Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature

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 per...

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Main Authors: Troy B Puga, McKenna W Box, Charles R Marchese, Alan Lam, Sam Stegelmann, John T Riehl
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/10225536251345196
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author Troy B Puga
McKenna W Box
Charles R Marchese
Alan Lam
Sam Stegelmann
John T Riehl
author_facet Troy B Puga
McKenna W Box
Charles R Marchese
Alan Lam
Sam Stegelmann
John T Riehl
author_sort Troy B Puga
collection DOAJ
description 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] ( p = .001)) when compared with fibular plating. fIMN showed equivalent outcomes and decreased wound complications compared to fibular plating. fIMN is a safe and effective alternative treatment method that can be used by surgeons to treat distal fibula fractures. Level of Evidence 3.
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spelling doaj-art-7e73ad4b88434cc4b77a99d4f76ab4b42025-08-20T01:56:19ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902025-05-013310.1177/10225536251345196Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literatureTroy B PugaMcKenna W BoxCharles R MarcheseAlan LamSam StegelmannJohn T RiehlAnkle 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] ( p = .001)) when compared with fibular plating. fIMN showed equivalent outcomes and decreased wound complications compared to fibular plating. fIMN is a safe and effective alternative treatment method that can be used by surgeons to treat distal fibula fractures. Level of Evidence 3.https://doi.org/10.1177/10225536251345196
spellingShingle Troy B Puga
McKenna W Box
Charles R Marchese
Alan Lam
Sam Stegelmann
John T Riehl
Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature
Journal of Orthopaedic Surgery
title Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature
title_full Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature
title_fullStr Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature
title_full_unstemmed Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature
title_short Comparison of fibula plating versus fibula nailing: A systematic review with meta-analysis of all current comparative literature
title_sort comparison of fibula plating versus fibula nailing a systematic review with meta analysis of all current comparative literature
url https://doi.org/10.1177/10225536251345196
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