Anatomical plate configuration affects mechanical performance in distal humerus fractures

Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model

“…Significantly smaller displacements under axial load obtained in this study as well suggest a substantially lesser importance of that load in the overall evaluation of the construction's biomechanical stability, which is in line with previous studies 17 , although they were not conducted on the same level of the distal humerus.…”

“…11,[13][14][15][16][17][18] No study to date has addressed the issue of biomechanical stability on the transition of the distal humeral diaphysis into the distal segment of the humerus.…”

“…[15][16][17] Loads applied in the study are within the physiological limits of loads in everyday activity of the postoperative rehabilitation period, and we avoided applying loads that would cause permanent plastic deformations on the implants. Furthermore, choosing the 10 mm gap length for this study was aimed at achieving extreme instability on the biomechanical model.…”

“…Computational simulations were performed with loads on the specific part of the articular segment of the distal humerus, distally from the gap, following the principles from the latest biomechanical studies dealing with distal humerus fractures 14,[16][17][18] , with the radial column being loaded with 60%, and the ulnar column with 40% of the total load. The load and humerus positions were as follows: Axial load or anterior deflection in which the upper arm was placed at a flexion angle of about 5° in relation to the longitudinal axis of the humeral diaphysis ( Figure 2a); Bending or posterior deflection with the upper arm flexed at a 75° angle in relation to the longitudinal axis of the humeral diaphysis ( Figure 2b); Lateral or varus load in which the load is applied laterally on the radial condylar, with the humerus placed horizontally (Figure 2c).…”

“…9 No prospective randomized studies have been published on their outcomes, and the majority of the studies carried out were retrospective and involved a small number of patients. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Hence it is not possible to draw conclusions from them on the ideal configuration of the implant for stabilization of distal humerus fractures. …”