Comparison 8. Percutaneous wire fixation and above‐elbow cast versus above‐elbow cast alone for displaced fractures.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 ABILHAND‐Kids score (0 to 42: no problems) at 6 months	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
2 Complications and secondary treatment			Other data	No numeric data
2.1 Complications			Other data	No numeric data
2.2 Secondary treatment			Other data	No numeric data
3 Overall treatment failure and adverse events	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
3.1 Overall complications (includes redisplacement)	4	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.53 [0.37, 0.74]
3.2 Overall complications (any redisplacement / malunion had to be treated)	4	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.68 [0.45, 1.02]
3.3 Treament failure (secondary procedures: early wire removal, rereduction etc)	4	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.52 [0.33, 0.83]
4 Fracture redisplacement and rereduction	5		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
4.1 Redisplaced fracture	5	323	Risk Ratio (M‐H, Fixed, 95% CI)	0.11 [0.05, 0.23]
4.2 Remanipulation (and secondary procedure for loss of position)	4	253	Risk Ratio (M‐H, Fixed, 95% CI)	0.06 [0.02, 0.22]
5 Complications (not redisplacement or re‐manipulation)	4		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
5.1 Failed reduction	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	0.37 [0.02, 8.55]
5.2 Failed insertion of wire	1	128	Risk Ratio (M‐H, Fixed, 95% CI)	3.29 [0.14, 79.28]
5.3 Pain resulting from wire	1	68	Risk Ratio (M‐H, Fixed, 95% CI)	2.83 [0.12, 67.19]
5.4 Pin site or superficial infection	2	162	Risk Ratio (M‐H, Fixed, 95% CI)	5.54 [0.67, 45.89]
5.5 Pin migration (wires removed)	2	102	Risk Ratio (M‐H, Fixed, 95% CI)	4.15 [0.49, 35.21]
5.6 Operation to remove subcutaneous wires	1	128	Risk Ratio (M‐H, Fixed, 95% CI)	16.45 [0.96, 282.13]
5.7 Nerve damage or irritation	3	185	Risk Ratio (M‐H, Fixed, 95% CI)	1.11 [0.16, 7.60]
5.8 Tendon irritation	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	3.35 [0.15, 76.93]
5.9 Compartment syndrome	1	34	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.10 Non‐union	2	57	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.11 Malunion	3	125	Risk Ratio (M‐H, Fixed, 95% CI)	0.17 [0.03, 0.93]
5.12 Prominent scar at K‐wire insertion site	2	91	Risk Ratio (M‐H, Fixed, 95% CI)	3.74 [0.44, 32.03]
5.13 Early physeal closure	2	57	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
5.14 Referral for physical therapy for range of motion limitation	1	128	Risk Ratio (M‐H, Fixed, 95% CI)	0.65 [0.44, 0.97]
5.15 Refracture	1	128	Risk Ratio (M‐H, Fixed, 95% CI)	7.68 [0.40, 145.68]
6 Cosmetic appearance at 6 months: VAS (0 to 10: same as non‐fractured arm)	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
6.1 Rated by parents	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
6.2 Rated by orthopaedic surgeon	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Range of motion limitations at 6 months (degrees)	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
7.1 Limitation of wrist flexion‐extension	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Limitation of elbow flexion‐extension	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 Limitation of pronation and supination	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 Restricted pronation and supination at 6 months	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected
8.1 Limitation > 31 degrees	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8.2 Limitation >/= 30 degrees	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
9 Days in cast and physiotherapy visits	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
9.1 Days in cast	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
9.2 Visits to physiotherapy	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]