Date	Event	Description
6 May 2009	New search has been performed	In this issue (Issue 3, 2009) the search for trials was updated to December 2008. One new trial evaluating conservative treatment options was identified and included. Outcomes were grouped into primary and secondary outcomes. Risk of bias was assessed. There were changes to the conclusions of the review.
6 May 2009	New citation required and conclusions have changed	Some changes were made to the conclusions as a result of the addition of evidence from a newly included trial.
12 January 2009	New search has been performed	Substantive changes made (January 2009) for Issue 3, 2009 1. Literature search extended to December 2008. 2. Addition of new included conservative treatment trial. 3. Restructuring of outcomes into primary and secondary outcomes 4. Risk of bias implemented.
5 August 2008	Amended	Converted to new review format.
3 October 2006	New search has been performed	In Issue 1, 2007, the search for trials was updated to September 2006. No new trials or associated data were identified. The 'Synopsis' was amended to a 'Plain language summary'. The 'Objectives' were reworded but remained as before. Methodological quality scores of individual criteria were no longer summed. There was no change to the conclusions of the review. For details of all updates, please see 'Published notes'.
2 October 2006	New search has been performed	Non substantive changes made (October 2006) for Issue 1, 2007 1. Literature search extended to September 2006. 2. Synopsis modified to a Plain language summary. 3. Objectives were reworded. 4. Overall methodological quality scores removed.
10 January 2005	New search has been performed	Non substantive changes made (January 2005) for Issue 2, 2005. 1. Literature search extended to January 2005. 2. Correspondence on one trial added and some other changes made to conform to Cochrane Style Guide.
5 January 2004	New search has been performed	Substantive changes made (January 2004) for Issue 2, 2004 1. Literature search extended to December 2003. 2. Addition of new included surgical trial evaluating two types of plates.
11 November 2002	New search has been performed	Non substantive changes made (November 2002) for Issue 2, 2003. 1. Literature search extended to November 2002. 2. Three more excluded studies.
5 November 2001	New search has been performed	Non substantive changes made (November 2001) for Issue 2, 2002. 1. Literature search extended to November 2001. 2. Some epidemiological information was added.
11 December 2000	New search has been performed	Non substantive changes made (December 2000) for Issue 2, 2001. 1. Literature search extended to December 2000. 2. One more excluded study. 3. Active follow‐up rated in methodological quality. 4. Relative risks presented instead of Peto odds ratios. 5. Some comments made on a recently published systematic review.
3 January 2000	New search has been performed	Non substantive changes made (January 2000) for Issue 2, 2000. 1. Literature search extended to August 1999. 2. Synopsis added. 3. One more excluded study. 4. Scores for individual items of the methodological quality assessment scheme changed from 3,2,1 to 2,1,0.