14 studies (5 prospective and 9 retrospective) were included in this meta-analysis (842 patients) comparing the clinical outcomes and complication rates between intramedullary nailing (IMN) and plating. Results from meta-analysis revealed significant between-group differences in infection rate favouring IMN, and malunion rate favouring plating. Rates of nonunion, secondary surgery, implant removal and total complications were not significantly different between groups. Operation time was significantly shorter with IMN, but time to union, and hospital stay duration were comparable. Functional scores were significantly better with IMN whereas pain scores were similar.