Internal fixation of the distal humerus: a biomechanical comparison of methods.

Three commonly used configurations of various implants used for fixation of distal humeral fractures were quantitatively compared. The double plate construct, irrespective of plate type (1/3 tubular and/or 3.5 mm reconstruction plate), was significantly stronger, both in rigidity and fatigue testing, than cross screws or the single "Y" plate. If rigid stabilization of supracondylar or bicondylar distal humeral fractures is desired, then two plate constructs, at right angles (the ulna plate medially, the lateral plate posteriorly), are biomechanically optimal.