6 randomized controlled trials (RCTs) and 10 clinical controlled trials (CCTs) involving 1140 patients were included in this meta-analysis, comparing plate fixation and intramedullary nail (IMN) technique in distal tibial fracture treatment. Pooled results indicated that IMN treatment had significantly lower incidence of superficial infection (SI), but significantly higher risk of malunion. The meta-analysis found no significant differences in operation time (OT), hospital time (HT), union time (UT), incidence of deep infection (DI), and union complications (UC) between these two treatment methods.