![]() Only very comorbid patients who are not likely to tolerate anesthesia and patients with non-displaced fractures are treated conservatively ( 4). Distal tibial fractures are almost always treated surgically because conservative treatment involves long leg casts, prolonged immobilization, and a high risk of malunion ( 2, 3). These fractures can occur in both high-energy and low-energy trauma, while simple falls are the most common mechanism of injury ( 1). No significant differences in radiation time, length of incision, length of hospital stay, time to return to work, time to union, the rates of healing complications or secondary procedures, ankle pain or stiffness, or functional scores were found.įractures of the distal tibia are relatively rare, with a reported annual incidence of 9.1 per 100,000. ![]() ![]() When combining all complication rates, the difference was risk ratio = 0.77 (95% confidence interval: 0.63 to 0.95) favoring intramedullary nail. Intraoperative blood loss (127.2, 95% confidence interval: 34.7 to 219.7 mL) and postoperative knee pain and stiffness (relative risk = 5.6, 95% confidence interval: 1.4–22.6) showed significant differences favoring plate fixation. There were statistically significant differences in operating time (−11.2, 95% confidence interval: −16.3 to −6.1 min), time to partial weight bearing (−0.96, 95% confidence interval: −1.8 to −0.1 weeks), time to full weight bearing (−2.2, 95% confidence interval: −4.32 to −0.01 weeks), the rates of deep infections (risk ratio = 0.37, 95% confidence interval: 0.19 to 0.69), and the rates of soft-tissue complications (risk ratio = 0.52, 95% confidence interval: 0.33 to 0.82) favoring intramedullary nail. The search resulted in 514 records, the final sample included 10 randomized controlled trials (782 patients).
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