Systematic Review and Meta-Analysis of Outcomes of Locking Compression Plates in Periarticular Fractures in Sub-Saharan Africa

Locking compression plates (LCP) have transformed the management of complex periarticular fractures by providing angular stability and enabling preservation of cortical blood supply through biological fracture fixation principles. Despite their widespread use in sub-Saharan African tertiary centres, a synthesis of outcomes data across the region has not been conducted. This systematic review and meta-analysis synthesises available evidence on outcomes of LCP fixation for periarticular fractures of the distal femur, proximal tibia, distal tibia, and proximal humerus in sub-Saharan African populations. A comprehensive search of PubMed, EMBASE, African Journals Online (AJOL), and Google Scholar will identify eligible original studies published from 2019 to 2024. Outcomes to be pooled will include union rates, malunion rates, implant failure, infection, and functional scores at minimum six-month follow-up. Heterogeneity will be assessed using the I-squared statistic. The study hypothesises that pooled union rates for LCP fixation in sub-Saharan Africa exceed 85 percent but infection rates are higher than reported in high-income country series, reflecting resource constraints. Findings will be submitted to the Journal of Bone and Joint Surgery (African Edition) and used to inform evidence-based implant selection across Nigerian tertiary hospitals. Keywords: locking compression plates, periarticular fractures, systematic review, meta-analysis, sub-Saharan Africa.