Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

106 questions · 108 findings · 13 reviews · Headline outcomes only

No studies found 32 · 29.6%GRADE not reported 0 · 0%Very low 36 · 33.3%Low 27 · 25%Moderate 10 · 9.3%High 3 · 2.8%

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

Functional outcomes · Children and adolescents with femoral shaft fractures
1 finding from 1 review

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

Unacceptable malunion · Children and adolescents with femoral shaft fractures

Surgical interventions probably leads to lower unacceptable malunion Assessed by imaging compared with conservative interventions (moderate certainty).

1 finding from 1 review

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

Serious adverse events · Children and adolescents with femoral shaft fractures

Surgical interventions may leads to higher serious adverse events compared with conservative interventions (low certainty).

1 finding from 1 review

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

Time to return to usual activities⁶(time to return to school) · Children and adolescents with femoral shaft fractures
1 finding from 1 review

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

Child satisfaction Assessed by an ordinal rating scale (11 points): very unhappy to very happy · Children and adolescents with femoral shaft fractures
1 finding from 1 review

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

Parent satisfaction Rated as excellent or good · Children and adolescents with femoral shaft fractures

Surgical interventions may leads to higher parent satisfaction Rated as excellent or good compared with conservative interventions (low certainty).

1 finding from 1 review

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

Resource use and other costs · Children and adolescents with femoral shaft fractures

The review found no eligible studies for this question.

1 finding from 1 review

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 vs conservative interventions

Total of participants with adverse event outcomel · adults (aged ≥ 16 years) with acute middle third clavicle fractures

It is very uncertain whether surgical changes total of participants with adverse event outcomel compared with conservative interventions (very low certainty).

1 finding from 1 review

Surgical thrombectomy vs different types of endovascular interventions

Patency at 30 days · thrombosed haemodialysis arteriovenous fistulas and grafts

It is very uncertain whether surgical thrombectomy changes patency at 30 days compared with different types of endovascular interventions (very low certainty).

1 finding from 1 review

Surgical thrombectomy vs different types of endovascular interventions

Technical success · thrombosed haemodialysis arteriovenous fistulas and grafts

It is very uncertain whether surgical thrombectomy changes technical success compared with different types of endovascular interventions (very low certainty).

1 finding from 1 review

Surgical thrombectomy vs different types of endovascular interventions

Major adverse events · thrombosed haemodialysis arteriovenous fistulas and grafts

It is very uncertain whether surgical thrombectomy changes major adverse events compared with different types of endovascular interventions (very low certainty).

1 finding from 1 review

Surgical thrombectomy vs different types of endovascular interventions

Minor adverse events · thrombosed haemodialysis arteriovenous fistulas and grafts

It is very uncertain whether surgical thrombectomy changes minor adverse events compared with different types of endovascular interventions (very low certainty).

1 finding from 1 review