ReviewCureus2025
Intramedullary Fibular Nail Versus Plate Fixation for Adult Lateral Malleolus (Fibula) Fractures: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Ankle fractures are among the most common orthopaedic injuries. While plate fixation has long been the standard method for distal fibular stabilization, intramedullary nailing (IMN) has emerged as a minimally invasive alternative. The relative clinical effectiveness of these techniques remains uncertain. This systematic review and meta-analysis was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered with PROSPERO (ID: CRD420251143494). Randomized controlled trials (RCTs) and comparative cohort studies published between 2015 and 2025 were included. A comprehensive search of six databases identified nine eligible studies (five RCTs, four cohort studies). Data were pooled using fixed- or random-effects models, and heterogeneity was assessed with the I² statistic. Pooled analysis demonstrated no significant difference in long-term functional outcomes or time to union between IMN and plate fixation. IMN was associated with a significantly lower risk of wound complications (p = 0.008), reduced operative time (p = 0.025), fewer cases of symptomatic hardware (p = 0.004), and a lower rate of non-union (p = 0.022). Event rates, however, were low, and study heterogeneity was moderate. Both IMN and plate fixation achieve reliable fracture union and functional recovery. IMN offers perioperative advantages, particularly fewer wound complications and shorter operative times, making it an appealing option for elderly or high-risk patients. Nevertheless, the evidence base is limited by small sample sizes, moderate heterogeneity, and short follow-up durations. Larger, multicenter randomized trials are warranted to confirm these findings, clarify subgroup benefits, and determine long-term cost-effectiveness.
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Registered trials
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