Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

190 questions · 198 findings · 22 reviews · Bone, Joint and Muscle Trauma

No studies found 15 · 7.6%GRADE not reported 11 · 5.6%Very low 122 · 61.6%Low 43 · 21.7%Moderate 4 · 2%High 3 · 1.5%

Intervention not reported

Treatment failure (meniscal surgery) at 5 years5,7 · Adults with acute anterior cruciate ligament (ACL) injuries (young, active individuals)

The intervention showed no clear difference in treatment failure (meniscal surgery) at 5 years5,7 (low certainty).

1 finding from 1 review

Intervention not reported

General health‐related quality of life: SF‐36 physical component score (range 0 to 100; higher score = better health state) at 2 years · Adults with acute anterior cruciate ligament (ACL) injuries (young, active individuals)
1 finding from 1 review

Intervention not reported

Return to activity or level of sport at 2 years · Adults with acute anterior cruciate ligament (ACL) injuries (young, active individuals)

The intervention showed no clear difference in return to activity or level of sport at 2 years (low certainty).

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

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

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

Intervention not reported

Patient‐reported functional outcomes (pooled data) · individuals more than 18 years old with distal tibial metaphyseal fractures

It is very uncertain whether the intervention changes patient‐reported functional outcomes (pooled data) (very 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

Intervention not reported

Symptomatic non‐union or malunion, including limping 1 year · individuals more than 18 years old with distal tibial metaphyseal fractures

It is very uncertain whether the intervention changes symptomatic non‐union or malunion, including limping 1 year (very low certainty).

1 finding from 1 review