Comparison of biomechanical stability between double posterior plate, parallel plate, and perpendicular (90˚) plate fixation in supracondylar humerus fracture
Keywords:
Supracondylar humerus fracture, distal humerus fracture, double posterior platingAbstract
Introduction:
Distal humerus fracture is still a problem in orthopaedics due to the limitation of the implant installation area and the difficulty of surgical procedures caused by the neurovascular structure present in the distal portion of the humerus so that the complication rate of this fracture is quite high. Current gold standard for distal humerus fracture is ORIF with double plating, but until now there is still controversy mentioning superiority of one technique compare to the others.
Methods:
This study is an in vitro experimental study on 27 cadaveric humerusbones, which is divided into 3 groups of treatment consisting of parallel plating; perpendicular plating; and double posterior plating fixation.Biomechanical tests were performed to determine the stability ofthese groups based on the displacement of the fracture fragments after repeated loading of 200 N of 10x, 20x, 50x, and 100x.
Results:
The result of pull test with 200 N force showed that double posterior plate hadthe lowest displacement fracture fragment comparedtoparallel plate and perpendicular plate, with mean of displacement of 0.20 mm (p = 0.400) after 10x repeated loading, 0.57 mm (p = 0.394) after 20x repeated loading, 0.82 mm (p = 0.107) after 50x repeated loading, and 1.58mm (p = 0.145) after 100x repeated loading.
Conclusion:
The biomechanics of double posterior plate is more stable than parallel plate and perpendicullar plate but not significantly different.Double posterior plate on the distal humerus fracture couldbecome one of the alternative fixations with an easier and safer approach.
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