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What do systematic reviews say?

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Evidence found and GRADE certainty

1,935 questions · 1,986 findings · 260 reviews · Headline outcomes only

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No studies found 503 · 25.3%GRADE not reported 76 · 3.8%Very low 593 · 29.9%Low 509 · 25.6%Moderate 241 · 12.1%High 64 · 3.2%

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

Physical function · children with either displaced distal radius fracture with intact or displaced ulna fracture (both‐bone fracture), or minimally displaced…

The review found no eligible studies for this question.

2 findings 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)

Physical function · children with displaced distal radius fracture with intact or involved or displaced ulna fracture (both‐bone fracture)

The review found no eligible studies for this question.

2 findings 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)

Serious adverse events (typically more serious complications) ( · 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 serious adverse events (typically more serious complications) ( 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