This is a prospective randomized trial of 35 patients with intra-articular distal humerus fractures who were assigned to either perpendicular plating or parallel plate fixation. The patients were treated with titanium reconstruction plates in the orthogonal plating and titanium precontoured plates in the parallel plate group. All patients in group two (the parallel plate group) achieved union without metal failure. Two patients in the orthogonal group went on to a nonunion. It is of note that 29% of patients in the orthogonal group and 38% of patients in the parallel plate group had complications. This highlights the difficulty of surgically treating these difficult injuries.
This report attempts to prove or disprove biomechanical studies using clinical outcomes research tools. While the numbers in this study do not support any significant difference between the two groups, it is clear that there are differences between these two constructs and that a larger study is needed to clarify the results.