A comparative analysis of functional and radiological outcomes in type C intra-articular distal humerus fractures: perpendicular vs. parallel plating

Abstract Background: Intra-articular distal humerus fractures, especially type C, present significant surgical challenges. This study aimed to compare the functional and radiological outcomes of two internal fixation methods, perpendicular and parallel plating. Materials and Methods: A hospital-based, randomized comparative study was conducted with a total of 62 patients with type C intra-articular distal humerus fractures. Two groups of 31 each were enrolled: Group A (perpendicular plating) and Group B (parallel plating). Functional outcomes were assessed using range of motion and the Mayo Elbow Performance Score (MEPS), while radiological parameters, including time to bony union and postoperative complications, were evaluated. Statistical analysis was performed to compare the results between the two groups. Results: The average patient age was 40.97 years, with a male predominance (77.4%). Baseline characteristics were comparable between the groups ( P > 0.05). Patients in the parallel plating group showed significantly better functional outcomes, with a higher mean range of motion (108.05° vs. 95.78°, P = 0.041) and higher MEPS scores (85.32 vs. 77.87, P = 0.025). This group also experienced a lower complication rate (20.4% vs. 38.7%) and a slightly shorter time to union (4.98 months vs. 5.66 months, P = 0.35). Implant failure occurred in 6.5% of cases in the perpendicular group, whereas none occurred in the parallel group. Conclusion: Parallel plating yields better functional outcomes, such as increased range of motion, fewer complications, and higher MEPS scores, compared to perpendicular plating in the treatment of type C intra-articular distal humerus fractures.