Evidence map›Paper›PMID 42359257›Full record

ArticleAdvances in orthopedics2026

Lateral Plate Versus Isolated Lag Screw Fixation of Unstable Distal Fibula Fractures: A Systematic Review.

Aarohanan Raguragavan, Dujinthan Jayabalan, Rajitha Gunaratne

Abstract read
In one paragraph

Article in Advances in orthopedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

3 authors.

Aarohanan RaguragavanDepartment of Orthopaedics, Fiona Stanley Hospital, Murdoch, Western Australia, Australia, fsh.health.wa.gov.au.ORCID https://orcid.org/0000-0001-7551-8005
Dujinthan JayabalanMedical School, The University of Western Australia, Nedlands, Western Australia, Australia, uwa.edu.au.ORCID https://orcid.org/0000-0001-9722-661X
Rajitha GunaratneDepartment of Orthopaedic Surgery, Joondalup Health Campus, Perth, Western Australia, Australia, joondaluphealthcampus.com.au.ORCID https://orcid.org/0000-0002-2054-5783

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Lateral plate fixation, the current standard for fixation of unstable distal fibular fractures, can compromise the minimal soft tissue envelope resulting in poorer postoperative outcomes. Isolated lag screw fixation represents a novel method of distal fibula fixation. Methods: Two independent reviewers conducted a literature search of PubMed, EMBASE, Google Scholar and MEDLINE (Ovid) in February 2024. Randomised control trials (RCTs), non-randomised control trials and cohort studies were included. Risk of bias was assessed with the ROBINS-I tool. PRISMA guidelines were followed. This systematic review was prospectively registered in the PROSPERO register (CRD42024521746). Results were synthesised by structured qualitative analysis. Results: Four studies (207 patients) were included. Compared to lateral plate fixation, lag screw-only fixation for distal fibula fractures resulted in reduced operative times, incision lengths, costs, hardware-related issues, ankle symptomatology, and complications, with comparable or improved functional outcomes and similar radiographic healing under equivalent postoperative care. These findings were applicable to patients under 60 years old with noncomminuted, oblique, or spiral unstable distal fibula fractures. Conclusion: Isolated lag screw fixation represents a novel method of distal fibular fracture fixation in select patients. Reducing hardware burden on the soft tissue envelope improved operative and patient outcomes without compromising standard postoperative care. The methodological and clinical differences among the included studies limited this review. Additionally, only four eligible studies were included, all with significant bias.

Indexed as

ankle fractures operative techniqueankle fractures postoperative outcomeslateral plate fixationunstable distal fibula ankle fractureunstable lateral malleolus fracture

Identifiers

PMID42359257
PMCPMC13291888

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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.