Surgical outcomes and complications of fixation strategies for distal tibial fractures: a systematic review and network meta-analysis.
Eur J Orthop Surg TraumatolSep 8, 2026 (epub)
Lei Zhang, Zhihui Fang, Wei Yu et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and network meta-analysis evaluated surgical outcomes and complications of various fixation strategies for distal tibial fractures in 2145 patients. The study found that minimally invasive plate osteosynthesis (MIPO) had a longer operative time and time to union compared to intramedullary nailing (IMN-IP), with a mean difference of 8.23 minutes. No single fixation strategy was consistently superior.
Key findings
- MIPO had a longer operative time than IMN-IP (MD = 8.23 minutes, 95% CI 0.44-16.01).
- ORIF had a lower risk of malunion compared to MIPO (RR = 0.30, 95% CI 0.11-0.82).
- MIPO had a higher risk of malunion than EF+LORIF (RR = 3.26, 95% CI 1.08-9.80).
- Infection risk was higher with ORIF and MIPO compared to several other techniques.
Why it matters
Understanding the comparative effectiveness and risks associated with different fixation strategies for distal tibial fractures can guide clinicians in selecting the most appropriate surgical approach, potentially improving patient outcomes.