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Alexei Buruian Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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Francisco Silva Gomes Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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Tiago Roseiro Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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Claudia Vale Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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André Carvalho Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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Emanuel Seiça Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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Antonio Mendes Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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Carlos Pereira Hospital Distrital da Figueira da Foz, Figueira Da Foz, Portugal

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nails. For unstable trochanteric fractures, intramedullary nailing appears to provide better results compared with extramedullary devices. 8 – 11 As for stable intertrochanteric fractures, there is still debate about the superiority of

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Hua Luo Fengxian District Central Hospital Graduate Student Training Base, Jinzhou Medical University, Shanghai, China
Department of Orthopaedics, Fengxian District Central Hospital, Shanghai, China

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Yongwei Su The First Affiliated Hospital of Jinzhou Medical University, Graduate Student Training Base, Jinzhou Medical University, Jinzhou, China

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Liang Ding Department of Orthopaedics, Fengxian District Central Hospital, Shanghai, China

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Haijun Xiao Department of Orthopaedics, Fengxian District Central Hospital, Shanghai, China

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Ming Wu Department of Orthopaedics, Fengxian District Central Hospital, Shanghai, China

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Feng Xue Fengxian District Central Hospital Graduate Student Training Base, Jinzhou Medical University, Shanghai, China
Department of Orthopaedics, Fengxian District Central Hospital, Shanghai, China

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Introduction Intramedullary nailing (IMN) has been a standard for treating acute adult femur shaft fracture for decades. It is known that the nonunion or delayed union rate after IM nailing for acute femoral shaft fractures is less than 2

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Elisa Pala Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Alberto Procura Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Giulia Trovarelli Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Antonio Berizzi Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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Pietro Ruggieri Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

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reconstruction. Another treatment option for long bone metastases is intramedullary (IM) nailing. Unfortunately, it is indicated in treating old patients with poor prognosis, multiple metastases, unfavorable histotype, and short disease-free interval. Thus, it is

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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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for 8.7% making these a significant clinical problem. 1 In recent years, closed reduction with minimally invasive plating and locked intramedullary nailing have both become widely used treatment modalities for proximal and distal tibial

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Arjun Sivakumar Centre for Orthopaedic & Trauma Research, University of Adelaide, Adelaide, South Australia, Australia

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Suzanne Edwards Adelaide Health Technology Assessment, University of Adelaide, Adelaide, South Australia, Australia

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Stuart Millar Centre for Orthopaedic & Trauma Research, University of Adelaide, Adelaide, South Australia, Australia

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Dominic Thewlis Centre for Orthopaedic & Trauma Research, University of Adelaide, Adelaide, South Australia, Australia

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Mark Rickman Centre for Orthopaedic & Trauma Research, University of Adelaide, Adelaide, South Australia, Australia
Department of Orthopaedics & Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia

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). Intertrochanteric fractures (ITF), accounting for approximately half of all hip fractures ( 3 ), are treated using intramedullary femoral nails with increasing frequency ( 4 , 5 , 6 ). While the principles of ITF stabilization via femoral nailing remain consistent

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Victor Lu School of Clinical Medicine, University of Cambridge, Cambridge, UK

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Maria Tennyson Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK

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Andrew Zhou School of Clinical Medicine, University of Cambridge, Cambridge, UK

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Ravi Patel Department of Trauma and Orthopaedics, Shrewsbury and Telford Hospital NHS Trust, UK

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Mary D Fortune Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

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Azeem Thahir Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK

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Matija Krkovic Department of Trauma and Orthopaedics, Addenbrooke’s Hospital, Cambridge, UK

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patient. Tibiotalocalcaneal (TTC) nailing is a viable alternative to ORIF. This involves the insertion of an intramedullary nail through the plantar surface of the calcaneus, subtalar, and tibiotalar joints into the tibial canal. Advantages include its

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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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publications have highlighted that the strength of the Gustilo–Anderson classification is the association between its grades and the incidence of the complications previously described ( 10 , 11 , 12 ). For many years, intramedullary nailing (IMN) has been

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Mario Herrera-Pérez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Pablo Martín-Vélez Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain

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David González-Martín Foot and Ankle Unit, Orthopaedic Department, Hospital Universitario de Canarias, Tenerife, Spain
School of Medicine, Universidad de La Laguna, Tenerife, Spain

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Miguel Domínguez-Meléndez Foot and Ankle Unit, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain

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Ahmed E Galhoum Specialty Doctor Trauma and Orthopaedics, George Eliot Hospital NHS Trust, Nuneaton, UK

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Victor Valderrabano Schmerzklinik, Basel, Switzerland
University of Basel, Basel, Switzerland

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Sergio Tejero Foot and Ankle Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
School of Medicine, Universidad de Sevilla, Sevilla, Spain

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and internal fixation (ORIF) is associated with a high rate of complications ( 1 , 2 , 3 , 4 ). Acute tibiotalocalcaneal (TTC) nailing has been used to treat osteoporotic ankle fractures with good results since 2005 ( 1 , 2 , 3 , 4 , 5 , 6

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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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distal femoral fractures, such as an angled blade plate, a locking plate and retrograde intramedullary nailing. Reamed Intramedullary nailing (RIMN) minimizes tissue damage and damage to blood circulation, but is limited in anatomical reposition. With

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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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’s complexity and associated risks are arguments against it. Osteosynthesis of the tibia is usually done by intramedullary nailing, 1 fibular osteosynthesis usually by plating. 2 , 3 We carried out a meta-analysis to discover whether our hypothesis

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