Findings

What do systematic reviews say?

14 questions · 14 findings · 2 reviews · Bone, Joint and Muscle Trauma

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No studies found 1 · 7.1%GRADE not reported 0 · 0%Very low 4 · 28.6%Low 8 · 57.1%Moderate 1 · 7.1%High 0 · 0%

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

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
no estimate extracted
1 study · 101 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

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

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
RR 0.29 [0.15, 0.59]
4 studies · 264 participants
Moderate

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

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
RR 2.39 [1.1, 5.17]
4 studies · 264 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

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

1 finding from 1 review

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
no estimate extracted
1 study · 46 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

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

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
no estimate extracted
1 study · 101 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

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

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
RR 1.34 [1.05, 1.73]
1 study · 46 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

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

Interventions for treating femoral shaft fractures in children and adolescents 2014 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

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