Parallel Versus Orthogonal Plate Osteosynthesis of Adult Distal Humerus Fractures: a Meta-analysis of Biomechanical Studies

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2018 Apr 22

PMID 29679109

Citations 6

Authors

Chien-An Shih

Wei-Ren Su

Wei-Chin Lin

Tai-Wei Tai

Affiliations

Soon will be listed here.

Abstract

Purpose: There are two widely used distal humerus fracture (DHF) fixation methods with either orthogonal or parallel double-plate osteosynthesis. However, biomechanical studies have shown inconsistent results on which technique is more effective. We performed a meta-analysis to compare these two fixation methods for adult DHF fixation.

Methods: We searched the literature for entries discussing the biomechanical testing of orthogonal and parallel fixation techniques for DHFs. We then performed a meta-analysis of the following biomechanical outcome measures: axial/sagittal/coronal/torsional stiffness, load to failure, and torque to failure.

Results: Seventeen studies comparing both constructs were included. The parallel configuration exhibited greater mechanical strength with respect to axial stiffness/load to failure, torsional stiffness, and posterior bending load to failure than the orthogonal constructs. Subgroup analysis revealed that parallel constructs also had higher torsional stiffness in supracondylar fractures.

Conclusions: This meta-analysis shows that parallel constructs provide greater axial stiffness, axial strength, and torsional stiffness than orthogonal plate for DHF fixation. A subgroup analysis revealed that parallel constructs had better torsional stiffness in supracondylar fracture fixation.

Level Of Evidence: IA.

Citing Articles

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PMID: 39123243 PMC: 11316439. DOI: 10.1186/s13256-024-04700-2.

Biomechanical Design Optimization of Distal Humerus Fracture Plates: A Review.

Zdero R, Brzozowski P, Schemitsch E Biomed Res Int. 2024; 2024:6015794.

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Intra-articular Distal Humerus Fractures: Parallel Versus Orthogonal Plating.

Haglin J, Kugelman D, Lott A, Belayneh R, Konda S, Egol K HSS J. 2022; 18(2):256-263.

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Modified pin and plate fixation for low intercondylar fractures of the humerus: biomechanical study corroborated with a case series.

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Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study.

Shih C, Kuan F, Hsu K, Hong C, Lin C, Yeh M BMC Musculoskelet Disord. 2021; 22(1):440.

PMID: 33990212 PMC: 8122534. DOI: 10.1186/s12891-021-04302-9.

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