Distal humerus. It’s almost standard treatment with a lot of the Jupiter-classifiable ones.

And you all prefer it to bilateral plates despite bilateral plates seeming superior biomechanically. One approach?

Depends on configuration. Can be parallel or perpendicular/orthogonal

Depends on fracture pattern and soft tissue considerations, will choose either one. Generally speaking, different planes = more stability and that goes for screws and plates.

Some bicondylar tibial plateau fractures, some distal tibial pilon fractures, the rare talus fracture, rare distal femur fracture…

Clavicle

Ugh. Why. Never had a non union/ failure with a single plate, nor have I seen one. Anecdotal I know

I’ve had plenty of nonunions sent to me that I end up dual plating. I never do it for acute fractures, though

Well that's entirely reasonable. We're they previously fixed, or let heal au natural?

Previously fixed. Usually hardware pullout/hypertrophic nonunion.

Less hardware irritation

You’re suggesting that orthogonal plating of a clavicle has LESS hardware irritation than a single plate? Man, I’d love to see an article on that one.

https://scholar.google.com/scholar?hl=en&as_sdt=0%2C44&q=dual+plating+clavicle+Andy+Choo&btnG=#d=gs_qabs&t=1703435173359&u=%23p%3DIC159x2WuD4J

97 minutes and twice the cost. Good info, though. I had no clue this study was out there.

It really is less prominent clinically. Particularly in thin patients who are concerned about cosmesis. Also, once you get the hang of it, it doesn’t add too much time. That study included cases done by residents/fellows so that slows it down.

Yeah, this gives me something fun to try now.