Casting, Bandaging and Thumb Inclusion for Scaphoid Fractures: A Multicenter Randomized Trial and a Systematic Review

Physical therapists, physical therapist assistants and certified hand therapists who see patients with acute wrist pain after a fall, or who manage non-displaced scaphoid fractures in a cast or orthosis.

Physical therapists, physical therapist assistants, occupational therapists and certified hand therapists working in outpatient orthopedics, emergency and urgent care follow-up, and hand therapy settings. Physical therapist assistants may take this course; the content describes their contribution as carrying out the plan of care under the direction and supervision of the physical therapist.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the content of two peer-reviewed papers and introduces no claims beyond them.

Cohen A, Reijman M, Kraan GA, Baart SJ, Verhaar JAN, Colaris JW, SUSPECT study group. Can we avoid casting for suspected scaphoid fractures? A multicenter randomized controlled trial. J Orthop Traumatol. 2025;26(1):14. doi:10.1186/s10195-025-00822-5

Harper KJ, Rees Y, Tan NX, Li H, Fonseca EA, Quach PG, Lee GS, Brayshaw JR, McGarry S. Determining the success of clinical outcomes for thumb immobilization compared to no thumb immobilization in adult non-displaced, non-surgically managed scaphoid fractures: A systematic review. Hong Kong J Occup Ther. 2025;38(2):143-154. doi:10.1177/15691861251338448

After completing this course, you will be able to:

1. Describe what the multicenter randomized trial reported about function, fracture union, wrist motion and patient satisfaction when suspected scaphoid fractures with normal initial radiographs were treated with three-day bandaging rather than two-week casting.
2. State what the systematic review concluded about including the thumb in the cast for adult non-displaced scaphoid fractures managed without surgery, across union, hand function, pain, grip strength, wrist motion and scaphoid stability.
3. Distinguish the findings on which the two papers agree from the points on which their results diverge, and explain the limits each set of authors placed on its own conclusions.

1. Start Here: Course Overview, Objectives and How Credit Is Earned
2. Part One: Bandaging Versus Casting for Suspected Scaphoid Fracture
3. Suspected Scaphoid Fracture With Normal Radiographs: Who Entered the Trial
4. Three-Day Bandage Versus Two-Week Cast: How the Trial Was Conducted
5. Function, Pain, Wrist Motion and Satisfaction: What the Trial Found
6. Safety Findings, Study Limits and What the Trial Authors Concluded
7. Part Two: Thumb Immobilization Versus No Thumb Immobilization for Non-Displaced Scaphoid Fractures
8. Adults in a Cast Without Surgery: The Studies the Review Pulled Together
9. Searching, Appraising and Summarizing: How the Review Was Built
10. Union, Hand Function, Pain, Grip Strength and Scaphoid Stability: What the Review Reported
11. Mixed Study Quality, Mixed Populations and What the Review Authors Concluded
12. Bringing It Together
13. Where the Two Papers Agree
14. Where the Findings Diverge and Which Paper Found What
15. Orthosis and Cast Decisions in Hand Therapy: Applying the Combined Evidence
16. What Remains Unanswered
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Cohen A, Reijman M, Kraan GA, Baart SJ, Verhaar JAN, Colaris JW, SUSPECT study group. Can we avoid casting for suspected scaphoid fractures? A multicenter randomized controlled trial. J Orthop Traumatol. 2025;26(1):14. doi:10.1186/s10195-025-00822-5
2. Harper KJ, Rees Y, Tan NX, Li H, Fonseca EA, Quach PG, Lee GS, Brayshaw JR, McGarry S. Determining the success of clinical outcomes for thumb immobilization compared to no thumb immobilization in adult non-displaced, non-surgically managed scaphoid fractures: A systematic review. Hong Kong J Occup Ther. 2025;38(2):143-154. doi:10.1177/15691861251338448