Internal Fixation of the Distal Humerus

Caravaggi, Paolo; Laratta, Joseph L.; Yoon, Richard S.; Biasio, Justin De; Ingargiola, Michael J.; Frank, M; Capo, John T.; Liporace, Frank A.

doi:10.1097/bot.0b013e3182a6693f

Cited by 34 publications

(26 citation statements)

References 24 publications

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“…According to a finite element model of an osteoporotic bone, perpendicular and parallel dual plating of the distal humerus result in equal stability of the construct [8]. Arnander et al [1] and Caravaggi et al [22] found that 1808 plate configuration offers superior stability when compared to perpendicular plate positioning. Locking plates seem to offer higher stability of the osteosynthesis in comparison to nonlocking plates [22].…”

Section: Discussionmentioning

confidence: 98%

“…Arnander et al [1] and Caravaggi et al [22] found that 1808 plate configuration offers superior stability when compared to perpendicular plate positioning. Locking plates seem to offer higher stability of the osteosynthesis in comparison to nonlocking plates [22]. While some biomechanical evidence points to the conclusion that 1808 positioning of the distal humerus plates might be preferred over 908 positioning [1,22], equal clinical results of both fixation techniques have been reported [15,23].…”

Section: Discussionmentioning

confidence: 98%

“…Many studies evaluated the biomechanical properties of different dual plate fixation techniques for distal humerus fractures [1,8,9,22]. According to a finite element model of an osteoporotic bone, perpendicular and parallel dual plating of the distal humerus result in equal stability of the construct [8].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Peri-implant failure in dual plating of the distal humerus—A biomechanical analysis with regard to screw and plate positioning

Hackl

Wegmann

Taibah

et al. 2015

Injury

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Peri-implant failure in dual plating of the distal humerus—A biomechanical analysis with regard to screw and plate positioning

Hackl

Wegmann

Taibah

et al. 2015

Injury

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“…The current gold standard for surgical treatment of intra-articular distal humeral fractures is open reduction and internal fixation with plates and/or screws [3]. In earlier studies, locked plating configurations demonstrated significantly better performance than nonlocked plating configurations, independently of their orientation [4]. The fixation methods evolved into the present third generation of locking plates which include anatomical plate design and poly-axial locking screws.…”

Section: Introductionmentioning

confidence: 99%

“…exposure of the distal humerus must be taken into consideration [4]. Hence, under some circumstances the 90°angle configuration might be preferable.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of anatomical plating systems for comminuted distal humeral fractures

Varady

Rüden

Greinwald

et al. 2017

International Orthopaedics (SICOT)

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Purpose Six different mono-axial and poly-axial distal humeral plating systems with an anatomical plate design were compared. The aim of the biomechanical tests was to examine differences regarding system stiffness, median fatigue limit, and failure mechanisms. Methods Different configurations of two double plate fixation systems by two manufacturers for the treatment of complex distal humeral fractures (AO/OTA type C2.3) were biomechanically tested in a physiologically relevant setup. Results The 180°Stryker configuration presented itself as the system with the highest stiffness, being significantly stiffer (p < 0.001) than every system other than the poly-axial 180°aap system (p = 0.378). For the median fatigue limit the 180°S tryker and poly-axial aap systems were ranked first and second. The failure mechanism for all 90°systems was a fatigue breakage of the posterolateral plate. The 180°aap systems demonstrated breakage of the most distal screws of the lateral plate. The 180°Stryker system demonstrated screw breakage on both the medial and lateral plates. Discussion Breakage of the posterolateral plate as a failure mechanism for the 90°systems was expected. The 180°s ystems demonstrated a higher stiffness compared to the 90°c onstructs for the axial loading. In conclusion, both poly-axial anatomical plating systems provide sufficient stability in this scenario, and the 180°configurations demonstrated superior stiffness.

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Dynamic effect of three locking plates fixated to humeral fracture based on multibody musculoskeletal model

Peng

Chen

et al. 2021

Robotics Computer Surgery

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Objective: This study attempts to analyse the biomechanical effect of internal fixation (plated in parallel or plated vertically) on the basis of distal humeral fractures on musculoskeletal multibody dynamics using AnyBody in Finite Element Method.Method: Humeral 3D models were reconstructed by MIMICS after volunteers' CT image input in *.dicom format, and processed by Geomagic Studio for surfaces, while locking plates and screws were then designed by Pro-E. A humeral model of T-type fracture was created and assembled in Hypermesh, to integrate fixtures (e.g., MPL/ PML/ML), to grid the mesh and then assign materials. A musculoskeletal model of the upper limb was established by AnyBody to simulate elbow flexion and extension.They were finally imported to Abaqus for boundary conditions and dynamic analysis. Result:In terms of Von Mises stress, its maximum increased and then decreased gradually during the joint motion, but p > 0.05 in SPSS suggests no significant difference for all three fixtures. In terms of displacement, when the elbow was at 90°, each motional pattern reached its peak as follows: ML180°= 0.28 mm, MPL90°= 0.49 mm & PML90°= 0.54 mm during flexion; ML180°= 0.073 mm, MPL90°= 0.10 mm & PML90°= 0.12 mm during extension. p < 0.05 suggests a significant difference for the displacements of all three fixations. p = 0.007 < 0.01667 suggests the significant difference between the two fixations, for example, PML90°and ML180°, indicating that the peak displacement of ML180°i s less than that of PML90°. Conclusion:After generally analysed in musculoskeletal dynamics, the biomechanical property of the fixtures was presented as follows: the displacement of the parallel plate was less than that of the vertical, and the parallel plate may optimise the clinical reduction anatomically.

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Internal Fixation of the Distal Humerus

Cited by 34 publications

References 24 publications

Peri-implant failure in dual plating of the distal humerus—A biomechanical analysis with regard to screw and plate positioning

Peri-implant failure in dual plating of the distal humerus—A biomechanical analysis with regard to screw and plate positioning

Biomechanical comparison of anatomical plating systems for comminuted distal humeral fractures

Dynamic effect of three locking plates fixated to humeral fracture based on multibody musculoskeletal model

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