Outcomes of proximal humeral fracture fixation with locked CFR-PEEK plating.

Abstract

To investigate the outcomes of proximal humeral fracture (PHF) fixation with a novel carbon-fiber-reinforced (CFR)-PEEK plate and to compare results with outcomes after conventional locked titanium plating. Twenty-one patients (7 male, 14 female) with operative treatment of unilateral displaced PHFs (mean age, 66.8 ± 9.9 years) with a novel CRF-PEEK plate were prospectively enrolled. Patients were followed up clinically (Constant Score, Simple Shoulder Test and Simple Shoulder Value) and radiologically 3 months postoperative and again clinically 12 months postoperative. Implant-related complications were evaluated after 3 and 12 months. Results at 1-year follow-up were compared with results of 21 patients (7 male, 14 female; mean age, 67.4 ± 9.7 years) with conventional titanium locked plating by matched case-control analysis. All functional outcomes improved after CFR-PEEK plating (p < 0.05). Twelve months postoperatively, the mean age- and gender-related Constant Score was 99.8 ± 21.2%. All fractures healed by the 3-month follow-up without evidence of secondary screw perforation, fragment displacement or loss of fixation. There were no significant differences between the functional outcomes of patients with the CF-PEEK plate and patients with locked titanium plating (p > 0.05). Patients with locked titanium plating were significantly more likely to require revision surgery related to articular screw perforations (p = 0.048). Fracture fixation of displaced PHFs with a novel CFR-PEEK plate resulted in good to excellent 1-year functional outcomes which were similar to outcomes of conventional locked titanium plating. The stiffer locked titanium plating was associated with a higher risk of articular screw perforations than the more elastic CFR-PEEK plate.