支具、夹板和护具 资料

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 after arthroscopic rotator cuff repair cannot be attributed solely to the type of immobilization [1].
• Removable splints for minimally displaced distal radial fractures save patients time and inconvenience by reducing additional hospital visits [2].
• Removable splints for minimally displaced distal radial fractures save the healthcare system money [2].
• The Cross Brace Protocol provides a 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 trigger finger management [4].
• Proximal interphalangeal joint orthosis and therapeutic exercise cannot establish superiority over other conservative treatments for trigger finger due to the absence of a control group [4].
• Splinting is an effective short-term conservative treatment for adult trigger finger [6].
• Splinting offers symptom relief and functional improvement comparable to corticosteroid injections for adult trigger finger [6].
• Supportive bandage, removable splint, and walking casts are all well tolerated with similar complication rates for low-risk ankle fractures in children [7].
• There remains equipoise regarding the best treatment among supportive bandage, removable splint, and walking casts for low-risk ankle fractures in children [7].
• Four weeks of cast immobilization is sufficient for most distal radial fractures in adequately reduced elderly patients [5].
• Orthoses offer a good alternative to plaster casts for stable distal radius fracture types [8].
• Pooling of studies on waterproof casts for upper limb fractures in children was limited by heterogeneity and small study sizes [11].
• Definitive RCTs are required to confirm the efficacy and investigate the cost-effectiveness of waterproof casts for upper limb fractures in children [11].
• Adult patients with a scaphoid waist fracture displaced by ≤ 2 mm should be treated initially with immobilization in a cast [14].
• Early fixation of nonunion is recommended for adult patients with a scaphoid waist fracture initially treated with cast immobilization [14].

How It Works

• Sling immobilization after arthroscopic rotator cuff repair is not inferior to brace immobilization [1].
• Removable splints for minimally displaced distal radial fractures save patients time and inconvenience by reducing hospital visits [2].
• 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].
• Supportive bandages, removable splints, and walking casts for low-risk ankle fractures in children are all well tolerated with similar complication rates [7].
• There remains equipoise regarding the best treatment among supportive bandages, removable splints, and walking casts for low-risk ankle fractures in children [7].
• Pain and functional outcomes after primary reverse total shoulder arthroplasty are comparable between no immobilization and a 3-week immobilization period [9].
• Scaphoid waist fracture union consolidated in patients with > 20% bridging without intervention between one and five years after randomization [10].
• Maintaining an appropriate balance between mobilization and immobilization has a decisive impact on tissue healing, functional recovery, and patient outcomes in hand rehabilitation [12].
• Relative motion orthoses and metacarpophalangeal joint blocking orthoses support interchangeable use for managing trigger finger based on symptom severity, pain, hand function, and wearability outcomes [13].
• Mid-frequency electrical muscle stimulation (MFEMS) during immobilization after arthroscopic rotator cuff repair effectively prevents early post-operative deltoid muscle atrophy [16].
• Mid-frequency electrical muscle stimulation (MFEMS) during immobilization after arthroscopic rotator cuff repair accelerates early recovery of shoulder muscle strength [16].
• Four weeks of cast immobilization is sufficient for most distal radial fractures in elderly patients [5].

What the Evidence Shows

Immobilization and Bracing Strategies

• Sling immobilization after arthroscopic rotator cuff repair is not inferior to brace immobilization, although this conclusion cannot be attributed solely to the type of immobilization [1].
• Removable splints offer a safe treatment option for minimally displaced distal radial fractures, reducing hospital visits and healthcare costs compared to plaster casts [2].
• A 4-week cast immobilization period is sufficient for most distal radial fractures in elderly patients [5].
• Orthoses provide a good alternative to plaster casts for stable distal radial fracture types [8].
• Waterproof casts are an option for upper limb fractures in children, but definitive RCTs are required to confirm efficacy and investigate cost-effectiveness due to study heterogeneity and small sample sizes [11].
• Three-week immobilization after primary reverse total shoulder arthroplasty yields pain and functional outcomes comparable to longer immobilization periods [9].
• Maintaining an appropriate balance between mobilization and immobilization is a central challenge in hand rehabilitation that decisively impacts tissue healing, functional recovery, and patient outcomes [12].

Specific Orthotic Protocols and Devices

• The Cross Brace Protocol provides a non-operative option for ACL injuries, potentially associated with satisfactory anatomical and functional healing for certain patient groups [3].
• Proximal interphalangeal joint orthosis combined with therapeutic exercise demonstrates feasibility and short-term clinical improvement for trigger finger, though superiority over other conservative treatments cannot be established 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].
• Relative motion orthoses and metacarpophalangeal joint blocking orthoses are interchangeable for managing trigger finger based on symptom severity, pain, hand function, and wearability outcomes [13].
• Supportive bandages, removable splints, and walking casts for low-risk ankle fractures in children are all well-tolerated with similar complication rates, leaving equipoise regarding the best treatment [7].

Surgical Fixation and Internal Bracing

• UCL repair with internal brace reports excellent midterm patient-reported outcomes statistically similar to UCL reconstruction, including similar proportions of athletes successfully returning to preinjury sport [19].
• The embrace technique for syndesmotic injury yields equivalent outcomes compared with suture button fixation [20].
• For adult scaphoid waist fractures displaced by ≤ 2 mm, initial treatment with cast immobilization followed by early fixation of nonunion is recommended [14].
• Between one and five years after randomization, scaphoid union consolidated in patients with > 20% bridging without intervention [10].

Adjunctive Therapies

• Adding thoracic extension exercises or thoracic kinesio taping to shoulder exercises results in significant improvements in activity-related pain and self-reported disability for adults with subacromial pain syndrome, exceeding previously reported MCID values [21].

Practical Considerations

• There remains equipoise regarding the best treatment for low-risk ankle fractures in children among supportive bandages, removable splints, and walking casts [7].
• Supportive bandages, removable splints, and walking casts for low-risk ankle fractures in children are well tolerated with similar complication rates [7].
• Pain and functional outcomes after primary reverse total shoulder arthroplasty are comparable between three-week immobilization and no immobilization [9].
• Between one and five years after randomization, scaphoid waist fracture union consolidated in patients with > 20% bridging without intervention [10].
• Definitive randomized controlled trials are required to confirm the efficacy of waterproof casts for upper limb fractures in children [11].
• Definitive randomized controlled trials are required to investigate the cost-effectiveness of waterproof casts for upper limb fractures in children [11].
• Limitations in the current state of 3D-printed orthoses include small sample sizes [15].
• Limitations in the current state of 3D-printed orthoses include a lack of standardized assessment methods [15].
• Limitations in the current state of 3D-printed orthoses include durability concerns [15].
• Further research is required to address limitations in the current state of 3D-printed orthoses [15].
• Initial cast immobilization with fixation for nonunion is the optimal treatment for adults with scaphoid waist fractures [17].
• Small quality-adjusted life year gains for initial surgical fixation of scaphoid waist fractures were not sufficient to justify the higher costs compared to initial cast immobilization [17].
• Use of a codesigned patient decision aid in practice for total knee arthroplasty decisions was feasible [18].

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)
• [L2] There remains equipoise regarding the best treatment of these injuries, with all three treatments appearing well tolerated with similar complication rates. [7] (10.1302/0301-620x.107b1.bjj-2024-0354.r1)
• [L1] Hence, orthoses offer a good alternative to plaster casts, especially for stable fracture types. [8] (10.1186/s12891-026-09585-4)
• [L1] The pain and functional outcomes are comparable to those obtained with a 3-week immobilization period. [9] (10.1016/j.jse.2025.02.015)
• [L1] Between one and five years after randomization, union consolidated in those with > 20% bridging without intervention. [10] (10.1302/0301-620x.108b1.bjj-2025-0125.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. [11] (10.1302/0301-620x.107b6.bjj-2025-0011)
• [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. [12] (10.1177/17531934251413908)
• [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)
• [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. [14] (10.1302/0301-620x.108b1.bjj-2025-0122.r1)
• [L1] However, limitations such as small sample sizes, lack of standardized assessment methods, and durability concerns must be addressed through further research. [15] (10.1186/s12891-025-09070-4)
• [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. [16] (10.1002/ksa.70303)
• [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. [17] (10.1302/0301-620x.108b1.bjj-2025-0116.r1)
• [L1] Use of the aid in practice was feasible. [18] (10.1016/j.arth.2025.05.104)
• [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 embrace technique yielded equivalent outcomes compared with suture button fixation for managing syndesmotic injuries. [20] (10.1186/s13018-025-06620-3)
• [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. [21] (10.1016/j.jse.2026.02.001)

References

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

[2] 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

[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] 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

[5] 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

[6] Efficacy of Splinting in Managing Adult Trigger Finger: A Systematic Review of Short-Term Outcomes. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2025.100881

[7] 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

[8] 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

[9] Three-week immobilization vs. no immobilization in primary reverse total shoulder arthroplasty: a randomized controlled trial. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2025.02.015

[10] 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

[11] 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

[12] 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

[13] 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

[14] Clinical effectiveness 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-2025-0122.r1

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

[16] 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

[17] Cost-effectiveness 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-2025-0116.r1

[18] A Codesigned Patient Decision Aid Supports the Decision Quality of Patients Considering Total Knee Arthroplasty: A Randomized Controlled Trial. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.05.104

[19] Clinical Outcomes of Ulnar Collateral Ligament Repair With Internal Brace Versus Ulnar Collateral Ligament Reconstruction in Competitive Athletes. The American Journal of Sports Medicine. 2025. DOI: 10.1177/03635465251314054

[20] Outcomes of suture button fixation versus embrace fixation for syndesmotic injury. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-025-06620-3

[21] 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