Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

16 questions · 19 findings · 3 reviews

No studies found 1 · 5.3%GRADE not reported 6 · 31.6%Very low 8 · 42.1%Low 4 · 21.1%Moderate 0 · 0%High 0 · 0%

Locking plate vs locking intramedullary nail

Self‐reported shoulder function · adults undergoing surgery for displaced proximal humeral fracturesa (2 trials)

Locking plate showed no clear difference in self‐reported shoulder function: functional scoresb(higher = better… compared with locking intramedullary nail (low certainty).

3 findings from 1 review

Locking plate vs locking intramedullary nail

Adverse events: number of participants with complications · adults undergoing surgery for displaced proximal humeral fracturesa (2 trials)

It is very uncertain whether locking plate changes adverse events: number of participants with complications compared with locking intramedullary nail (very low certainty).

1 finding from 1 review

Locking plate vs 2 mm non-locking titanium plates

Post-operative adverse events and complications (paraesthesia, swelling, segmental mobility) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Agarwal 2011: paraesthesia in one participant in the non-locking plate group (resolved by 3 months), none in the locking group; infection rates similar at 6 weeks and 3 months; post-operative swelling in 20% of both…
    1 study
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Requirement for additional (surgical) interventions · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Only Collins 2004 provided data: 6/122 participants had minor complications (three in each group); five required surgical removal of the locking plates and one post-operative malocclusion was managed with elastic…
    1 study · 122 participants
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Drop-out rate due to protocol deviation · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Early premature removal of IMF (from hours up to 2 weeks) was reported in 13 of the 90 participants analysed (Collins 2004); participants released their own IMF or reported that "the wires fell off".
    1 study · 90 participants
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Restoration of function (functional occlusion; bite force as surrogate) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Functional occlusion was achieved in all participants in both intervention groups (Agarwal 2011); the measurement of this outcome was not clearly reported. Bite force was reported as a surrogate/proxy outcome.
    1 study
    GRADE not reported

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