{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:14:47Z","timestamp":1775736887432,"version":"3.50.1"},"reference-count":28,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T00:00:00Z","timestamp":1545091200000},"content-version":"vor","delay-in-days":351,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2018,11,19]]},"published-print":{"date-parts":[[2018]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>: Minimally invasive percutaneous plate osteosynthesis (MIPPO) has emerged as a viable alternative for the treatment of distal tibial fractures. However, the clinical outcomes of this procedure compared to intramedullary (IM) nail fixation have yet to be established. The present meta-analysis aims to compare the clinical outcomes following MIPPO and IM nail fixation for closed distal tibial fractures.<\/jats:p>\n<jats:p><jats:italic>Methods<\/jats:italic>: MEDLINE and EMBASE databases were searched from date of inception to 10th April 2017. Randomized controlled trials (RCTs) comparing MIPPO with IM nail fixation for closed and Gustilo Grade I distal tibial fractures were included. Outcomes assessed included time to union, complications and functional outcomes. Quality and risk of bias of the RCTs were assessed using the Cochrane Collaboration Tool.<\/jats:p>\n<jats:p><jats:italic>Results<\/jats:italic>: Five RCTs comprising 497 patients were included. MIPPO was associated with a longer time to union (MD: 1.08, 95% CI: 0.26, 1.90, <jats:italic>p\u2009<\/jats:italic>=\u20090.010, <jats:italic>I<\/jats:italic>\n<jats:sup>2\u2009<\/jats:sup>=\u200984%) and increased risk of wound complications (RR: 1.58, 95% CI: 1.01, 2.46, <jats:italic>p\u2009<\/jats:italic>=\u20090.04, <jats:italic>I<\/jats:italic>\n<jats:sup>2<\/jats:sup>\u2009=\u20090%). Both MIPPO and IM nail fixation had comparable risks of malunion, delayed union, non-union and deep infections, with similar functional outcomes.<\/jats:p>\n<jats:p><jats:italic>Discussion<\/jats:italic>: Compared to IM nail fixation, a MIPPO fixation technique for distal tibial fractures is associated with a longer time to fracture union and an increased risk of wound complications. Neither technique demonstrates a clear advantage with regard to risk of malunion\/non-union, or functional outcome. Assuming equivalent surgical expertise with both techniques, the results suggest that IM nail fixation is the treatment modality of choice for these challenging fractures.<\/jats:p>","DOI":"10.1051\/sicotj\/2018055","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T10:05:36Z","timestamp":1545127536000},"page":"58","source":"Crossref","is-referenced-by-count":16,"title":["Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for closed distal tibial fractures: a meta-analysis of the clinical outcomes"],"prefix":"10.1051","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0331-1803","authenticated-orcid":false,"given":"En 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