Introduction: This systematic review and meta-analysis compared orthogonal and parallel plating techniques for these fractures, focusing on functional recovery, complication rates, and biomechanical stability.

Methods: A comprehensive literature search was conducted on January 25, 2025, across PubMed, EMBASE, Europe PMC, and Scopus. Studies involving pediatric patients (aged 0-18 years) with distal humeral fractures treated using orthogonal or parallel plating were included. Eligible studies reported outcomes such as Mayo Elbow Performance Score (MEPS), range of motion (ROM), union time, and non-union rate. Two independent reviewers extracted data, and study quality was assessed using the Cochrane risk of bias (RoB) tool version 2.0. Statistical analyses were performed using a random-effects model in RStudio.

Results: From an initial pool of 659 records, five studies (three randomized controlled trials [RCTs] and two cohort studies) met the inclusion criteria. Meta-analyses revealed no significant differences between orthogonal and parallel plating in MEPS (SMD - 0.25, p = 0.07), ROM (SMD - 0.15, p = 0.27), flexion range (SMD - 0.11, p = 0.46), non-union rate (RR 1.01, p = 0.99), union time (RR 1.01, p = 0.99), or surgical duration (SMD 0.06, p = 0.74). However, orthogonal plating showed a statistically significant advantage in extension range (SMD 0.45, p = 0.005). The risk of bias was minimal, and the certainty of evidence was rated as high.

Conclusions: Both orthogonal and parallel plating techniques demonstrated comparable efficacy in managing pediatric distal humeral fractures, with no significant differences in most outcomes. Orthogonal plating exhibited a slight advantage in extension range, though its clinical relevance requires further investigation.

Keywords: Biomechanics; Fixation; Fractures; Outcomes; Pediatrics.

© 2025. The Author(s), under exclusive licence to Istituto Ortopedico Rizzoli.

简介： 本系统综述和元分析比较了正交钢板和平行钢板技术在治疗这些骨折时的功能恢复、并发症发生率及生物力学稳定性方面的效果。

方法： 2025年1月25日，我们在PubMed、EMBASE、Europe PMC 和Scopus数据库中进行了全面的文献检索。纳入了涉及儿童患者（0-18岁）使用正交钢板或平行钢板治疗远端肱骨骨折的研究。符合条件的研究报告了梅奥肘关节功能评分（MEPS）、活动范围（ROM）、愈合时间及非愈合率等结果指标。两名独立评审员提取数据，并使用Cochrane风险偏倚工具版本2.0评估研究质量。统计分析在RStudio中使用随机效应模型进行。

结果： 从最初的659篇文献记录中，五项研究（三项随机对照试验和两项队列研究）符合纳入标准。元分析显示，在梅奥肘关节功能评分（MEPS）、活动范围（ROM）、屈曲范围、非愈合率、愈合时间和手术时间方面，正交钢板与平行钢板技术之间没有显著差异（SMD -0.25, p = 0.07；SMD -0.15, p = 0.27；SMD -0.11, p = 0.46；RR 1.01, p = 0.99；RR 1.01, p = 0.99；SMD 0.06, p = 0.74）。然而，正交钢板在伸展范围上表现出统计学上的显著优势（SMD 0.45, p = 0.005）。偏倚风险很小，并且证据的确定性被评为很高。

结论： 正交和平行钢板技术在管理儿童远端肱骨骨折方面表现出相当的疗效，大多数结果指标上没有显著差异。尽管如此，正交钢板在伸展范围上的微弱优势需要进一步研究以确定其临床意义。

关键词： 生物力学；固定；骨折；结果；儿科。

© 2025. The Author(s), under exclusive licence to Istituto Ortopedico Rizzoli.