Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

353 questions · 368 findings · 26 reviews · Bone, Joint and Muscle Trauma

No studies found 70 · 19%GRADE not reported 19 · 5.2%Very low 166 · 45.1%Low 86 · 23.4%Moderate 20 · 5.4%High 7 · 1.9%

Retrograde intramedullary nail (RIMN) vs locking plate

Direct adverse events (reoperation): we report reoperation for removal of implant as this is the most clinically relevant. Other adverse events with data included: loss of fixation, superficial infection, deep infection, haematoma formation, impla... · adults with fractures of the distal femur

It is very uncertain whether retrograde intramedullary nail (RIMN) changes direct adverse events (reoperation): we report reoperation for… compared with locking plate (very low certainty).

1 finding from 1 review

Summary of findings. Below‐elbow vs above‐elbow cast

'Treatment failure': secondary procedures such as remanipulation for early loss of position (only data for this used here); and change in treatment ( · children with either displaced distal radius fracture with intact or displaced ulna fracture (both‐bone fracture), or minimally displaced…

It is very uncertain whether summary of findings. Below‐elbow changes 'Treatment failure': secondary procedures such as remanipulation for… compared with above‐elbow cast (very low certainty).

1 finding from 1 review

Summary of findings. Below‐elbow vs above‐elbow cast

Minor complications (less serious).j Here represented by referral for physical therapy for range of motion limitation (post‐immobilisation after 4 weeks) · children with either displaced distal radius fracture with intact or displaced ulna fracture (both‐bone fracture), or minimally displaced…

It is very uncertain whether summary of findings. Below‐elbow changes minor complications.,j,k Here represented by Referral for physical… compared with above‐elbow cast (very low certainty).

1 finding from 1 review

Summary of findings. Surgery (percutaneous wire fixation) vs not surgery (cast only)

'Treatment failure': various secondary procedures such as remanipulation for early loss of position; early or more complex wire removal ( · children with displaced distal radius fracture with intact or involved or displaced ulna fracture (both‐bone fracture)

It is very uncertain whether summary of findings. Surgery (percutaneous wire fixation) changes 'Treatment failure': various secondary procedures such as… compared with not surgery (cast only) (very low certainty).

1 finding from 1 review

Summary of findings. Surgery (percutaneous wire fixation) vs not surgery (cast only)

Minor complications (less serious).j Here represented by referral for physical therapy for range of motion limitation (post‐immobilisation after 4 weeks) · children with displaced distal radius fracture with intact or involved or displaced ulna fracture (both‐bone fracture)

It is very uncertain whether summary of findings. Surgery (percutaneous wire fixation) changes minor complications (less serious).j Here represented by referral… compared with not surgery (cast only) (very low certainty).

1 finding from 1 review

Intervention not reported

Failure: continued failure after second attempt using same procedure as before · Children with pulled elbow1

It is very uncertain whether the intervention changes failure: continued failure after second attempt using same procedure… (very low certainty).

1 finding from 1 review

Summary of findings: figure‐of‐eight bandage vs arm sling

Treatment failure (Number of participants who have undergone or are being considered for a surgical intervention) · patients (mainly young male adults) with fractures of the middle third of the clavicle

The review found no eligible studies for this question.

1 finding from 1 review

Intramedullary fixation vs open reduction and internal fixation with plate

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

Intramedullary fixation may leads to higher function or disability (overall) Various tools (Constant score and… compared with open reduction and internal fixation with plate (low certainty).

1 finding from 1 review

Intervention not reported

Need for a secondary/revision operation or substantive physiotherapy for adverse outcomes (e.g. non‐union, malunion or infection) · individuals more than 18 years old with distal tibial metaphyseal fractures

It is very uncertain whether the intervention changes need for a secondary/revision operation or substantive physiotherapy… (very low certainty).

1 finding from 1 review