Comparison of biomechanical stability between double posterior plate, parallel plate, and perpendicular (90˚) plate fixation in supracondylar humerus fracture

Published by Admin Journal on

No. 2



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.

Materials and 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


The result of pull test with 200 N force showedthat
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.


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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