Biomechanical performance evaluation of a modified proximal humerus locking plate for distal humerus shaft fracture using finite element analysis

This study evaluates the biomechanical performance of a modified proximal humerus locking plate (PHILOS) for distal humerus shaft fracture (DHSF) using finite element analysis (FEA), comparing it to the traditional extra-articular distal humerus plate (EADHP). The EADHP is commonly used but has issues like iatrogenic radial nerve injury and skin irritation. Anterior plating with an upside-down PHILOS plate is proposed as an alternative. The study used FEA to assess the stability and performance of both plating methods under axial, bending, and varus force conditions. Results showed that both the EADHP and modified PHILOS provided adequate biomechanical performance and stability. The PHILOS achieved comparable stability with fewer locking screws. Image review and segmentation for FEA were conducted using AVIEW Research software (Coreline Soft Inc.). The findings suggest that the PHILOS could be a viable alternative to the EADHP for DHSF treatment, considering dissection range and patient comfort.