatment of these injuries, with all three treatments appearing well tolerated with similar complication rates. [14] (10.1302/0301-620x.107b1.bjj-2024-0354.r1)
  • [L1] However, pooling of studies was limited by heterogeneity and small study sizes, and definitive RCTs are required to confirm efficacy and investigate cost-effectiveness. [15] (10.1302/0301-620x.107b6.bjj-2025-0011)
  • [L1] The recommendation that adult patients with a fracture of the waist of the scaphoid which is displaced by ≤ 2 mm should be treated initially with immobilization in a cast, followed by early fixation of a nonunion, is further corroborated by these findings. [16] (10.1302/0301-620x.108b1.bjj-2025-0122.r1)
  • [L1] Use of the aid in practice was feasible. [17] (10.1016/j.arth.2025.05.104)
  • [L1] Initial cast immobilization with fixation for nonunion is the optimal form of treatment for adults with a scaphoid waist fracture, as the small quality-adjusted life year gains for those who underwent surgery initially were not sufficient to justify the higher costs. [18] (10.1302/0301-620x.108b1.bjj-2025-0116.r1)
  • [L3] Athletes who underwent UCL repair with internal brace reported excellent midterm PROs statistically similar to those after UCL reconstruction, including proportion successfully returning to preinjury sport. [19] (10.1177/03635465251314054)
  • [L3] The application of the MFEMS during immobilization period after ARCR effectively prevented early post-operative deltoid muscle atrophy and accelerated early recovery of shoulder muscle strength. [20] (10.1002/ksa.70303)
  • [L4] Shoelace repair with internal brace may be a viable surgical option for UCL injuries with chronic avulsion bone fragments in carefully selected young athletes with minimal ligament degeneration and good tissue quality, particularly when early return to play is prioritized. [21] (10.1016/j.jseint.2026.101649)
  • [L3] The embrace technique yielded equivalent outcomes compared with suture button fixation for managing syndesmotic injuries. [22] (10.1186/s13018-025-06620-3)
  • [L4] Importantly, the level of supporting force did not significantly influence these architectural or activation outcomes. [25] (10.1186/s12891-026-09917-4)
  • [L4] Anthropometric studies can aid in discerning fundamental ratios for orthoses design, allowing for custom-fitted designs and manufacturing with ease and efficiency. [26] (10.1016/j.jht.2026.01.004)
  • [Paper] The two claws shown in Fig. 1 form a useful addition to Charnley's clamp and have proved effective and easy to use. [27] (10.1016/s0020-1383(70)80248-0)
  • [L1] All interventions resulted in significant improvements across several outcomes, with improvements in activity-related pain and self-reported disability exceeding previously reported MCID values. [29] (10.1016/j.jse.2026.02.001)
  • [L4] The combined intervention of kinesio taping and conventional rehabilitation led to more significant improvements in shoulder range of motion and functional scores compared to conventional rehabilitation alone. [30] (10.1186/s12891-026-09753-6)
  • [L2] Positive results of exercise under BFR, in combination with a brace, could serve as an alternative treatment for participants with acute or subacute complete ACL tears, potentially reducing recovery time or even avoiding surgery. [31] (10.1186/s13018-025-06285-y)
  • [L5] The technique aims to restore knee stability more isometrically, which can improve the long-term efficacy of the reconstruction and help prevent complications such as osteoarthritis and functional limitations. [32] (10.1016/j.eats.2025.103625)
  • [L4] This pilot case series shows promising short-term results of using UCL repair with internal brace for high-level pitchers with recurrent UCL injury after UCL reconstruction, with excellent return-to-sport and patient-reported outcomes. [33] (10.1177/23259671261422231)
  • [L5] Utilizing an open approach, meniscotibial repair with suture anchors with internal brace augmentation for the MCL repair can provide a strong final construct, and a safe and fast recovery. [34] (10.1016/j.eats.2023.09.013)

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