Functional Outcome of Perpendicular Plating Versus Parallel Plating In The Management Of Distal Humerus Fractures- A Comparative Study

Abstract

Distal humerus fractures are quite uncommon but pose significant challenges in management due to their complex anatomy and varied fracture patterns. Surgical intervention, particularly using plate fixation, is often necessary to achieve stable fracture union and restore functional elbow mobility. This prospective comparative study aimed to analyse the outcomes of distal humeral fracture management using perpendicular and parallel plating techniques. Thirty patients with distal humeral fractures underwent osteosynthesis with either perpendicular or parallel plating between November 2020 and October 2022 at Saveetha Medical College and Hospital in Chennai. The Mayo Elbow Performance Score has been utilized to measure the following assessment parameters: pain, radiological, stiffness and clinical union, and functional elbow ability at 6 weeks, 3 months, 6 months, and 1 year after the surgery.Both techniques yielded satisfactory outcomes in terms of fracture union and functional recovery. However, complications and biomechanical properties differed significantly between the two methods. Parallel plating demonstrated superior stability and resistance to plastic deformation, particularly in osteoporotic bone, suggesting potential advantages in managing comminuted distal humerus fractures with an intraarticular component. This study contributes valuable insights into the optimal management strategies for distal humeral fractures and highlights the importance of considering individual patient factors and fracture characteristics when selecting the most suitable surgical approach. Additional investigation is necessary to verify these results and improve methods of treatment for this difficult kind of fracture.