Efficacy and safety of MIPO versus ORIF in distal tibial fractures: a systematic review and meta-analysis

Background: Distal tibial fractures are challenging to manage owing to limited soft-tissue coverage and compromised blood supply. Minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) are among the widely used surgical options, but the optimal approach remains unclear. MIPO preserves periosteal blood flow with smaller incisions, while ORIF offers direct visualisation but increases soft-tissue damage. With growing comparative evidence, an updated evaluation of these techniques is necessary.

Aim: To compare the efficacy and safety of MIPO versus ORIF in adult patients with distal tibial #fractures.

Methods: Following PRISMA guidelines and the Cochrane Handbook, we searched in PubMed, Embase, Cochrane, Scopus, and Web of Science till November 2025. Randomised trials and cohort studies comparing MIPO and ORIF were included. Data extraction was performed independently by two reviewers. Risk of bias was assessed using RoB 2 for RCTs and the Newcastle-Ottawa Scale for observational studies. Random-effects models were used to estimate pooled mean differences and odds ratios, and heterogeneity was assessed using I2. Sensitivity and subgroup analyses were conducted by study design.

Results: Nine studies involving 530 patients met our inclusion criteria. No significant differences were found between MIPO and ORIF in AOFAS scores, union time, operative duration, hospital stay, return-to-work time, or major complications. MIPO showed trends toward shorter union time, reduced blood loss, and lower infection rates. Infection analysis showed a nonsignificant odds ratio (OR 0.57; 95% CI 0.24-1.33) but a statistically significant risk difference (RD -0.06; 95% CI -0.11 to -0.01), reflecting an absolute reduction of 4.6% with MIPO. Rates of malunion, delayed union, nonunion, and wound complications were similar between groups.

Conclusions: MIPO and ORIF provide comparable functional and radiological outcomes for distal tibial fractures. MIPO offers modest advantages in soft-tissue preservation and infection risk. Surgical choice should be individualized on the basis of fracture characteristics and soft-tissue condition. Further multicenter randomized trials are needed.

https://link.springer.com/article/10.1186/s10195-026-00938-2

Il Fatto Quotidiano: “C’era una panic room con tre persone che picchiavano. Fratture, abusi sessuali e anche anziani torturati”: il racconto di Carotenuto e Mantovani

È un racconto agghiacciante quello fatto dall’inviato del Fatto Quotidiano Alessandro Mantovani e dal deputato del Movimento 5 Stelle, Dario Carotenuto, appena atterrati all’aeroporto di Roma Fiumicino dopo essere stati deportati in Israele, insieme ad altre 430 persone della Global Sumud Flotilla.

“C’era addirittura una panic room – racconta visibilmente scosso l’onorevole pentastellato che mostra anche il braccialetto rosso con numero di matricola assegnato ai fermati – all’interno c’erano 3 persone che, dicendoci Welcome to Israel, ci picchiavano selvaggiamente. C’erano 20 o 30 persone con probabili fratture, 5 traumi cranici, alcuni abusi di violenza sessuale, anche anziani di 70 anni sono stati torturati.”

“Ci hanno sbattuto per terra – aggiunge l’inviato del Fatto Quotidiano – io sono stato colpito sul volto e sulle gambe.”

All’aeroporto ad accoglierli, oltre ai familiari, erano presenti anche altri parlamentari, come Arturo Scotto del Partito democratico, che ha partecipato alla precedente missione e Alessandra Maiorino del Movimento 5 Stelle, oltre a Tony La Piccirella, attivista della Global Sumud Flotilla.
L'articolo “C’era una panic room con tre persone che picchiavano. Fratture, abusi sessuali e anche anziani torturati”: il racconto di Carotenuto e Mantovani proviene da Il Fatto Quotidiano.

“There was a panic room with three people beating. Fractures, sexual abuse, and even the torture of the elderly”: the story of Carotenuto and Mantovani.

It’s a chilling account made by Fatto Quotidiano reporter Alessandro Mantovani and Five Star Movement deputy Dario Carotenuto, who just landed at Rome Fiumicino Airport after being deported to Israel, along with another 430 members of the Global Sumud Flotilla.

“There was even a panic room – visibly shaken MP Carotenuto recounts, showing the red bracelet with the identification number assigned to the detainees – inside, there were 3 people who, saying ‘Welcome to Israel,’ beat us savagely. There were 20 or 30 people with probable fractures, 5 head traumas, some sexual abuse, and even elderly people of 70 years old were tortured.”

“They threw us to the ground – adds the Fatto Quotidiano reporter – I was hit on the face and legs.”

At the airport to greet them, in addition to family members, were other parliamentarians, such as Arturo Scotto of the Democratic Party, who participated in the previous mission and Alessandra Maiorino of the Five Star Movement, as well as Tony La Piccirella, an activist from the Global Sumud Flotilla.
The article “There was a panic room with three people beating. Fractures, sexual abuse and even elderly people tortured”: the account by Carotenuto and Mantovani comes from Il Fatto Quotidiano.

#Fractures #Carotenuto #Mantovani #FattoQuotidiano #AlessandroMantovani #StarMovement #DarioCarotenuto #Israel #ArturoScotto #theDemocraticParty #AlessandraMaiorino #theFiveStarMovement #TonyLaPiccirella #IlFattoQuotidiano

https://www.ilfattoquotidiano.it/2026/05/21/flotilla-gaza-carotenuto-mantovani-violenze-notizie/8394181/

💊 Taking a calcium, vitamin D, or combined supplement likely won't reduce the risk of a fall or fracture in older age

✨Follow the link in our bio for more information on this story✨
https://www.scimex.org/newsfeed/calcium-and-vitamin-d-supplements-likely-dont-help-older-people-avoid-fractures-and-falls

#science #sciencenews #research #stem #facts #knowledge #sciencefacts #supplement #bonehealth #Fractures #fallsprevention

بعض #الصور لحظة إطلاق سراح معتقل من #أسطول #الصمود الذين تم #اختطافهم وإنزالهم في جزيرة #كريت #اليونانية بعد تعرضهم لـ#الضرب المبرح و#تعنيف شديد ما تسبب في #جروح عميقة و#كسور خطيرة على يد #الاحتلال.

Some #photos show the moment a detainee from the #Freedom #Flotilla was released after being #abducted and dropped on the Greek island of #Crete following severe #beating and #abuse causing deep #injuries and serious #fractures by the #occupation.

بعض #الصور لحظة إطلاق سراح معتقل من #أسطول #الصمود الذين تم #اختطافهم وإنزالهم في جزيرة #كريت #اليونانية بعد تعرضهم لـ#الضرب المبرح و #تعنيف شديد ما تسبب في #جروح عميقة و#كسور خطيرة على يد #الاحتلال.

Some #photos show the moment a detainee from the #Freedom #Flotilla was released after being #abducted and dropped on the Greek island of #Crete following severe #beating and #abuse causing deep #injuries and serious #fractures by the #occupation.