Comparison of use of plaster casting versus elastic bandage following carpal tunnel release: a randomized controlled study.
Johannes Svegard, Astrid Nordvall Persson, Christina Zetterlund and 1 others
PMID 33443290WHAT IT FOUND
Plaster casting after carpal tunnel surgery offered no advantage over elastic bandaging for strength, pain, or healing.
The cast group reported significantly more difficulty with daily activities at two weeks, but groups were equal by four weeks. Elastic bandaging is sufficient for postoperative care.
Key findings
01There were no significant differences between the plaster cast and elastic bandage groups regarding strength, flexibility, swelling, sensitivity, or scar width.
02Patients in the plaster cast group experienced significantly more difficulty performing daily activities two weeks post-surgery compared to the elastic bandage group, but no differences remained after that time-point.
03The elastic bandage group had significantly better DASH health scores at week 2, but no differences were found at other time-points.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was powered for grip strength, but the analysis treated subjects as a single group for time factors after finding no group-by-time interactions, which simplifies the comparison. Six patients had bilateral surgery, with the second surgery occurring before the final follow-up, which could potentially affect global health scores, though hand-specific measures were unaffected. A large number of eligible patients declined participation, primarily due to travel distance or lack of time, which may introduce selection bias, although the authors argue the sample remains representative. The study did not include a bulky bandage arm, which is common in other settings, though the authors argue it is unlikely to change the results given the lack of difference between the tested interventions.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the null physical outcomes as evidence that plaster casting is equivalent in patient experience. The cast group had significantly worse self-reported function and daily activity scores at 2 weeks compared to the bandage group, indicating a short-term negative impact of casting on patient comfort and capability.