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PEEK versus titanium locking plates for proximal humerus fracture fixation: a comparative biomechanical study in two- and three-part fractures

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The high rigidity of metal implants may be a cause of failure after fixation of proximal humerus fractures. Carbon fiber-reinforced polyetheretherketone (PEEK) plates with a modulus similar to human cortical bone may help to overcome this problem. The present study assesses the biomechanical behavior of a PEEK plate compared with a titanium locking plate.

Materials and methods

Unstable two- and three-part fractures were simulated in 12 pairs of cadaveric humeri and were fixed with either a PEEK or a titanium locking plate using a pairwise comparison. With an optical motion capture system, the stiffness, failure load, plate bending, and the relative motion at the bone–implant interface and at the fracture site were evaluated.

Results

The mean load to failure for two- and three-part fracture fixations was, respectively, 191 N (range 102–356 N) and 142 N (range 102–169 N) in the PEEK plate group compared with 286 N (range 191–395 N) and 258 N (range 155–366 N) in the titanium locking plate group. The PEEK plate showed significantly more bending in both the two- and three-part fractures (p < 0.05), an increased relative motion at the bone–implant interface and lower stiffness values (p < 0.05).

Conclusion

In this biomechanical study on unstable proximal humerus fractures, fixation with a PEEK plate showed lower fixation strength and increased motion at the bone–implant interface compared with a titanium locking plate.

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Acknowledgements

This work was supported by the fund “Innovative Medical Research” (IMF, Grant SC 211305 to B.S. and A.W.) of the University of Münster Medical School and by the ASSOCIATION FOR ORTHOPAEDIC RESEARCH (AFOR). B.S. had a research fellowship from the University of Münster Medical School. Depuy Synthes and Lima Corporate provided implants and instruments used in this project. Neither funding source played a role in the study design, collection, analysis, and interpretation of the data and in the preparation and editing process of the manuscript. The manuscript was edited by the American Journal Experts service (http://www.AJE.com).

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    Authors and Affiliations

    1. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, building W1, 48149, Münster, Germany

      Benedikt Schliemann, Robert Seifert, Christina Theisen, Dirk Wähnert, Martin Schulze & Michael J. Raschke

    2. AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland

      Dominic Gehweiler

    3. OCP-Münster, Schaumburgstraße 1, 48145, Münster, Germany

      Andre Weimann

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    Correspondence to Benedikt Schliemann.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    Twelve pairs’ human cadaveric specimens were used for the study. In life, all the donors provided written consent of their own free will for the use of their bodies for research purposes. Institutional review board approval was obtained prior to the study (IRB No. 2014-421-f-N).

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    B. Schliemann and R. Seifert contributed equally to this study.

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    Schliemann, B., Seifert, R., Theisen, C. et al. PEEK versus titanium locking plates for proximal humerus fracture fixation: a comparative biomechanical study in two- and three-part fractures. Arch Orthop Trauma Surg 137, 63–71 (2017). https://doi.org/10.1007/s00402-016-2620-8

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