Evidence map›Paper›PMID 40387937›Full record

SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

One-third tubular plates versus anatomical distal fibula plates in ankle fracture fixation: a systematic review and meta-analysis.

Brandon Lim, Ariel Chai, Wed Al Attas, Mohamed Shaalan

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Functional outcome in mini-fragment plating of the fibula in unstable ankle fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Brandon LimGeneral Surgery, Sengkang General Hospital, Singapore, Singapore. limkengkiatbrandon@gmail.com.ORCID http://orcid.org/0009-0006-5999-8364
Ariel ChaiGeneral Surgery, Sengkang General Hospital, Singapore, Singapore.ORCID http://orcid.org/0009-0004-3114-2615
Wed Al AttasEmergency Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.ORCID http://orcid.org/0009-0009-9192-5626
Mohamed ShaalanTrauma and Orthopaedic Surgery, Tallaght Hospital, Dublin, Ireland.ORCID http://orcid.org/0000-0002-0227-1483

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAnkle fractures, especially fractures of the distal fibula, are very common. This review aims to compare the postoperative clinical and radiological outcomes between one-third tubular plating and anatomical distal fibula plating.

methodsThe PubMed, Embase, and Scopus databases were searched from inception to 29 June 2024. Data was extracted and analyzed by RevMan Web. Differences in operative times, and clinical and radiological outcomes were evaluated by mean difference (MD) with a 95% confidence interval (95%CI). Risks of various complications and mortality were assessed by risk ratio (RR) with 95%CI. The quality of studies was assessed using the Good Research for Comparative Effectiveness (GRACE) checklist.

resultsA total of 14 studies comprising a total of 2,802 patients were included, 1,792 in the one-third tubular plating group, and 1,010 in the anatomical distal fibula plating group. There were no significant differences in ≥ 12 months post-operative AOFAS results, range of motion from full extension to full flexion, time to fracture union, superficial or deep infections, delayed wound healing, hardware irritation, hardware removal rates, revision surgery rates, non-union, and implant failures. However, one-third tubular plating had a significantly shorter operative time in minutes (MD = -11.41, 95%CI [-20.95, -1.87]; p = 0.02), a significantly lower risk of overall wound complications (RR = 0.55, 95%CI [0.40, 0.74]; p-value = 0.0001). The average GRACE score of the 14 observational studies was 10.6 (range 8-11), suggesting good methodological quality of these studies.

conclusionThis systematic review and meta-analysis showed that one-third tubular plating had a significantly shorter operative time in minutes and a significantly lower risk of overall wound complications than anatomical distal fibula plating. As such, these factors should be taken into consideration and evaluated when choosing between one-third tubular plating and anatomical distal fibula plating in the management of an ankle fracture.

Indexed as

Ankle FracturesBone PlatesFibulaFracture Fixation, InternalHumansOperative TimePostoperative ComplicationsRange of Motion, ArticularAnatomical distal fibula platingAnkle fractureLateral malleolus fractureOne-third tubular platingTrauma

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Registered trials

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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.