Intramedullary nailing versus minimally invasive plate osteosynthesis (MIPO) for proximal tibial fracture: a systematic review and meta-analysis

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Systematic review shows intramedullary nailing reduces infection rates in proximal tibial fractures, suggesting it may be preferable over MIPO.

Intramedullary nailing significantly lowers infection rates compared to minimally invasive plate osteosynthesis.
Traditional intramedullary approaches are linked to higher anterior knee pain incidence than MIPO.
No significant differences were found in nonunion rates or knee range of motion between the two treatments.
Further studies on suprapatellar intramedullary nailing approaches are needed for clarity on outcomes.

Xu et al. (2025) studied this question.

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Systematic review shows intramedullary nailing reduces infection rates in proximal tibial fractures, suggesting it may be preferable over MIPO.