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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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SURGICAL TREATMENT OF TIBIAL STRESS FRACTURE: NAIL X PLATE.

Paulo Henrique Schmidt Lara1, Guilherme Leme Cabello1, Danilo Cabral Domingues1

  • 1Universidade Federal de Sao Paulo (UNIFESP), Faculdade de Medicina Paulista, Centro de Traumatologia Esportiva, Sao Paulo, SP, Brazil.

Acta Ortopedica Brasileira
|September 25, 2025
PubMed
Summary
This summary is machine-generated.

This systematic review compares intramedullary nailing and anterior tension plate for tibial stress fractures. Both methods offer stabilization, but the tension plate may provide faster healing with less knee pain, despite being more invasive.

Keywords:
Fracture Fixation, IntramedullaryStress FractureTibia

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Tibial stress fractures are common injuries, particularly in athletes.
  • Surgical interventions are sometimes necessary for persistent or complex cases.
  • Intramedullary nailing and anterior tension plating are two surgical options.

Purpose of the Study:

  • To systematically review and compare intramedullary nailing versus anterior tension plate surgical techniques for tibial stress fractures.
  • To analyze and compare functional outcomes and postoperative results between the two surgical methods.

Main Methods:

  • Systematic review conducted following PRISMA guidelines.
  • Bibliographic search performed in PubMed, Lilacs, Cochrane, and Embase databases (January-September 2024).
  • Inclusion of ten studies: five case reports, four case series, and one retrospective cohort study.

Main Results:

  • Intramedullary nailing provides good stabilization and allows a gradual return to sports but may lead to knee pain and further fractures.
  • Anterior tension plate offers effective stabilization with reduced anterior knee pain and potentially faster healing, but is more invasive.
  • Tension plate surgery may necessitate implant removal and intensive rehabilitation.

Conclusions:

  • The choice between intramedullary nailing and anterior tension plate depends on patient-specific factors, fracture characteristics, and potential risks.
  • Both surgical techniques have distinct advantages and disadvantages regarding outcomes and recovery.
  • Further high-quality comparative studies are warranted to definitively establish superiority.