Chien-An Shih1,2,3, Wei-Ren Su1,2,4, Wei-Chin Lin1, Tai-Wei Tai5,6. 1. Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 2. Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan. 3. Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan. 4. Medical Innovation Center, National Cheng Kung University, Tainan, Taiwan. 5. Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. david0803@gmail.com. 6. Medical Device R & D Core Laboratory, National Cheng Kung University Hospital, Tainan, Taiwan. david0803@gmail.com.
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.
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.
Authors: Jan Korner; Gerd Diederichs; Michael Arzdorf; Helmut Lill; Christoph Josten; Erich Schneider; Berend Linke Journal: J Orthop Trauma Date: 2004 May-Jun Impact factor: 2.512
Authors: Magnus W T Arnander; Alexander Reeves; Iain A R MacLeod; Thomas M Pinto; Arshad Khaleel Journal: J Orthop Trauma Date: 2008 May-Jun Impact factor: 2.512