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Enrique Gómez-Barrena Servicio de Cirugía Ortopédica y Traumatología, Hospital La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain

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Norma G. Padilla-Eguiluz Servicio de Cirugía Ortopédica y Traumatología, Hospital La Paz-IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain

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Philippe Rosset Service de Chirurgie Orthopédique et Traumatologie, CHU Tours, Université de Tours, Tours, France

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Introduction Non-union or pseudarthrosis represents the inability of bone to heal after a fracture. Although this is a general definition that is well accepted by most orthopaedic trauma surgeons, it is not a simple concept. The absence of

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Enrique Gómez-Barrena Department of Orthopaedic Surgery and Traumatology, Hospital La Paz-IdiPaz, Universidad Autónoma de Madrid, Madrid, Spain

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Christian Ehrnthaller Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Germany

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Introduction: non-union definition and epidemiology Delayed union and non-union fractures are well-defined medical conditions that represent the inability of bone to heal without further intervention, which is usually identified based on

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Wout Füssenich Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

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Gesine H Seeber Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany

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Julian R Zwoferink Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

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Matthijs P Somford Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands

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Martin Stevens Department of Orthopedic Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

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-reported outcomes and a relatively low risk of complications ( 7 , 8 , 9 ). However, non-union after first MTPJ arthrodesis is one of the most common complications, with an incidence range of 0–24% ( 10 , 11 , 12 , 13 , 14 ). The reported incidence of non-union

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Paul L Rodham Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland

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Vasileios P Giannoudis Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland

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Nikolaos K Kanakaris Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland
Department of Trauma & Orthopaedics, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland

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Peter V Giannoudis Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Leeds, United Kingdom of Great Britain and Northern Ireland

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and healing in high-risk fractures such as peri-prosthetic femoral fractures, or in improving the biological activity of an atrophic non-union ( 4 , 5 , 6 , 7 ). Irrespective of the aim, successful healing with bone grafts can be considered using

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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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open reduction and internal fixation (ORIF) or minimally invasive plate osteosynthesis (MIPO), and retrograde and antegrade intramedullary nailing (IM) ( 6 , 8 , 9 ). Complications of both conservative and operative treatment approaches are non-union

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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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Giuseppe Toro Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy.
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.

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Antimo Moretti Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy.

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Marco Paoletta Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy.

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Annalisa De Cicco Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy.

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Adriano Braile Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy.

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Alfredo Schiavone Panni Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy.

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. 35. Giannoudis PV Ahmad MA Mineo GV Tosounidis TI Calori GM Kanakaris NK . Subtrochanteric fracture non-unions with implant failure managed with the “Diamond” concept . Injury . 2013 ; 44 : S

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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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Karl Stoffel Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland

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Christoph Sommer Department of Surgery, Kantonsspital Graubuenden, Chur, Switzerland

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Mark Lee Department of Orthopaedic Surgery, UC Davis Medical Center, Sacramento, California, USA

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Tracy Y Zhu AO Innovation Translation Center, AO Foundation, Davos, Switzerland

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Karsten Schwieger AO Innovation Translation Center, AO Foundation, Davos, Switzerland

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Christopher Finkemeier Sutter Roseville Medical Center, Roseville, California, USA

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over 60 years old ( 3 ). Retrograde intramedullary nail (rIMN) and lateral locking compression plate (LCP) are common surgical treatments for distal femoral fractures. Healing difficulties following locking plate are not uncommon. Rates of non-union are

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Michael Millrose Department of Trauma Surgery and Sports Medicine, Garmisch-Partenkirchen Medical Center, Garmisch-Partenkirchen, Germany
Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany

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Markus Gesslein Department of Orthopaedics and Traumatology, Paracelsus Medical University, Nuremberg, Germany

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Till Ittermann Institute for Community Medicine, SHIP/Clinical-Epidemiological Research, University of Greifswald, Greifswald, Germany

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Simon Kim Department of Trauma and Orthopedic Surgery, University Medicine Greifswald, Greifswald, Germany

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Hans-Christoph Vonderlind Department of Trauma Surgery, Helios Kliniken Schwerin, Schwerin, Germany

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Mike Ruettermann Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Institute for Hand- and Plastic Surgery, Oldenburg, Germany

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indication in the current literature as to which technique shows the most promising results in terms of union. Typical major complications of PIP joint arthrodesis are non-union and mal-union; minor complications are superficial infections ( 61 ). The aim

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