A biomechanical comparison of plate configuration in distal humerus fractures

Our aim was to test the hypothesis that two plates placed parallel to each other are stronger and stiffer than plates placed perpendicular to each other for fixation of a distal humerus fracture model.

We created an artificial distal humeral fracture model by osteotomizing two groups of identical epoxy resin humera. Screw and plate constructs were built to mimic osteosynthesis. In the first group, 3.5-mm reconstruction plates were placed parallel to each other along each of the medial and lateral supracondylar ridges. In the second group, 3.5-mm reconstruction plates were placed perpendicular to each other with a medial supracondylar ridge plate and a posterolateral plate. Stiffness and strength data of the two constructs were obtained by testing to failure with sagittal plane bending forces.

The parallel plate group (n = 7) had a mean stiffness of 214.9 +/- 43.3 N/mm and a mean strength of 304.4 +/- 63.5 N. The perpendicular plate group (n = 8) had a mean stiffness of 138.3 +/- 44.6 N/mm and a mean strength of 214.9 +/- 43.3 N. These differences were significant (Student's t test, P < 0.05).

As theoretically expected, a parallel plate configuration is significantly stronger and stiffer than a perpendicular plate configuration when subjected to sagittal bending forces in a distal humerus fracture model.