Response to Letter to the Editor—Plate fixation versus flexible intramedullary nails for management of closed femoral shaft fractures in the paediatric population: A systematic review and meta-analysis of the adverse outcomes (J Child Orthop 2023,17(5),442–452)

The article is a response to a letter critiquing a systematic review and meta-analysis on the management of closed femoral shaft fractures in pediatric patients. The authors acknowledge the difficulty in conducting systematic reviews due to the lack of strict definitions in the included studies. They clarify their methodology, emphasizing that adverse outcomes were only considered if explicitly mentioned in the studies. The authors address differing interpretations of the data and disagree with the assertion that their data support the use of flexible nails. They conclude by advocating for prospective trials using core outcome sets with defined terminology. [Extracted from the article]