5. Different forms of surgical interventions: effects of critical and other important outcomes for other comparison groups.
| Lateral crossed (Dorgan) wires versus retrograde crossed wires | ||
| Outcome | Studies | Effect estimate |
| Nerve injury | Altay 2011; Ducic 2016a; Kalia 2018; Othman 2017; Rizk 2019 | RR 0.26, 95% CI 0.09 to 0.76, favours Dorgan wires; I2 = 0%; 5 studies, 307 participants; Analysis 2.1 |
| Major complications: all complications | Altay 2011; Ducic 2016a; Kalia 2018; Othman 2017; Rizk 2019 | RR 1.94, 95% CI 0.88 to 4.30, favours retrograde crossed wires; I2 = 0%; 5 studies, 307 participants; Analysis 2.2 |
| Major complications: pin site infection | Altay 2011; Ducic 2016a; Kalia 2018; Othman 2017; Rizk 2019 | RR 2.51, 95% CI 0.92 to 6.82, favours retrograde crossed wires; I2 = 0%; 5 studies, 307 participants; Analysis 2.2 |
| Major complications: vascular injuries | Ducic 2016a | RR 1.06, 95% CI 0.28 to 4.07, favours retrograde crossed wires; 1 study, 138 participants; Analysis 2.2 |
| Cosmetic deformity: loss of carrying angle > 10° (long term) | Ducic 2016a; Othman 2017; Rizk 2019 | RR 1.35, 95% CI 0.37 to 4.85, favours retrograde crossed wires; I2 = 0%; 3 studies, 218 participants; Analysis 2.3 |
| Cosmetic deformity: loss of carrying angle (degrees of loss) | Rizk 2019 | MD 0.30°, 95% CI ‐2.20° to 2.80°, favours retrograde crossed wires; 1 study, 50 participants; Analysis 2.4 |
| Range of motion: loss of total range of motion > 10° (long term) | Ducic 2016a; Othman 2017; Rizk 2019 | RR 1.14, 95% CI 0.08 to 16.63, favours retrograde crossed wires; I2 = 0%; 3 studies, 218 participants; Analysis 2.5 |
| Radiographic deformity: loss of Baumann's angle (long term) | Othman 2017; Rizk 2019 | MD 0.04°, 95% CI ‐0.01° to 0.09°, favours retrograde crossed wires; 2 studies, 80 participants; Analysis 2.6 |
| Radiographic deformity: loss of lateral humeral‐capitellar angle (long term) | Othman 2017; Rizk 2019 | MD 0.08°, 95% CI 0.00° to 0.16°, favours retrograde crossed wires; I2 = 0%; 2 studies, 80 participants; Analysis 2.6 This difference is unlikely to be clinically important. |
| Resource use (operative time; minutes) | Ducic 2016a | MD 7.88, 95% CI 6.27 to 9.49; favours retrograde crossed wires; 1 study, 138 participants; Analysis 2.7 |
| Resource use (radiographic exposure time; minutes) | Ducic 2016a | MD 2.65, 95% CI 1.90 to 3.40, favours retrograde crossed wires; 1 study, 138 participants; Analysis 2.7 |
| Lateral crossed (Dorgan) wires versus retrograde lateral wires | ||
| Outcome | Studies | Effect estimate |
| Nerve injury | Othman 2017; Sadek 2018 | RR 1.07, 95% CI 0.07 to 15.54, favours retrograde lateral wires; I2 = 0%; 2 studies, 69 participants; Analysis 3.1 |
| Major complications: pin site infections | Othman 2017; Sadek 2018 | RR 2.06, 95% CI 0.56 to 7.56, favours retrograde lateral wires; I2 = 0%; 2 studies, 69 participants; Analysis 3.2 |
| Cosmetic deformity: loss of carrying angle > 10° (long‐term) | Othman 2017; Sadek 2018 | RR 0.68, 95% CI 0.21 to 2.15, favours Dorgan wires; I2 = 0%; 2 studies, 69 participants; Analysis 3.3 |
| Range of motion: loss of total range of motion > 10° (long term) | Othman 2017; Sadek 2018 | RR 0.72, 95% CI 0.26 to 2.00, favours Dorgan wires; I2 = 0%; 2 studies, 69 participants; Analysis 3.4 |
| Radiographic deformity: degrees of loss of Baumann's angle (long term) | Othman 2017 | MD ‐0.02°, 95% CI ‐0.08° to 0.04°, favours Dorgan wires; 1 study, 29 participants; Analysis 3.5 |
| Radiographic deformity: degrees of loss of lateral humeral‐capitellar angle ‐ long term | Othman 2017 | MD 0.07°, 95% CI ‐0.01° to 0.15°, favours Dorgan wires; 1 study, 29 participants; Analysis 3.6 |
| Posterior intrafocal wire versus retrograde crossed wires | ||
| Outcome | Studies | Effect estimate |
| Nerve injury | Jain 2019 | RR 0.33, 95% CI 0.07 to 1.60, favours intrafocal; 1 study, 168 participants; Analysis 4.1 |
| Major complications: pin site infections | Jain 2019 | RR 0.71, 95% CI 0.24 to 2.16, favours intrafocal; 1 study, 168 participants; Analysis 4.2 |
| Cosmetic deformity: loss of carrying angle (long term) | Jain 2019 | RR 1.88, 95% CI 0.84 to 4.19, favours retrograde crossed wires; 1 study, 168 participants; Analysis 4.3 |
| Cosmetic deformity: cubitus varus | Jain 2019 | RR 1.25, 95% CI 0.35 to 4.49, favours retrograde crossed wires; 1 study, 168 participants; Analysis 4.3 |
| Range of motion: loss of total range of motion > 10° (long term) | Jain 2019 | RR 1.33, 95% CI 0.73 to 2.42, favours retrograde crossed wires; 1 study, 168 participants; Analysis 4.4 |
| Radiographic deformity: loss of reduction (long term) | Jain 2019 | RR 1.79, 95% CI 1.28 to 2.52, favours retrograde crossed wires; 1 study, 168 participants; Analysis 4.5 |
| Retrograde lateral wires in a parallel versus divergent configuration | ||
| Outcome | Studies | Effect estimate |
| Nerve injury | Gopinathan 2018; Shamma 2020 | Not estimable (no events in either group) |
| Major complications: compartment syndrome | Gopinathan 2018 | RR 1.80, 95% CI 0.08 to 40.75, favours divergent wires; 1 study, 30 participants; Analysis 5.1 |
| Range of movement: loss of movement (medium term) | Shamma 2020 | MD ‐0.10, 95% CI ‐1.32 to 1.12, favours parallel wires; 1 study, 30 participants; Analysis 5.2 |
| Range of movement: loss of extension (medium term) | Shamma 2020 | MD 0.40, 95% CI ‐0.42 to 1.22, favours divergent wires; 1 study, 30 participants; Analysis 5.2 |
| Cosmetic deformity: loss of carrying angle > 10° (medium term) | Gopinathan 2018; Shamma 2020 | Not estimable (no events in either group) |
| Cosmetic deformity: degrees of loss of carrying angle (medium term) | Gopinathan 2018; Shamma 2020 | MD 0.02°, 95% CI ‐0.65° to 0.69°, favours divergent wires; 2 studies, 60 participants; Analysis 5.3 |
| Range of motion: loss of flexion (medium term) | Gopinathan 2018; Shamma 2020 | RR 0.87, 95% CI 0.17 to 4.42, favours parallel wires; 2 studies, 60 participants; Analysis 5.4 |
| Range of motion: loss of extension (medium term) | Gopinathan 2018; Shamma 2020 | RR 3.00, 95% CI 0.16 to 57.36, favours divergent wires; 2 studies, 60 participants; Analysis 5.4 |
| Radiographic deformity: degrees of loss of Baumann's angle (medium term) | Gopinathan 2018; Shamma 2020 | MD 0.87°, 95% CI ‐0.00° to 1.75°, favours divergent wires; 2 studies, 60 participants; Analysis 5.5 This difference is unlikely to be clinically important. |
| Mini‐open crossed wires versus percutaneous crossed wires | ||
| Outcome | Studies | Effect estimate |
| Nerve injury | Ercin 2016 | RR 2.05, 95% CI 0.48 to 8.69, favours percutaneous wires; 1 study, 104 participants; Analysis 6.1 |
| Major complications: pin site infections | Ercin 2016 | RR 1.02, 95% CI 0.18 to 5.87, favours percutaneous wires; 1 study, 104 participants; Analysis 6.2 |
| Resource use (length of hospital stay; days) | Ercin 2016 | MD 0.28, 95% CI ‐0.19 to 0.75, favours percutaneous wires; 1 study, 104 participants; Analysis 6.3 |
| Resource use (anaesthesia time) | Ercin 2016 | MD ‐5.85, 95% CI ‐12.82 to 1.12, favours mini‐open wires; 1 study, 104 participants; Analysis 6.3 |
| Buried versus non‐buried wires | ||
| Outcome | Studies | Effect estimate |
| Major complications: pin site infections | Saeed 2020 | RR 0.13, 95% CI 0.02 to 0.95, favours buried wires; 1 study, 80 participants; Analysis 7.1 |
CI: confidence interval; MD: mean difference; RR: risk ratio