The Computational Design of a Novel Anterior Plate for Extra-Articular Distal Humerus Fractures

Extra-articular distal humerus fractures present surgical challenges, often requiring technically demanding posterior approaches with high radial nerve injury risks or off-label use of anatomically mismatched proximal plates. This study aimed to computationally design and optimize a novel anterior osteosynthesis plate for these fractures. A three-dimensional fracture model was developed, utilizing a parametric design exploration and finite element analysis to evaluate fourteen plate geometries. Evaluated variables included length, thickness, screw configuration, and locking mechanisms under physiological axial compression, bending, and varus loads. The analysis revealed that plate thickness primarily determines construct stability, with a four-millimeter profile optimally balancing rigidity and a low anatomical footprint. Lengths exceeding 40 mm yielded diminishing stability returns, while a dense distal locking screw configuration proved essential for maintaining fracture reduction. Compared to conventional clinical systems, the optimized plate substantially reduced the severe axial instability observed in extra-articular distal humerus plates and mitigated the critical bending stress concentrations inherent to proximal humeral internal locking systems. By achieving balanced, multi-planar stability with a minimized footprint, this novel design provides a favorable mechanical environment for secondary bone healing while facilitating a less invasive surgical approach.