ReviewCureus2025
An Optimal Screw Fixation Strategy for Posterior Malleolar Fractures: A Systematic Review and Meta-Analysis Comparing Posteroanterior Versus Anteroposterior Screws.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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
1 citing paper in PubMed.
- Plate versus screw fixation and long-term ankle osteoarthritis in posterior malleolar fractures: A Bartoníček-based cohort study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The most appropriate fixation trajectory for posterior malleolar fractures (PMFs) still remains a matter of debate. This meta-analysis aimed to evaluate and compare the outcomes of posteroanterior (PA) and anteroposterior (AP) screw fixation strategies. We conducted a systematic review and meta-analysis following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both manual and electronic searches of multiple databases were conducted. Two independent reviewers screened the studies in accordance with the predefined PICOS criteria: Population (adult patients diagnosed with PMFs); Intervention (PA screw fixation); Comparison (AP screw fixation); Outcome (radiological parameters, screw malpositioning error, American Orthopaedic Foot and Ankle Society (AOFAS) scores, postoperative complications); and Study Design (evidence levels I-III). Statistical synthesis was carried out using Stata 15.1 software (StataCorp LLC, College Station, Texas, USA). A total of 14 articles were included, encompassing 1258 study participants. The findings revealed that there were no statistically significant differences in the postoperative complication rates between the posterior-anterior screw fixation technique and the anterior-posterior screw fixation technique for the management of posterior ankle fractures. Nevertheless, statistically significant differences were observed in the AOFAS scores, the incidence of screw malpositioning, and the radiographic parameters with displacement exceeding 2 mm (P < 0.05). However, the clinical relevance of the difference in AOFAS scores is uncertain. In comparison to the AP method, PA screw fixation yielded superior radiographic outcomes, higher implant accuracy, and better functional recovery as evaluated by the AOFAS scores. The choice of technique should be individualized based on fracture pattern and surgeon expertise.
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Registered trials
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