Extraarticular distal-tibial fractures

Summary

It is not clear whether plating or intermedullary nailing is better for treating extraarticular distal-tibial fractures based on evidence from one moderate sized randomized controlled trial and three retrospective cohort studies. Time to union and functional scores appear to be similar in patients treated with plating and nailing, but infection may be more frequent for the plating based on the results from one randomized controlled trial. Statistical significance was not consistent across studies, which may be a function of sample size and / or bias in some studies. Results did not clearly favor one treatment over the other. To better understand the differences in outcomes between plating and nailing for extraarticular distal-tibial fractures, additional larger, methodologically rigorous trials are needed.