SynthesisScandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society2021
Comparison Between Nailing and Plating in the Treatment of Distal Tibial Fractures: A Meta-Analysis.
Synthesis in Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Surgical outcomes and complications of fixation strategies for distal tibial fractures: a systematic review and network meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Pooled it
- Efficacy comparison between intramedullary nail fixation and plate fixation in distal tibia fractures: a meta-analysis of randomized controlled trials.Journal of orthopaedic surgery and research · 2024Pooled it
- Suprapatellar vs infrapatellar approaches for intramedullary nailing of distal tibial fractures: a systematic review and meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2023Pooled it
- Intramedullary Nailing Versus Plate Fixation for AO/OTA Types 43A and 43B Distal Tibial Fractures: Early Pain Trajectories, 3-Month Ankle Function, and Return to Work in a Retrospective Cohort.Journal of clinical medicine · 2026Article
- Plate fixation vs. intramedullary nailing: Which is more cost-effective for tibial shaft fractures?Cost effectiveness and resource allocation : C/E · 2026Article
- Minimally invasive posterior plate osteosynthesis of a periprosthetic distal tibia shaft fracture: case report and review of literature.International journal of surgery case reports · 2026Article
- Article
- Acupuncture for Post-Operative Pain Relief and Functional Improvement in Tibial Fracture: A Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2025Review
- Article
- Review
- Treatment of Soft Tissue Defects after Minimally Invasive Plate Osteosynthesis in Fractures of the Distal Tibia: Clinical Results after Reverse Sural Artery Flap.Medicina (Kaunas, Lithuania) · 2023Article
- Cerclage Wiring Improves Biomechanical Stability in Distal Tibia Spiral Fractures Treated by Intramedullary Nailing.Journal of clinical medicine · 2023Article
- A systematic review of outcome reporting in clinical trials of distal tibia and ankle fractures : the need for a core outcome set.Bone & joint open · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsTo evaluate evidence on the superiority of plate fixation over intramedullary nail fixation in the treatment of distal tibial fractures regarding functional outcomes and complication rates. MATERIAL AND
methodsCochrane Controlled Trials Register, Medline, Embase, CINAHL, Scopus, and Web of Science databases were searched in December 2019. The risk of systematic bias was assessed according to the Cochrane Collaboration's domain-based evaluation framework.
resultsThe search resulted in 514 records, the final sample included 10 randomized controlled trials (782 patients). There were statistically significant differences in operating time (-11.2, 95% confidence interval: -16.3 to -6.1 min), time to partial weight bearing (-0.96, 95% confidence interval: -1.8 to -0.1 weeks), time to full weight bearing (-2.2, 95% confidence interval: -4.32 to -0.01 weeks), the rates of deep infections (risk ratio = 0.37, 95% confidence interval: 0.19 to 0.69), and the rates of soft-tissue complications (risk ratio = 0.52, 95% confidence interval: 0.33 to 0.82) favoring intramedullary nail. Intraoperative blood loss (127.2, 95% confidence interval: 34.7 to 219.7 mL) and postoperative knee pain and stiffness (relative risk = 5.6, 95% confidence interval: 1.4-22.6) showed significant differences favoring plate fixation. When combining all complication rates, the difference was risk ratio = 0.77 (95% confidence interval: 0.63 to 0.95) favoring intramedullary nail. No significant differences in radiation time, length of incision, length of hospital stay, time to return to work, time to union, the rates of healing complications or secondary procedures, ankle pain or stiffness, or functional scores were found.
conclusionThis meta-analysis suggests that intramedullary nail might be slightly superior in reducing postoperative complications and result in slightly faster healing when compared to plate fixation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.