Plate vs. nail for extra-articular distal tibia fractures: How should we personalize surgical treatment? A meta-analysis of 1332 patients

•Plate fixation and IMN are both viable treatment options for distal tibia fractures, each with its advantages and disadvantages.•Intramedullary nailing is associated with a slightly increased risk of mal-union and anterior knee pain.•Plating, however, results in a slightly higher rate of infection.•The treatment of distal tibia fractures should, therefore, be based on a personalized approach and rely on shared decision-making.