Orthogonal versus Parallel Plating for Distal Humeral Fractures

Moon,  Jun Gyu; Lee,  Ji Ho

doi:2015.18.2.105

Clin Shoulder Elb > Volume 18(2); 2015 > Article

Review

Clinics in Shoulder and Elbow 2015;18(2):105-112.
DOI: https://doi.org/10.5397/cise.2015.18.2.105 Published online June 30, 2015.

Orthogonal versus Parallel Plating for Distal Humeral Fractures

Jun Gyu Moon, Ji Ho Lee

Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, Korea. moonjg@korea.ac.kr

Received: 23 May 2015 • Revised: 7 June 2015 • Accepted: 8 June 2015

Abstract

In orthopedic trauma surgery, treatment of intraarticular distal humerus fractures is a challenge. With development of implants and biomechanical studies, surgical strategies with recommendations including preoperative computed tomography images, proper approaches and open reduction and internal fixation with dual plates have emerged. In addition, as an effort to provide stable fixation to permit early elbow motion, different methods of internal fixation, particularly plate configuration, have evolved. Using dual plates, either oriented parallel to each other or orthogonal, stable fixation has been achieved and satisfactory clinical outcomes have been reported. With rationales and advantages/disadvantages of each plate configuration, both techniques are selected according to surgeons' preference, and, in specific cases, one could be preferred over another. The key to successful fixation by either technique is obtaining anatomical reduction with restoration of two stable columns of the distal humerus.

Key Words: Humerus; Humeral fractures; Fracture fixation