Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,268 questions · 1,343 findings · 197 reviews

No studies found 317 · 23.6%GRADE not reported 189 · 14.1%Very low 356 · 26.5%Low 271 · 20.2%Moderate 173 · 12.9%High 37 · 2.8%

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

Intramedullary fixation vs open reduction and internal fixation with plate

Pain ‐ using the section of Constant score Scale from 0 to 15; with 15 being the best positive score · adults (aged ≥ 16 years) with acute middle third clavicle fractures

It is very uncertain whether intramedullary fixation changes pain ‐ using the section of Constant score Scale from 0 to 15; with… compared with open reduction and internal fixation with plate (very low certainty).

1 finding from 1 review

Intramedullary fixation vs open reduction and internal fixation with plate

Treatment failure (participants who have a non‐routine secondary surgical intervention) ‐ Overall treatment failure · adults (aged ≥ 16 years) with acute middle third clavicle fractures

It is very uncertain whether intramedullary fixation changes treatment failure (participants who have a non‐routine secondary… compared with open reduction and internal fixation with plate (very low certainty).

1 finding from 1 review

Intramedullary fixation vs open reduction and internal fixation with plate

Clinical healing ‐ time to clinical/radiographic fracture consolidation (weeks) · adults (aged ≥ 16 years) with acute middle third clavicle fractures

It is very uncertain whether intramedullary fixation changes clinical healing ‐ time to clinical/radiographic fracture… compared with open reduction and internal fixation with plate (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

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

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

Return to activity · adults with tibial plateau fracture (Schatzker types V or VI)

It is very uncertain whether circular external fixation with limited internal fixation (hybrid… changes return to pre‐injury activity level compared with standard open reduction internal fixation (very low certainty).

1 finding from 1 review

Closed kinetic chain exercises vs open kinetic chain exercises

Pain during activity (short‐term) · patients with patellofemoral pain syndrome (symptoms > 4 weeks (1 study); symptoms > 6 weeks (1 study); symptoms > 8 weeks (1 study); not…

It is very uncertain whether closed kinetic chain exercises changes pain during activity (short‐term) VAS (0 to 10; higher scores mean… compared with open kinetic chain exercises (very low certainty).

1 finding from 1 review

Closed kinetic chain exercises vs open kinetic chain exercises

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · patients with patellofemoral pain syndrome (symptoms > 4 weeks (1 study); symptoms > 6 weeks (1 study); symptoms > 8 weeks (1 study); not…

It is very uncertain whether closed kinetic chain exercises changes usual pain (short‐term) VAS (0 to 10; higher scores mean worse pain) compared with open kinetic chain exercises (very low certainty).

2 findings from 1 review

Closed kinetic chain exercises vs open kinetic chain exercises

Pain during activity (long‐term) VAS (0 to 10; higher scores mean worse pain) · patients with patellofemoral pain syndrome (symptoms > 4 weeks (1 study); symptoms > 6 weeks (1 study); symptoms > 8 weeks (1 study); not…

It is very uncertain whether closed kinetic chain exercises changes pain during activity (long‐term) VAS (0 to 10; higher scores mean… compared with open kinetic chain exercises (very low certainty).

1 finding from 1 review