• Arch Orthop Trauma Surg · Nov 2022

    Randomized Controlled Trial

    Biomechanical stability of complex coronal plane fracture fixation of the capitellum.

    • Paul Borbas, Rafael Loucas, Marios Loucas, Maximilian Vetter, Simon Hofstede, Lukas Ernstbrunner, and Karl Wieser.
    • Department of Orthopedics, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland. paul.borbas@balgrist.ch.
    • Arch Orthop Trauma Surg. 2022 Nov 1; 142 (11): 3239-3246.

    IntroductionCoronal plane fractures of the distal humerus are relatively rare and can be challenging to treat due to their complexity and intra-articular nature. There is no gold standard for surgical management of these complex fractures. The purpose of this study was to compare the biomechanical stability and strength of two different internal fixation techniques for complex coronal plane fractures of the capitellum with posterior comminution.Materials And MethodsFourteen fresh frozen, age- and gender-matched cadaveric elbows were 3D-navigated osteotomized simulating a Dubberley type IIB fracture. Specimens were randomized into one of two treatment groups and stabilized with an anterior antiglide plate with additional anteroposterior cannulated headless compression screws (group antiGP + HCS) or a posterolateral distal humerus locking plate with lateral extension (group PLP). Cyclic testing was performed with 75 N over 2000 cycles and ultimately until construct failure. Data were analyzed for displacement, construct stiffness, and ultimate load to failure.ResultsThere was no significant difference in displacement during 2000 cycles (p = 0.291), stiffness (310 vs. 347 N/mm; p = 0.612) or ultimate load to failure (649 ± 351 vs. 887 ± 187 N; p = 0.140) between the two groups.ConclusionsPosterolateral distal humerus locking plate achieves equal biomechanical fixation strength as an anterior antiglide plate with additional anteroposterior cannulated headless compression screws for fracture fixation of complex coronal plane fractures of the capitellum. These results support the use of a posterolateral distal humerus locking plate considering the clinical advantages of less invasive surgery and extraarticular metalware.Level Of EvidenceBiomechanical study.© 2021. The Author(s).

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