Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

12 questions · 12 findings · 8 reviews · Bone, Joint and Muscle Trauma

No studies found 0 · 0%GRADE not reported 3 · 25%Very low 7 · 58.3%Low 2 · 16.7%Moderate 0 · 0%High 0 · 0%

Surgical vs non‐surgical treatment

Adverse events / complications ‐ Number of participants with complications · (mainly older) adults with most types of displaced proximal humeral fracturesa (10 trials)

Surgical showed no clear difference in adverse events / complications ‐ Number of participants with… compared with non‐surgical treatment (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

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 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

Circular external fixation with limited internal fixation (hybrid fixation) vs standard open reduction internal fixation

Adverse eventse · adults with tibial plateau fracture (Schatzker types V or VI)

It is very uncertain whether circular external fixation with limited internal fixation (hybrid… changes adverse eventse compared with standard open reduction internal fixation (very low certainty).

1 finding from 1 review

Intramedullary fixation vs open reduction and internal fixation with plate

Adverse events ‐ total of adverse events (various: mainly infection; cosmetic result ‐ e.g. prominent metalwork ‐ and symptomatic hardware) · adults (aged ≥ 16 years) with acute middle third clavicle fractures

It is very uncertain whether intramedullary fixation changes adverse events ‐ total of adverse events (various: mainly infection;… compared with open reduction and internal fixation with plate (very low certainty).

1 finding from 1 review