Effect of intramedullary nail fixation and internal plate fixation in distal tibia fracture surgery on post-operative wound infection in patients: A meta-analysis

Distal tibial fracture is the most commonly seen type of fracture of the lower extremities. Both intramedullary nail fixation (INF) and plate fixation (PF) have been used to treat distal tibial fractures, but the best way to treat them is still in dispute. The purpose of this meta-analysis is to compare INF versus PF fixation with respect to the incidence of injury. For studies that have been published between inception and June 2023, a systematic review has been carried out on PubMed, Embase, Cochrane Library and Web of Scientific databases. All of the trials that looked at INF and PF-related complications were enrolled. Data from the 13 primary results were analysed with RevMan 5.3. The meta-analyses comprised 13 randomized controlled trials (RCTs). INF indicates that there is a tendency for patients with distal tibia fractures to reduce the risk of operative site infection (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.40, 3.13; p = 0.0003) after surgery compared with PF. INF resulted in a reduction in total wound complications (OR, 14.20; 95% CI, 1.81, 111.57; p = 0.01) but shortened operation time (mean difference, 13.03; 95% CI, 2.08, 23.99; p = 0.02). In view of these findings, INF seems to be a preferred method of surgery for the treatment of distal tibial fractures with respect to the reduction of post-operative wound complications.