Biomechanical comparison of a hybrid fixation technique with traditional methods for distal humeral shaft fractures: a finite element analysis

Background Distal humeral shaft fractures pose significant challenges in orthopedic surgery due to their complex anatomy and biomechanical demands. Traditional fixation methods, such as posterolateral locked plating and double reconstruction plating, have limitations, including radial nerve injury risk and insufficient stability. Purpose This study evaluates the biomechanical performance of a hybrid technique combining an intramedullary nail (IMN) with a reconstruction plate (RP) for managing distal humeral shaft fractures. Methods Finite element analysis (FEA) was conducted to compare the biomechanical properties of IMN + RP, posterolateral locked plating, and double reconstruction plating under axial compression, torsional loading, and bending forces. Key outcomes included displacement, stress distribution, and overall stability. Results The IMN + RP technique demonstrated superior biomechanical performance, achieving lower displacement and more balanced stress distribution across all loading conditions. It outperformed traditional methods in minimizing stress concentrations and maintaining fixation stability. Conclusion This study highlights the biomechanical superiority of the IMN + RP technique, providing robust evidence for its application in managing distal humeral shaft fractures. These findings contribute to the understanding of hybrid fixation strategies and support further clinical and experimental validation.