Abstract
OBJECTIVES: To estimate the prevalence of TDI in the Spanish population through a systematic review and meta-analysis, identifying differences by sex, age, and study setting. MATERIALS AND METHODS: An exhaustive search was conducted in databases such as PubMed, Scopus, Embase, Ovid Medline, and CINAHL, including gray literature and other alternative sources. Observational studies evaluating the prevalence of TDI in Spain, with a total of 8662 participants. The methodological quality of the studies was assessed using the JBI tool, and the PRISMA guidelines were followed to ensure transparency and reproducibility. RESULTS: The estimated overall prevalence of TDI was 9.94% (95% CI: 5.98%-16.6%). The results showed a higher prevalence in males (10.5%) compared to females (5.7%), and in children (11.1%) compared to adolescents (6.1%). Fractures were the most common type of TDI (56.5%), followed by avulsion (4.0%). High heterogeneity was observed among the studies, suggesting variability in data collection methods and TDI classification. CONCLUSIONS: This study is the first to estimate the prevalence of TDI in Spain, which sheds light on the need for a standardized approach in future research. Although it presents significant methodological strengths, limitations such as high heterogeneity and lack of standardization should be considered when interpreting the results.