R Rotini1, M Cavaciocchi2, D Fabbri2, G Bettelli2, F Catani3, G Campochiaro3, M Fontana4, A Colozza4, C F De Biase5, G Ziveri5, C Zapparoli6, F Stacca6, R Lupo7, S Rapisarda7, E Guerra2. 1. Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy. roberto.rotini@ior.it. 2. Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy. 3. Orthopedic Clinic, Modena University, Modena, Italy. 4. Orthopedic and Trauma Unit, Faenza Hospital, Faenza, Italy. 5. Orthopedic Clinic, Parma University, Parma, Italy. 6. Orthopedic and Trauma Unit, New Civil Hospital, Modena, Italy. 7. Orthopedic and Trauma Unit, San Giovanni di Dio Hospital, Agrigento, Italy.
Abstract
BACKGROUND: Locking plate fixation is a reliable treatment for many displaced proximal humeral fractures. Carbon fiber-reinforced-poly-ether-ether-ketone (CFR-PEEK) plates have recently been introduced as an alternative to traditional metallic plates. METHODS: In a multicenter study involving the Orthopedic Services of 6 Italian hospitals, 182 patients with a proximal humeral fracture were treated with a Diphos H (Lima Corporate, San Daniele del Friuli, Italy) CFR-PEEK plate, 160 of whom were followed clinically and radiographically for 2 years or more. Fractures were classified by Neer's system. The functional results were assessed by Constant and DASH scores. RESULTS: The average time to radiographic healing was 5.6 months in 158 of 160 cases. Mean Constant score was 76, and mean DASH score was 28 at 2 years. There were two nonunions (one septic and one aseptic) and 13 cases of partial (9) or massive (4) humeral head necrosis. In three of the 78 patients treated with the first-generation plates, hardware breakage happened during the operation and the plate was replaced. There was no failure among the cases treated with the thicker second-generation plate. In eight cases, there was a perforation of the humeral head by the cephalic screws. CONCLUSIONS: CFR-PEEK plates proved as reliable as metallic plates in the treatment of proximal humeral fractures. The advantages of these new devices include a better visualization of fracture reduction during intraoperative fluoroscopic assessment and easy hardware removal due to the absence of screw-plate cold fusion.
BACKGROUND: Locking plate fixation is a reliable treatment for many displaced proximal humeral fractures. Carbon fiber-reinforced-poly-ether-ether-ketone (CFR-PEEK) plates have recently been introduced as an alternative to traditional metallic plates. METHODS: In a multicenter study involving the Orthopedic Services of 6 Italian hospitals, 182 patients with a proximal humeral fracture were treated with a Diphos H (Lima Corporate, San Daniele del Friuli, Italy) CFR-PEEK plate, 160 of whom were followed clinically and radiographically for 2 years or more. Fractures were classified by Neer's system. The functional results were assessed by Constant and DASH scores. RESULTS: The average time to radiographic healing was 5.6 months in 158 of 160 cases. Mean Constant score was 76, and mean DASH score was 28 at 2 years. There were two nonunions (one septic and one aseptic) and 13 cases of partial (9) or massive (4) humeral head necrosis. In three of the 78 patients treated with the first-generation plates, hardware breakage happened during the operation and the plate was replaced. There was no failure among the cases treated with the thicker second-generation plate. In eight cases, there was a perforation of the humeral head by the cephalic screws. CONCLUSIONS: CFR-PEEK plates proved as reliable as metallic plates in the treatment of proximal humeral fractures. The advantages of these new devices include a better visualization of fracture reduction during intraoperative fluoroscopic assessment and easy hardware removal due to the absence of screw-plate cold fusion.
Authors: Rony-Orijit Dey Hazra; Karol Szewczyk; Alexander Ellwein; Robert Blach; Gunnar Jensen; Andreas Kühnapfel; Helmut Lill; Mara Warnhoff Journal: Eur J Orthop Surg Traumatol Date: 2022-05-27
Authors: George D Chloros; Apostolos D Prodromidis; Jo Wilson; Peter V Giannoudis Journal: Eur J Trauma Emerg Surg Date: 2021-09-06 Impact factor: 2.374