Functional results and unfavorable events after treatment of proximal humerus fractures using a new locking plate system

BackgroundProximal humerus fractures are often treated with a fixed-angle titanium plate osteosynthesis. Recently, plates made of alternative materials such as carbon fibre-reinforced polyetheretherketone (CFR-PEEK) have been introduced. This study presents the postoperative results of patients treated with a CFR-PEEK plate.MethodsPatients with proximal humerus fractures treated with a CFR-PEEK plate (PEEKPower (TM) Humeral Fracture Plate (HFP)) were included. In follow-up examination, age and gender adjusted Constant-Murley Score (ACS), Subjective Shoulder Value (SSV), Quick Disabilities of the Arm, Shoulder and Hand Score (QDASH) and pain score (Visual Analog Scale (VAS)) were analyzed. General condition at follow-up was measured by European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L). Range of motion was recorded. In addition, radiographs at follow-up, unfavorable events and revision rate were analyzed.ResultsIn total, 98 patients (66.0 +/- 13.2 years, 74 females, 24 males) were reexamined. Mean follow-up was 27.6 +/- 13.2 months. There were 15 2-part, 28 3-part and 55 4-part fractures. The functional scores showed good results: SSV 83.3 +/- 15.6%, QDASH 13.1 +/- 17.0 and ACS 80.4 +/- 16.0. A 4-part-fracture, head split component, nonanatomic head shaft reposition and preoperative radiological signs of osteoarthritis were significant negative predictors for poorer clinical scores. Unfavourable events were observed in 27 patients (27.6%). Revision surgery was performed in 8 (8.2%) patients. Risk factors for an unfavourable event were female gender, age of 50 years and older, diabetes, affected dominant hand, 4-part fracture, head split and preoperative radiological signs of osteoarthritis.ConclusionThere are several advantages of the CFR-PEEK plate (PEEKPower (TM) Humeral Fracture Plate (HFP)) such as the polyaxial screw placement and higher stability of locking screws. In summary, the CFR-PEEK plate osteosynthesis is a good alternative with comparable clinical results and some biomechanical advantages. Proximal humerus fractures show good clinical results after treatment with a CFR-PEEK plate. The revision rate and the risk of unfavorable events are not increased compared to conventional titanium plate osteosynthesis.

Automated summary

This study presents the postoperative results of patients treated with a carbon fibre-reinforced polyetheretherketone (CFR-PEEK) plate for proximal humerus fractures. The results show that using CFR-PEEK plates for fixed-angle osteosynthesis in proximal humerus fractures has comparable clinical outcomes and some biomechanical advantages.