Comparison of Early Bracing Versus Splinting for the Initial Treatment of Acute Humeral Shaft Fractures (The COBRAS Trial)

The COBRAS Trial aimed to compare the effectiveness of two initial immobilization methods for acute humeral shaft fractures: coaptation splinting followed by delayed functional bracing versus immediate functional bracing. Results indicated that immediate Sarmiento bracing led to higher pain scores and increased skin-related complications without providing benefits in function, analgesic use, or patient satisfaction compared to coaptation splinting. These findings suggest that the traditional approach of initial coaptation splinting may be preferable.