Parallel versus orthogonal plate osteosynthesis of adult distal humerus fractures: a meta-analysis of biomechanical studies

Chien An Shih, Wei-Ren Su, Wei Chin Lin, Ta-Wei Tai

Research output: Contribution to journalArticle

Abstract

Purpose: There are two widely used distal humerus fracture (DHF) fixation methods with either orthogonal or parallel double-plate osteosynthesis. However, biomechanical studies have shown inconsistent results on which technique is more effective. We performed a meta-analysis to compare these two fixation methods for adult DHF fixation. Methods: We searched the literature for entries discussing the biomechanical testing of orthogonal and parallel fixation techniques for DHFs. We then performed a meta-analysis of the following biomechanical outcome measures: axial/sagittal/coronal/torsional stiffness, load to failure, and torque to failure. Results: Seventeen studies comparing both constructs were included. The parallel configuration exhibited greater mechanical strength with respect to axial stiffness/load to failure, torsional stiffness, and posterior bending load to failure than the orthogonal constructs. Subgroup analysis revealed that parallel constructs also had higher torsional stiffness in supracondylar fractures. Conclusions: This meta-analysis shows that parallel constructs provide greater axial stiffness, axial strength, and torsional stiffness than orthogonal plate for DHF fixation. A subgroup analysis revealed that parallel constructs had better torsional stiffness in supracondylar fracture fixation. Level of evidence: IA.

Original languageEnglish
Pages (from-to)449-460
Number of pages12
JournalInternational Orthopaedics
Volume43
Issue number2
DOIs
Publication statusPublished - 2019 Feb 14

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Fracture Fixation
Humerus
Meta-Analysis
Torque
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

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abstract = "Purpose: There are two widely used distal humerus fracture (DHF) fixation methods with either orthogonal or parallel double-plate osteosynthesis. However, biomechanical studies have shown inconsistent results on which technique is more effective. We performed a meta-analysis to compare these two fixation methods for adult DHF fixation. Methods: We searched the literature for entries discussing the biomechanical testing of orthogonal and parallel fixation techniques for DHFs. We then performed a meta-analysis of the following biomechanical outcome measures: axial/sagittal/coronal/torsional stiffness, load to failure, and torque to failure. Results: Seventeen studies comparing both constructs were included. The parallel configuration exhibited greater mechanical strength with respect to axial stiffness/load to failure, torsional stiffness, and posterior bending load to failure than the orthogonal constructs. Subgroup analysis revealed that parallel constructs also had higher torsional stiffness in supracondylar fractures. Conclusions: This meta-analysis shows that parallel constructs provide greater axial stiffness, axial strength, and torsional stiffness than orthogonal plate for DHF fixation. A subgroup analysis revealed that parallel constructs had better torsional stiffness in supracondylar fracture fixation. Level of evidence: IA.",
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Parallel versus orthogonal plate osteosynthesis of adult distal humerus fractures : a meta-analysis of biomechanical studies. / Shih, Chien An; Su, Wei-Ren; Lin, Wei Chin; Tai, Ta-Wei.

In: International Orthopaedics, Vol. 43, No. 2, 14.02.2019, p. 449-460.

Research output: Contribution to journalArticle

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