Noteworthy in 2015: Clinical Performance of PEEK Humeral Plates

    • Reference:
    • Rotini R, Cavaciocchi M, Fabbri D, Bettelli G, Catani F, Campochiaro G, Fontana M, Colozza A, De Biase CF, Ziveri G, Zapparoli C, Stacca F, Lupo R, Rapisarda S, Guerra E. Proximal humeral fracture fixation: multicenter study with carbon fiber peek plate. Musculoskelet Surg. 2015. DOI: 10.1007/s12306-015-0371-2.
    • Keywords:
    • CFR-PEEK, trauma, fracture fixation, humerus
    • Permissions:
    • Musculoskeletal Surgery - Formerly La Chirurgia degli Organi di Movimento founded in 1917, is a peer-reviewed journal published three times a year, and aims at being international in scope and readership, as reflected by its editorial team, gathering experts from around the globe. The journal is indexed in PubMed/MEDLINE and is available in its electronic format at

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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.



Trauma is a relatively new application of CFR-PEEK. In this clinical study of PEEK fracture plates, investigators from Italy evaluated a specific CFR-PEEK humeral fracture plate design. After experiencing some implant complications with their first-generation, 4.2 mm thick design, a 2nd-generation, 5.2 mm thick design was more successful. This well-executed, observational cohort study provides compelling evidence of safety and effectiveness for a CFR-PEEK humeral plate design. In particular, the radio-opacity of the CFR-PEEK fracture plate proved to be an important benefit during the repair of comminuted fractures.  


Steve Kurtz, Ph.D.

Editor, Medical PEEK Lexicon