Comparison 1. Nailing versus plating.

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Patient‐reported functional outcome (pooled data)	3	172	Std. Mean Difference (IV, Fixed, 95% CI)	0.28 [‐0.02, 0.59]
1.1 American Orthopaedic Foot and Ankle surgery score at 12 months	1	85	Std. Mean Difference (IV, Fixed, 95% CI)	0.29 [‐0.13, 0.72]
1.2 OMAS % of normal side at 24 months	1	64	Std. Mean Difference (IV, Fixed, 95% CI)	0.09 [‐0.40, 0.58]
1.3 Olerud and Molander Ankle Score at 12 months	1	23	Std. Mean Difference (IV, Fixed, 95% CI)	0.83 [‐0.03, 1.69]
2 Patient‐reported functional outcome	3		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
2.1 American Orthopaedic Foot and Ankle surgery score at 12 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 OMAS % of normal side at 24 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 Olerud and Molander Ankle Score at 3 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.4 Olerud and Molander Ankle score at 6 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.5 Olerud and Molander Ankle Score at 12 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.6 Disability Rating Index at 3 months (0 = full ability, 100 = maximal disability)	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.7 Disability Rating Index at 6 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.8 Disability Rating Index at 12 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Need for a secondary/revision operation or substantive physiotherapy for adverse outcomes (e.g. nonunion, malunion, and infection)	3	173	Risk Ratio (M‐H, Fixed, 95% CI)	0.37 [0.12, 1.12]
4 Symptomatic nonunion or malunion, including limping	3	173	Risk Ratio (M‐H, Fixed, 95% CI)	0.72 [0.18, 2.80]
5 Pain (0 to 40: no pain) at 12 months	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected
6 Wound complications including superficial/deep wound infection and osteomyelitis	3	173	Risk Ratio (M‐H, Fixed, 95% CI)	0.47 [0.20, 1.10]
7 Fracture union	3	173	Risk Ratio (M‐H, Fixed, 95% CI)	1.02 [0.95, 1.09]
8 Fracture union time (weeks)	2	149	Mean Difference (IV, Fixed, 95% CI)	0.09 [‐1.46, 1.65]
9 Operation time (minutes)	2	149	Mean Difference (IV, Fixed, 95% CI)	‐16.78 [‐24.67, ‐8.88]
10 Radiation time (minutes)	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected