Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

43 questions · 45 findings · 7 reviews · Bone, Joint and Muscle Trauma

No studies found 3 · 6.7%GRADE not reported 0 · 0%Very low 16 · 35.6%Low 21 · 46.7%Moderate 2 · 4.4%High 3 · 6.7%

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 non‐surgical treatment

Subsequent requirement for surgery (re‐operations) for complications Incidence · people with lateral patellar dislocation

It is very uncertain whether surgical changes subsequent requirement for surgery (reoperations) for complicationsa… compared with non‐surgical treatment (very 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 vs non‐surgical treatment

Number of participants sustaining recurrent patellar dislocation · people with lateral patellar dislocation

It is very uncertain whether surgical changes number of participants sustaining recurrent patellar dislocationa compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Kujala patellofemoral disorders score Scale from: 0 to 100 (higher scores = better function) · people with lateral patellar dislocation

It is very uncertain whether surgical changes knee and physical functiona Measured using the Kujala patellofemoral… compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Adverse effects of treatment Overall incidence of complications · people with lateral patellar dislocation

It is very uncertain whether surgical changes adverse effects of treatment Overall incidence of complications compared with non‐surgical treatment (very low certainty).

1 finding from 1 review

Surgical vs non‐surgical treatment

Patient‐reported knee instabilitya Incidence of patellar subluxation · people with lateral patellar dislocation

It is very uncertain whether surgical changes patient‐reported knee instabilitya Incidence of patellar subluxation compared with non‐surgical treatment (very low certainty).

1 finding from 1 review