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Elizabeth K Tissingh The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
King’s Global Health Partnerships, School of Life Course and Population Sciences, King’s College London, London, UK

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Leonard Marais Department of Orthopaedic Surgery, School of Clinical Medicine, University of KwaZulu-Natal, KwaZulu-Natal, South Africa

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Antonio Loro Comprehensive Rehabilitation Services for People with Disability in Uganda (CoRSU) Hospital, Kisubi, Uganda

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Deepa Bose University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Nilo T Paner Department of Orthopaedics, University of the Philippines, Philippine General Hospital Manila, The Phillipines

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Jamie Ferguson The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK
Department of Orthopaedics, University of the Philippines, Philippine General Hospital Manila, The Phillipines

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Mario Morgensten Centre for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland

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Martin McNally The Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, Oxford, UK

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Introduction and aims The global burden of fracture-related infection (FRI) is likely to be concentrated in countries with limited healthcare resources. Conditions associated with FRI (road injuries, other musculoskeletal disorders, falls and

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Abdel Rahim Elniel Leeds Teaching Hospitals Trust, UK

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Peter V. Giannoudis Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, University of Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, UK

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consideration for treatment should be guided by the individual clinical picture and established standards. Principles of management The fundamental objectives of treatment are to manage the soft-tissue injury, minimize the risk of infection, stabilize

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Luke Turley Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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Ian Barry Department of Plastic Surgery, Royal Perth Hospital, Perth, Western Australia, Australia

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Eoin Sheehan Department of Orthopaedics, Midland Regional Hospital Tullamore, Tullamore, Ireland

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tibial shaft fractures are associated with high rates of complications including malunion, non-union and infection ( 5 , 6 ). The severity of the soft tissue injury associated with open fractures has been considered significant for many years. In 1976

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Olga D. Savvidou First Department of Orthopedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece

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Frantzeska Zampeli First Department of Orthopedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece

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Panagiotis Koutsouradis Department of Orthopaedic Surgery, 417 Veterans Hospital (NIMTS), Athens, Greece

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George D. Chloros First Department of Orthopedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece

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Aggelos Kaspiris Department of Trauma and Orthopaedics, Thriasio General Hospital-NHS, Athens, Greece

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Savas Sourmelis First Department of Orthopaedics, Hygeia Hospital, Athens, Greece

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Panayiotis J. Papagelopoulos First Department of Orthopedic Surgery, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece

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. 64 Infection and wound complications The incidence of wound complications after fixation of distal humerus fractures is substantial, with significant morbidity. The elbow is at risk for serious wound complications after surgery because of

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Maria Anna Smolle Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Sandra Bösmüller AUVA Trauma Centre Vienna Meidling, Vienna, Austria

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Paul Puchwein Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Martin Ornig Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Andreas Leithner Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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Franz-Josef Seibert Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria

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-union, while post-operative infections and iatrogenic radial nerve palsy (iRNP) do naturally occur following surgical therapy. As complication profiles are known to differ between conservative and surgical therapy, operative techniques, and implant types, but

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Andreas Frodl Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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Johannes Hauss Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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Andreas Fuchs Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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Markus Siegel Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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Hagen Schmal Department of Orthopedic Surgery, University Hospital Odense, Odense, Denmark

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Jan Kühle Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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of non-union, delayed union and wound infections there is no consensus concerning the treatment of distal femoral fractures. We carried out a meta-analysis to validate our hypothesis, that RIMN is superior to plate fixation for lowering the risk of

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Duy Nguyen Anh Tran The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Bao Tu Thai Nguyen The International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Tan Thanh Nguyen Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam

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Yu-Pin Chen Department of Orthopedics, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan
Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

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Yi-Jie Kuo Department of Orthopedics, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan
Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

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impact on mental health ( 4 , 5 , 6 , 7 , 8 ). Smoking is associated with impaired wound healing and increased susceptibility to surgical site infections (SSIs) ( 9 , 10 , 11 ). SSIs, occurring in 1–20% of patients after ankle and calcaneal

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J Tomás Rojas Shoulder, Elbow and Orthopaedic Sports Medicine, Orthopädie Sonnenhof, Bern, Switzerland
Department of Orthopaedics and Trauma Surgery, Hospital San José – Clínica Santa María, Santiago, Chile

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Mustafa S Rashid Department of Trauma & Orthopaedic Surgery, Wrightington Hospital, Wigan, United Kingdom

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Matthias A Zumstein Shoulder, Elbow and Orthopaedic Sports Medicine, Orthopädie Sonnenhof, Bern, Switzerland
Shoulder, Elbow Unit, Sportsclinicnumber1, Bern, Switzerland
Shoulder, Elbow and Orthopaedic Sports Medicine, Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Bern, Switzerland
Campus Stiftung Lindenhof Bern, Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland

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mechanical effect ( 12 ). Screw penetration due to malposition or secondary collapse may lead to secondary damage of the joint and stiffness ( 13 ). Stiffness due to infection Infection should always be considered. Low-grade infections can be hard to

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Andreas Frodl Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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Benjamin Erdle Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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Hagen Schmal Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany
University Hospital Odense, Dep. Of Orthopedic Surgery, Sdr. Boulevard 29, 5000 Odense C, Denmark

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demographics, number of patients, malunion rate, malrotation, number of postoperative nonunions, follow-up period and surgical technique, as well as duration of surgery and number of infections were extracted by the authors ( Table 1 ). According to the studies

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Maria Tennyson Department of Trauma & Orthopaedic Surgery, Cambridge University Hospital, Cambridge, UK

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Matija Krkovic Department of Trauma & Orthopaedic Surgery, Cambridge University Hospital, Cambridge, UK

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Mary Fortune The Department of Public Health & Primary Care, Strangeways Research Laboratory, Cambridge, UK

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Ali Abdulkarim Department of Trauma & Orthopaedic Surgery, Cambridge University Hospital, Cambridge, UK

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, pain, infection. Study selection Management of the search results was carried out in Covidence Systematic Review Software ( www.covidence.org ). Two reviewers (MT and AA) worked independently and in duplicate, screened all titles and abstracts

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