Does posterior configuration have similar strength as parallel configuration for treating comminuted distal humerus fractures? A cadaveric biomechanical study

BMC Musculoskeletal Disorders

Kai-Lan Hsu¹  Chien-An Shih¹  Fa-Chuan Kuan²  Ming-Long Yeh³  Chih-Kai Hong⁴  Cheng-Li Lin⁴  Wei-Ren Su⁵ 

[1] Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan;Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan;Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;Department of Orthopedics, National Cheng Kung University Hospital Dou-Liou Branch, Tainan, Taiwan;Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan;Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan;Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan;Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan;

关键词: Biomechanical study;    Distal humeral fracture;    Fracture fixation;    Comminuted fracture;    Parallel plating;    Posterior plating;   

DOI  :  10.1186/s12891-021-04302-9

来源: Springer

【 摘 要 】

BackgroundThe posterior plating technique could be used as a clinical alternative to parallel plating for treating comminuted distal humerus fractures (DHFs) successfully with good clinical results. However, the biomechanical characteristics for posterior fixation are still unclear. The purpose of this study is to evaluate the biomechanical properties of the posterior fixation and to make comparisons between the parallel and the posterior fixation systems.Materials and methodsWe performed a cadaveric biomechanical testing with two posterior plating systems (a posterior two plating and a single posterior pre-contoured Y plating system) and one parallel two plating system to treat AO/OTA type-C2.3 DHFs. Among three groups, we compared construct stiffness, failure strength, and intercondylar width changes after 5000-cycle fatigue loading and failure loads and failure modes after destructive tests in both the axial compression and (sagittal) posterior bending directions. The correlations between construct failure loads and bone marrow density (BMD) were also compared.ResultsIn axial direction, there were no significant differences in the stiffness and failure load between the posterior and the parallel constructs. However, in sagittal direction, the two-plate groups (posterior two plating and parallel plating group) had significant higher stiffness and failure loads than the one-plate group (single posterior Y plating). There was no fixation failure after 5000-cyclic loading in both directions for all groups. Positive correlation was noted between BMD and failure loads on parallel fixation.ConclusionsWe found that when using two plates for treating comminuted DHFs, there were no significant differences in terms of most biomechanical measurements between posterior and parallel fixation. However, the single pre-contoured posterior Y plate construct was biomechanically weaker in the sagittal plane than the parallel and the posterior two-plate constructs, although there was no fixation failure after the fatigue test for all groups regardless of the fixation methods.Level of evidenceBiomechanical study

【 授权许可】

CC BY