Abstract
The standard surgical treatment for unstable ankle fractures involves open reduction
and internal fixation (ORIF) with plates. However, ORIF has been associated with several
complications, such as soft tissue irritation, wound infection, and nerve injury.
Previous studies have shown that closed reduction and internal fixation with locked
intramedullary nails (LIMNs) yields satisfactory efficacy in the treatment of ankle
fractures and is associated with low complication rates. Therefore, a systematic review
and meta-analysis of randomized controlled trials is imperative to provide evidence
on whether or not LIMN fixation is comparable to or superior than traditional ORIF.
We conducted a comprehensive literature search in the PubMed, Cochrane Library and
EMBASE databases. A total of 4 randomized controlled trials involving 359 participants
who suffered ankle fractures were included in this systematic review and meta-analysis.
The results showed that the LIMN fixation group was statistically significant in terms
of functional outcomes at the 3-month follow-up and wound-related complications. There
was no statistical advantage for patients in the LIMN fixation group in terms of nonwound-related
complications, total complications, or mid-term follow-up functional outcomes. There
was no statistical difference between the LIMN and ORIF groups regarding operation
time and quality of reduction. We believe LIMN fixation is a viable option for the
treatment of unstable ankle fractures in both young and elderly individuals.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: October 12, 2022
Footnotes
Financial Disclosure: None reported.
Competing interests: None reported.
Identification
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
