ReviewCureus2025
Plate Versus Intramedullary Nail Fixation for Distal Fibula Fractures: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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
3 citing papers in PubMed.
- Fixing geriatric ankle fractures: fibular nail versus locking plate in a prospective multicenter study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Trial
- Sustained Decrease in Oxygen Saturation in Human Fibular Fractures Monitored with Laser-Doppler and White-Light Spectroscopy: A Longitudinal Observational Pilot Study.Journal of functional biomaterials · 2026Article
- Modified 3D-Controlled Inside-Out Compression Screw Fixation Technique in Posterior Malleolar Fractures: A Narrative Review and Case Report.Journal of clinical medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Equipoise exists regarding implant choice for treating unstable distal fibula fractures. This study aimed to compare intramedullary nail (IMN) fixation and plate fixation (PF), considering solely randomised controlled trials (RCTs). A systematic review and meta-analysis of all published RCTs was conducted. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), and Cochrane databases were searched. Outcomes were patient-reported functional measures, union rates, complications, revision rates, and cost-effectiveness. The Cochrane risk-of-bias v2.0 tool was used for bias assessment. Five RCTs involving 455 patients (222 with IMN and 233 with PF) were included. Patient ages ranged from 18 to 93 years, with a mean age of 56.4 years. Functional outcomes, measured by the American Orthopaedic Foot and Ankle Society (AOFAS) score and Olerud and Molander Ankle Score (OMS), showed no significant differences between IMN and PF at 24 months. Meta-analysis demonstrated no significant difference in OMS at one year between studies (mean difference -2.33, 95% CI -10.03 to 5.37, P=0.55). Complication and union rates were similar between the groups. One study suggested cost savings with IMN despite the higher initial implant cost. Some concerns were raised about the risk of bias assessment of all the included studies. IMN and PF provide comparable functional recovery for distal fibula fractures with similar complication profiles. Patient-specific factors should guide the choice of fixation method. IMN may offer cost benefits for certain populations, though further research is needed. Larger longitudinal studies including outcomes such as return to work and sports are recommended to refine clinical guidelines for selecting the appropriate fixation method.
Indexed as
Identifiers
What OpenQuestion holds
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.