SynthesisJournal of orthopaedic surgery and research2024
Efficacy comparison between intramedullary nail fixation and plate fixation in distal tibia fractures: a meta-analysis of randomized controlled trials.
Synthesis in Journal of orthopaedic surgery and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparison of suprapatellar and infrapatellar intramedullary nailing for tibial fractures: a systematic review and meta-analysis of randomized controlled trials.BMC musculoskeletal disorders · 2025Pooled it
- Intramedullary nailing versus plate fixation for the treatment of proximal tibia extra-articular fractures: a meta-analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Pooled it
- Clinical and Functional Outcomes of Closed Intramedullary Interlocking Nailing in Extra-articular Distal Tibial Fractures: A Prospective Observational Study.Journal of orthopaedic case reports · 2026Article
- 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
- Staged screw removal in external plate fixation for distal tibial fractures: a finite element study on adaptive biomechanics.Scientific reports · 2026Article
- [Study on occurrence of anterior ankle pain after distal tibial extra-articular fractures treated with retrograde tibial intramedullary nail].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- The masquelet technique for severe open fractures: current insights.Journal of orthopaedic surgery and research · 2026Review
- Article
- Comparative clinical outcomes of suprapatellar intramedullary nailing vs. minimally invasive plate osteosynthesis fixation for distal tibial fractures: a retrospective cohort study.Frontiers in surgery · 2026Article
- Occult cement plug causing femoral canal obstruction during nailing after TKA: a case report.Frontiers in surgery · 2026Article
- Management and Treatment Strategies for Distal Tibia and Ankle Infections: Our Clinical Experience.Journal of clinical medicine · 2025Article
- Distal tibial nail for complex nonunion of open distal tibial fracture with diabetes and prior pin-site infection: A case report.International journal of surgery case reports · 2025Article
- Review
Corrections and comments
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Authors and funding
5 authors.
Funding
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Abstract
backgroundIntramedullary nail (IMN) and plate fixation are the most commonly used surgical modalities for distal tibia fractures. However, the superiority of their efficacy regarding functional outcomes and complications remains controversial. Here, we performed a systematic review and meta-analysis to compare the efficacy of these two modalities.
methodsRandomized controlled trials (RCTs) comparing the efficacy of IMN and plate fixation in distal tibia fractures were searched in PubMed, Web of Science, EMBASE, ClinicalTrials.gov, and Cochrane Library up to January 31, 2024. Weighted mean difference (WMD) and odds ratio (OR) with corresponding 95% confidence interval (CI) were estimated using a random-effect model for continuous and categorical outcomes, respectively.
resultsA total of 20 RCTs comprising 1528 patients were included. Compared with plate fixation, IMN significantly shortened surgery time (WMD=-10.73 min, 95%CI: -15.93 to -5.52), union time (WMD=-1.56 weeks, 95%CI: -2.82 to -0.30), and partial (WMD=-1.71 weeks, 95%CI: -1.91 to -0.43) and full (WMD=-2.61 weeks, 95%CI: -3.53 to -1.70) weight-bearing time. IMN was associated with markedly reduced risk of wound infection (OR = 0.44, 95%CI: 0.31-0.63) and secondary procedures (OR = 0.72, 95%CI: 0.55-0.95), but increased the risk of malunion (OR = 1.53, 95%CI: 1.02-2.30) and anterior knee pain (OR = 3.94, 95%CI: 1.68-9.28). The rates of nonunion, delayed union, and functional assessment scores did not significantly differ between the two groups. The percentages of patients obtaining an excellent functional outcome or an excellent and good functional outcome post-operation were comparable.
conclusionsBoth IMN and plate fixation are effective modalities for the surgical treatment of distal tibia fractures. IMN seems to be preferred since it confers more advantages, but the elevated rates of malunion and knee pain require attention. The decision on fixation modality should be tailored to the specific fracture, considering these pros and cons.
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