Biomechanical study of different plate configurations for distal humerus osteosynthesis

  • M. Bogataj
  • F. Kosel
  • R. Norris
  • M. Krkovic
  • M. Brojan
Original Article

Abstract

Fractures of the distal humerus are most commonly fixed by open reduction and internal fixation, using plates and screws, either in a locking or in a non-locking construct. Three different plating systems are commonly used in practice. The most important differences between them are in plate orientation, which affects both the rigidity of the osteosynthesis and invasiveness of the surgical procedure. Unfortunately, there is no common agreement between surgeons about which plate configuration brings the best clinical outcome. In this study, we investigate the theoretical rigidity of plate osteosyntheses considering two types of AO/ASIF configurations (90° angle between plates), Mayo clinic (Acumed) configuration (180° between plates) and dorsal fixation of both plates. We also compared the results for cases with and without contact between the bone fragments. In the case of no bone contact, the Mayo clinic plate configuration is found to be the most rigid, followed by both AO/ASIF plate configurations, and the least rigid system is the Korosec plate configuration. On the other hand, no significant differences between all types of fixation configurations are found in cases with contact in-between the bone fragments. Our findings show that this contact is very important and can compensate for the lack of load carrying capacity of the implants. This could therefore incite other implant fixation solutions, leading to less invasive surgical procedures and consequently improved clinical outcome.

Keywords

Distal humerus Fracture Osteosynthesis Minimally invasive surgery Finite element analysis 

Supplementary material

11517_2015_1247_MOESM1_ESM.docx (2.8 mb)
Supplementary material 1 (DOCX 2911 kb)

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Copyright information

© International Federation for Medical and Biological Engineering 2015

Authors and Affiliations

  • M. Bogataj
    • 1
  • F. Kosel
    • 1
  • R. Norris
    • 2
  • M. Krkovic
    • 3
  • M. Brojan
    • 1
  1. 1.Laboratory for Nonlinear Mechanics, Faculty of Mechanical EngineeringUniversity of LjubljanaLjubljanaSlovenia
  2. 2.University Hospitals Coventry and WarwickshireCoventryUK
  3. 3.Addenbrookes HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK

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