Abstract
To analyze and compare two surgical treatment methods for tibial stress fractures: intramedullary nailing and tension plate, taking into account functional outcomes and postoperative results. This systematic review was conducted and written in accordance with the guidelines for systematic reviews - PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The bibliographic search was carried out between January and September 2024 in journals indexed in the PubMed, Lilacs, Cochrane and Embase databases. Ten studies were selected. Among them, five were case reports, four were case series, and one was a retrospective cohort study. Intramedullary nailing offers good stabilization and a gradual return to sports activities, but it can cause complications such as knee pain and additional fractures. The anterior tension plate, on the other hand, provides effective stabilization with less anterior knee pain and faster healing times, but it is more invasive and may require implant removal and intensive rehabilitation. The choice between intramedullary nailing and tension plate should be based on a detailed assessment of the individual characteristics of the patient, the nature of the fracture, and the potential risks associated with each technique. Level of Evidence IIA; Systematic Review of Cohort Studies.