Early Functional Bracing Versus Coaptation Splinting for Closed Humeral Shaft Fractures: Critical Narrative Review
Abstract: Background: Functional bracing is a common nonoperative treatment for humeral shaft fractures, yet the timing of brace application during acute swelling affects early comfort and skin safety. Objective: To appraise the 2026 Journal of Orthopaedic Trauma COBRAS randomized trial and place its short-term findings within the broader fracture-care pathway. Methods: A focused narrative review of COBRAS and selected randomized trials comparing operative fixation with functional bracing. No systematic search or meta-analysis was performed. Results: In 58 analyzed patients, immediate Sarmiento bracing produced a mean 0.97-point higher daily pain rating over the first ten days than initial coaptation splinting (95% CI 0.26-1.69). Skin complications were reported in 33.3% and 7.1%, respectively. Day-seven function, cumulative opioid consumption, and satisfaction did not differ significantly. These outcomes concern initial immobilization, not fracture union or the choice between surgery and nonoperative care. Conclusion: Initial coaptation splinting with planned conversion after swelling subsides is a reasonable default for eligible closed fractures, provided fit, skin, neurovascular status, and alignment are reassessed. Longer term treatment decisions require a separate discussion of nonunion risk, functional recovery, and operative harms.
Keywords: humeral shaft fracture; coaptation splint; Sarmiento brace; functional bracing; pain; skin complication
How to Cite?: Nishant, "Early Functional Bracing Versus Coaptation Splinting for Closed Humeral Shaft Fractures: Critical Narrative Review", Volume 15 Issue 10, October 2026, International Journal of Science and Research (IJSR), Pages: 491-493, https://www.ijsr.net/getabstract.php?paperid=SR261007085341, DOI: https://dx.doi.org/10.21275/SR261007085341