Findings

What do systematic reviews say?

729 questions · 775 findings · 58 reviews · Bone, Joint and Muscle Trauma

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No studies found 166 · 21.4%GRADE not reported 24 · 3.1%Very low 356 · 45.9%Low 162 · 20.9%Moderate 47 · 6.1%High 20 · 2.6%

NSAIDs vs paracetamol

Neurological adverse effects · people with acute soft tissue injury, such as ankle sprain

NSAID showed no clear difference in neurological adverse events compared with paracetamol (low certainty).

1 finding from 1 review

Oral non‐steroidal anti‐inflammatory drugs versus other oral analgesic agents for acute soft tissue injury 2020 · Cochrane Headline outcomes only
RR 0.85 [0.62, 1.17]
9 studies · 1679 participants
Low

NSAIDs vs paracetamol

Early re‐injury (with 3 months) · people with acute soft tissue injury, such as ankle sprain

The review found no eligible studies for this question.

1 finding from 1 review

Oral non‐steroidal anti‐inflammatory drugs versus other oral analgesic agents for acute soft tissue injury 2020 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

NSAIDs vs opioid

Reduction in pain intensity · acute soft tissue injury

1 finding from 1 review

Oral non‐steroidal anti‐inflammatory drugs versus other oral analgesic agents for acute soft tissue injury 2020 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 1058 participants
Moderate

Immobilisation in external rotation vs immobilisation

Re‐dislocation · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

It is very uncertain whether immobilisation in external rotation changes re‐dislocation compared with immobilisation (very low certainty).

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
RR 0.67 [0.38, 1.19]
6 studies · 488 participants
Very low

Immobilisation in external rotation vs immobilisation

Validated patient‐reported outcome measures for shoulder disabilityf · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
no estimate extracted
4 studies · 380 participants
Very low

Immobilisation in external rotation vs immobilisation

Resumption of pre‐injury activities · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
no estimate extracted
3 studies · 347 participants
Very low

Immobilisation in external rotation vs immobilisation

Participant satisfaction with the intervention · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

The review found no eligible studies for this question.

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Immobilisation in external rotation vs immobilisation

Quality of life · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

The review found no eligible studies for this question.

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Immobilisation in external rotation vs immobilisation

Any instability: re‐dislocation or subluxation, composite outcome · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

It is very uncertain whether immobilisation in external rotation changes any instability: re‐dislocation or subluxation, composite outcome compared with immobilisation (very low certainty).

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
RR 0.84 [0.62, 1.14]
3 studies · 395 participants
Very low

Immobilisation in external rotation vs immobilisation

Adverse events · patients undergoing conservative management after closed reduction of traumatic anterior dislocation of the shoulder

1 finding from 1 review

Conservative management following closed reduction of traumatic anterior dislocation of the shoulder 2019 · Cochrane Headline outcomes only
no estimate extracted
7 studies · 645 participants
Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

DASH questionnaire (0 (best function) to 100 (worst function)) ‐ at 1 year · adults with acute acromioclavicular dislocation of the shouldera

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 112 participants
Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Pain: presence of pain (slight or moderate) at 1 year · adults with acute acromioclavicular dislocation of the shouldera

It is very uncertain whether surgical intervention changes pain: presence of pain (slight or moderate) at 1 year compared with conservative intervention (very low certainty).

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
RR 1.32 [0.54, 3.19]
1 study · 79 participants
Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Treatment failure requiring re‐intervention · adults with acute acromioclavicular dislocation of the shouldera

It is very uncertain whether surgical intervention changes treatment failure (usually requiring a subsequent operation) at 1 year compared with conservative intervention (very low certainty).

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
RR 0.99 [0.51, 1.94]
6 studies · 342 participants
Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Number of participants to return to work/sport ‐ at 1 year · adults with acute acromioclavicular dislocation of the shouldera

Surgical intervention showed no clear difference in number of participants to return to work/sport ‐ at 1 year compared with conservative intervention (low certainty).

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
RR 0.96 [0.85, 1.1]
2 studies · 137 participants
Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Health‐related quality of life (physical) · adults with acute acromioclavicular dislocation of the shouldera

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
no estimate extracted
2 studies · 122 participants
Low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Participants with adverse events at 1 year · adults with acute acromioclavicular dislocation of the shouldera

It is very uncertain whether surgical intervention changes participants with adverse events at 1 year compared with conservative intervention (very low certainty).

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
RR 2.82 [1.65, 4.82]
6 studies · 342 participants
Very low

Surgical interventions (exploration and decompression / external neurolysis, internal neurolysis, neurorrhaphy / direct repair, neuroma excision, anastomosis, autologous or allograft nerve grafting or tubulization) vs conservative interventions

Patient dissatisfaction with the cosmetic result at 1 yearh · adults with acute acromioclavicular dislocation of the shouldera

It is very uncertain whether surgical intervention changes patient dissatisfaction with the cosmetic result at 1 yearh compared with conservative intervention (very low certainty).

1 finding from 1 review

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults 2019 · Cochrane Headline outcomes only
RR 0.34 [0.07, 1.62]
1 study · 70 participants
Very low

Surgical vs conservative interventions

Function (overall) Various tools · adults (aged ≥ 16 years) with acute middle third clavicle fractures

1 finding from 1 review

Surgical versus conservative interventions for treating fractures of the middle third of the clavicle 2019 · Cochrane Headline outcomes only
no estimate extracted
10 studies · 838 participants
Low

Surgical vs conservative interventions

Pain intensity VAS (0 to 100; 0 = no pain, 100 = worst pain) · adults (aged ≥ 16 years) with acute middle third clavicle fractures

1 finding from 1 review

Surgical versus conservative interventions for treating fractures of the middle third of the clavicle 2019 · Cochrane Headline outcomes only
no estimate extracted
3 studies · 277 participants
Low

Surgical vs conservative interventions

Treatment failure (indication for non‐routine secondary surgery) · adults (aged ≥ 16 years) with acute middle third clavicle fractures

Surgical may leads to lower treatment failuref Indication for non‐routine secondary surgery compared with conservative interventions (low certainty).

1 finding from 1 review

Surgical versus conservative interventions for treating fractures of the middle third of the clavicle 2019 · Cochrane Headline outcomes only
RR 0.32 [0.2, 0.5]
12 studies · 1197 participants
Low