Message for the clinic:
In this systematic review, we found high-level evidence of lack of
effectiveness or harm for 6 of these practices: routine initial imaging
of ankle injury, orthosis for A0-A3 thoracolumbar burst fracture in
patients < 60 years of age, cast or splint immobilization for
suspected scaphoid fracture negative on MRI or confirmed fifth
metacarpal neck fracture, and routine follow-up imaging for distal
radius and ankles fractures.