title: A biomechanical comparison of plate configuration in distal humerus fractures.
abstract: OBJECTIVE
  Our aim was to test the hypothesis that two plates placed parallel to each other are stronger and stiffer than plates placed perpendicular to each other for fixation of a distal humerus fracture model.
  
  
  METHODS
  We created an artificial distal humeral fracture model by osteotomizing two groups of identical epoxy resin humera. Screw and plate constructs were built to mimic osteosynthesis. In the first group, 3.5-mm reconstruction plates were placed parallel to each other along each of the medial and lateral supracondylar ridges. In the second group, 3.5-mm reconstruction plates were placed perpendicular to each other with a medial supracondylar ridge plate and a posterolateral plate. Stiffness and strength data of the two constructs were obtained by testing to failure with sagittal plane bending forces.
  
  
  RESULTS
  The parallel plate group (n = 7) had a mean stiffness of 214.9 +/- 43.3 N/mm and a mean strength of 304.4 +/- 63.5 N. The perpendicular plate group (n = 8) had a mean stiffness of 138.3 +/- 44.6 N/mm and a mean strength of 214.9 +/- 43.3 N. These differences were significant (Student's t test, P < 0.05).
  
  
  CONCLUSIONS
  As theoretically expected, a parallel plate configuration is significantly stronger and stiffer than a perpendicular plate configuration when subjected to sagittal bending forces in a distal humerus fracture model.
authors.affiliation: Rowley Bristow Orthopaedic Unit, St Peter's Hospital, Chertsey, Surrey, UK. magnus1@hotmail.co.uk
authors.forename: Magnus W T
authors.initials: MW
authors.lastname: Arnander
authors.forename: Alexander
authors.initials: A
authors.lastname: Reeves
authors.forename: Iain A R
authors.initials: IA
authors.lastname: MacLeod
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Pinto
authors.forename: Arshad
authors.initials: A
authors.lastname: Khaleel
mesh_terms: D001860:Bone Plates; D001863:Bone Screws; D019245:Compressive Strength; D004867:Equipment Design; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D008422:Materials Testing; D008954:Models, Biological; D018583:Pliability