Best Evidence Topics
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No evidence for collar and cuff or sling in uncomplicated shaft of humerus fractures

Three Part Question

In [adults with uncomplicated shaft of humerus fracture] is [collar and cuff better than broad arm sling] at [reducing pain and non-union].

Clinical Scenario

A 45 year old man attends emergency department having fallen off his bicycle. He has pain around his left upper arm. Examination reveals a probable fracture of the humerus and an x-ray confirms this. There are no neurovascular complications. You have received differing advice about the best way to support the arm after this injury. You wonder whether a broad arm sling or collar and cuff is best.

Search Strategy

Medline 1966-12/98 using the OVID interface.
[exp immobilization OR exp bandages OR collar and OR broad arm sling$.mp] AND ({[exp humerus OR OR] AND [exp fractures OR fracture$.mp]} OR exp humeral fractures) LIMIT to human AND english language.

Search Outcome

45 papers found none of which were relevant.


There is no literature on the use of collar and cuff or sling in uncomplicated shaft of humerus injury.

Clinical Bottom Line

There is no evidence to determine if collar and cuff is better than sling for management of uncomplicated fractures of the shaft of humerus. Local advice should be followed.