Type

Description

Type I

A mild injury involving spraining the acromioclavicular ligaments while leaving the joint intact.

Type II

Injury where the acromioclavicular ligaments are torn and acromioclavicular joint is disrupted, while the coracoclavicular ligaments are intact.

Type III

Injury involves complete tearing of both the acromioclavicular and coracoclavicular ligaments with 100% dislocation of the joint.

Type IV

Injury is a complete acromioclavicular dislocation with posterior displacement of the clavicle through or into the trapezius fascia

Type V

Injury is a complete acromioclavicular dislocation with 100% to 300% superior dislocation of the clavicle. It can involve significant disruption of the deltotrapezial fascia.

Type VI

Injury involves inferior displacement of the clavicle into a subacromial or subcoracoid position.

Items

Scores

Notes

(1) Was the assigned treatment adequately concealed prior to allocation?

Yes = method did not allow disclosure of assignment.
Unclear = small but possible chance of disclosure of assignment or unclear.
No = quasi‐randomised, or open list or tables.

Cochrane code (see Handbook): Clearly yes = A; Not sure = B; Clearly no = C.

(2) Were the outcomes of participants who withdrew described and included in the analysis (intention‐to‐treat)?

Yes = withdrawals well described and accounted for in analysis.
Unclear = withdrawals described and analysis not possible, or probably no withdrawals.
No = no mention, inadequate mention, or obvious differences and no adjustment.

(3) Were the outcome assessors blinded to treatment status?

Yes = effective action taken to blind assessors.
Unclear = small or moderate chance of unblinding of assessors, or some blinding of outcomes attempted.
No = not mentioned or not possible.

(4) Were important baseline characteristics reported and comparable?

Yes = good comparability of groups, or confounding adjusted for in analysis.
Unclear = confounding small, mentioned but not adjusted for, or comparability reported in text without confirmatory data.
No = large potential for confounding, or not discussed.

Although many characteristics including hand dominance are important, the principal confounders are considered to be age, gender, type of lesion (dislocation or subluxation).

(5) Were the trial participants blind to assignment status after allocation?

Yes = effective action taken to blind participants.
Unclear = small or moderate chance of unblinding of participants.
No = not possible, or not mentioned (unless double‐blind), or possible but not done.

(6) Were the treatment providers blind to assignment status?

Yes = effective action taken to blind treatment providers.
Unclear = small or moderate chance of unblinding of treatment providers.
No = not possible, or not mentioned (unless double‐blind), or possible but not done.

(7) Were care programmes, other than the trial options, identical?

Yes = care programmes clearly identical.
Unclear = clear but trivial differences, or some evidence of comparability.
No = not mentioned or clear and important differences in care programmes.

Examples of clinically important differences in other interventions are: time of intervention, duration of intervention, difference in rehabilitation.

(8) Were the inclusion and exclusion criteria for entry clearly defined?

Yes = clearly defined (including type of fracture).
Unclear = inadequately defined.
No = not defined.

(9) Were the outcome measures used clearly defined?

Yes = clearly defined.
Unclear = inadequately defined.
No = not defined.

(10) Were the accuracy and precision, with consideration of observer variation, of the outcome measures adequate; and were these clinically useful and did they include active follow up?

Yes = optimal.
Unclear = adequate.
No = not defined, not adequate.

(11) Was the timing (e.g. duration of surveillance) clinically appropriate?

Yes = optimal (> 1 year)
Unclear = adequate (6 months ‐ 1 year)
No = not defined, not adequate (< 6 months)