The interference of distal humeral plating with the medial and lateral collateral ligaments of the elbow

The aim of the present study was to determine the anatomical relationship and evaluate the potential interference of today's common distal humerus plates with the medial and lateral collateral ligaments of the elbow. The elbow joints of 23 embalmed upper extremities were dissected. Three different brands of distal humerus double-plating systems were applied in a standardized fashion. We used a caliper to measure the amount of absolute overlap of the plates on the corresponding collateral ligaments. The data show contact and overlap with the medial and lateral collateral ligaments in all tested medial and lateral plates. The posterolateral and posteromedial plates showed no contact with the ligaments, yet they did contact the posterior joint capsules. The medial plates showed less contact/overlap when compared with the lateral and extended medial plates. Based on the present data, we conclude that distal humerus plating using the perpendicular technique with standard-sized medial plates shows the least amount of overlap over the medial and lateral collateral ligaments. The extent of the overlap of the ligaments by the humeral plates is clearly shown in the present study.