Splint for Minimally Displaced Fractures

For the purposes of this recommendation minimal displacement was defined as acceptable alignment after the initial injury and prior to any reduction. Rigid immobilization was any form of immobilization that was firm (e.g. plaster, fiberglass) and not intended for self-removal, and less-rigid immobilization was any type of wrap or brace that either incompletely immobilized the wrist or was intended to be removed by the patient.   

Four clinical trials that compared cast to splint treatment met the inclusion criteria. ^{47, 52-54}  All had at least one methodological flaw and were downgraded to Level II.  There were no age criteria.

Pain at 2 weeks was significantly lower in casted patients in one of 4 trials.  Pain at six or eight weeks was significantly lower in splinted patients in 2 of 4 trials. This resulted in the downgrading of the recommendation to “Limited.” All other durations of follow-up did not have significant differences between patients treated with less-rigid immobilization or rigid immobilization.