Review article
The Position of the Implant for Extraarticular Fractures of the Distal Humerus – the new Hypotheses for Management
Srećko Sabalić
; Clinical Hospital for Traumatology, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Janoš Kodvanj
; Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia
Stjepan Jecić
; Croatian Academy of Sciences and Arts, Zagreb, Croatia
Abstract
Through many stages of development, from conservative to operative treatment, open reduction and internal fixation with dual plating systems are the golden standard for fixation of distal humerus fractures. The plates are placed with a slight offset, posteromedially and posterolaterally. In recent publications, a higher stiffness and strength of osteosynthesis in the parallel plating technique were compared to the perpendicular technique with different plate designs. As noted in previous studies, non-union of the distal humerus usually occurs in the region at the metaphyseal and supracondylar level of radial columns due to varus stresses. Therefore the hypothesis is that in the case of extraarticular methphyseal fractures, which are treated with two plates perpendicular or parallel to form, the radial side of the plate should be longer than the ulnar side in order to prevent varus stresses as the main cause of the distal humeral pseudoarthrosis. Sufficient stability can be ensured with newly designed Y-shaped plate which should have a longer radial arm and be configured to prevent varus stresses. To prove this hypothesis, biomechanical studies at the supracondylar metaphyseal level on the border of the distal humerus diaphysis should be performed.
Keywords
distal humerus; extraarticular fracture; biomechanics
Hrčak ID:
141370
URI
Publication date:
14.7.2015.
Visits: 2.002 *