Comparison of Fibula Plating Versus Fibula Nailing: A Systematic Review with Meta-Analysis of all Current Comparative Literature

Division

North Texas

Hospital

Medical City Denton

Document Type

Manuscript

Publication Date

5-1-2025

Keywords

Humans, Ankle Fractures, Bone Nails, Bone Plates, Fibula, Fracture Fixation, Internal, Fracture Fixation, Intramedullary

Disciplines

Medicine and Health Sciences | Orthopedics | Wounds and Injuries

Abstract

Ankle fracture surgeries are common orthopaedic procedures. Fibular fixation is often an important component in restoring ankle stability. Fibular intramedullary nailing (fIMN) has gained recent interest as an alternative technique to fibular plating. This systematic review and meta-analysis was performed to compare the outcomes of fibular nailing versus fibular plating for all current available literature. A PRISMA-compliant systematic review was conducted across MEDLINE/Pubmed, Cochrane, and Embase databases for cohort and clinical trial studies comparing outcomes of fibular nailing and fibular plating of ankle fractures. Demographics and results of the studies were extracted from the articles. Outcomes of interest extracted included operative time, functional outcomes scores, hardware/loss of reduction, malunion/nonunion, re-operations, and wound complications. Meta-analysis of included studies used odds ratios and standardized mean difference when appropriate. Nine studies were included in this systematic review. Eight studies were then used for meta-analysis comparison. fIMN showed equivalent operating times to fibular plating. fIMN had equivalent outcomes when compared with fibular plating for hardware failure/loss of reduction, Olerud and Molander Ankle Score, malunion/nonunion, and re-operations. Fibular nailing showed a decrease in wound complications (OR: 0.35 [0.18, 0.66] (

Publisher or Conference

Journal of Orthopaedic Surgery

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