CFR-PEEK plates with a lower rate of tuberosity
resorption and similar clinical results could become the choice over metal
plates for proximal humeral fractures.
A
recently published study in the journal 'Musculoskeletal Surgery' described
that the carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates provide
a viable substitute to conventional titanium plates in proximal humeral
fractures (PHFs). It further ensures similar clinical outcomes and a lower rate
of tuberosity resorption, although they require higher stress shielding under
the plate.
The metal
plates are the fixation devices commonly used for PHFs. But, recently the use of CFR-PEEK plates are on the
rise. This is used as a material for orthopaedic implants, for instance in
spinal cages, hip prostheses, or intramedullary nails.
Padolino
A et al. undertook a retrospective controlled study to distinguish between
the clinical and radiographic outcomes of 42 Neer three- and four-part PHFs
treated with CFR-PEEK or metal (titanium) plates.
Out of
the total 42 PHF patients, 21 patients (males/females 9/12 with mean age of
57.4 years) were managed with CFR-PEEK plates (mean follow-up 30.7 months; CFR-PEEK
group) and 21 with metal plates (males/females 7/14 with a mean age 55.8 years;
mean follow-up 52.7 months; Metal group). Active shoulder mobility including
anterior elevation, lateral elevation, external rotation, and internal
rotation, the Constant-Murley Score, the Simple Shoulder Test Score, and the
pain score were noted. The preoperative computed tomography scans and X-rays
were acquired. The postoperative fracture healing and displacement, tuberosity
resorption and/or malposition, hardware position, and cortical thinning (CT)
under the plate were examined radiographically.
This
study resulted in similar shoulder mobility, clinical, and pain scores in both
patient groups. With the mean difference of 1.14 mm, the cortical thinning was
significantly prominent in CFR-PEEK patients. In both groups, the incomplete or
poor calcar reduction was found to be associated with a substantially higher
complication rate, especially stiffness and muscle weakness. The rate of
tuberosity resorption was significantly higher in the Metal group. Revision to
a hemiarthroplasty (CFR-PEEK) and reverse arthroplasty was needed in 2 patients
in the metal group.
Musculoskelet Surg. 2018 Oct;102(Suppl 1):49-56.
Comparison of CFR-PEEK and conventional titanium locking plates for proximal humeral fractures: a retrospective controlled study of patient outcomes
Padolino A et al.
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