Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 9/2017

01-09-2017 | Original Paper

Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates

Authors: David J. Hak, Ryan Fader, Todd Baldini, Vivek B. S. Chadayammuri

Published in: International Orthopaedics | Issue 9/2017

Login to get access

Abstract

Purpose

Carbon-fibre reinforced polyetheretherketone (CFR-PEEK) plates have recently been introduced for proximal humerus fracture treatment. The purpose of this study was to compare the locking screw-plate interface stability in CFR-PEEK versus stainless steel (SS) proximal humerus plates.

Methods

Locking screw mechanical stability was evaluated independently in proximal and shaft plate holes. Stiffness and load to failure were tested for three conditions: (1) on-axis locking screw insertion in CFR-PEEK versus SS plates, (2) on-axis locking screw insertion, removal, and reinsertion in CFR-PEEK plates, and (3) 10-degree off-axis locking screw insertion in CFR-PEEK plates. Cantilever bending at a rate of 1 mm/minute was produced by an Instron machine and load-displacement data recorded.

Results

Shaft locking screw load to failure was significantly greater in CFR-PEEK plates compared to SS plates (746.4 ± 89.7 N versus 596.5 ± 32.6 N, p < 0.001). The stiffness and load to failure of shaft locking screws was significantly decreased when inserted 10 degrees off-axis compared to on-axis in CFR-PEEK plates (p < 0.001). Stiffness and load to failure did not vary significantly following screw reinsertion in CFR-PEEK plates.

Conclusion

The mechanical stability of locking screws in CFR-PEEK plates is comparable or superior to locking screws in SS plates.
Literature
1.
2.
Steinberg EL, Rath E, Shlaifer A, Chechik O, Maman E, Salai M (2013) Carbon fiber reinforced PEEK optima—A composite material biomechanical properties and wear/debris characteristics of CF-PEEK composites for orthopedic trauma implants. J Mech Behav Biomed Mater 17:221–228CrossRefPubMed
3.
Hak DJ, Mauffrey C, Seligson D, Lindeque B (2014) Use of carbon-fiber-reinforced composite implants in orthopedic surgery. Orthopedics 37:825–830CrossRefPubMed
4.
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 (2015) Proximal humeral fracture fixation: multicenter study with carbon fiber peek plate. Musculoskelet Surg 99(Suppl 1):S1–S8CrossRefPubMed
5.
Schliemann B, Hartensuer R, Koch T, Theisen C, Raschke MJ, Kösters C, Weimann A (2015) Treatment of proximal humerus fractures with a CFR-PEEK plate: 2-year results of a prospective study and comparison to fixation with a conventional locking plate. J Shoulder Elb Surg 24:1282–12883CrossRef
6.
Kääb MJ, Frenk A, Schmeling A, Schaser K, Schütz M, Haas NP (2004) Locked internal fixator: sensitivity of screw/plate stability to the correct insertion angle of the screw. J Orthop Trauma 18:483–487CrossRefPubMed
7.
Schliemann B, Seifert R, Theisen C, Gehweiler D, Wähnert D, Schulze M, Raschke MJ, Weimann A (2017) 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(1):63–71CrossRefPubMed
8.
Maldonado ZM, Seebeck J, Heller MO, Brandt D, Hepp P, Lill H, Duda GN (2003) Straining of the intact and fractured proximal humerus under physiological-like loading. J Biomech 36(12):1865–1873CrossRefPubMed
9.
Gardner MJ, Nork SE, Huber P, Krieg JC (2010) Less rigid stable fracture fixation in osteoporotic bone using locked plates with near cortical slots. Injury 41(6):652–656CrossRefPubMed
10.
Lill H, Hepp P, Korner J, Kassi JP, Verheyden AP, Josten C, Duda GN (2003) Proximal humeral fractures: how stiff should an implant be? A comparative mechanical study with new implants in human specimens. Arch Orthop Trauma Surg 123(2–3):74–81CrossRefPubMed
11.
Bottlang M, Doornink J, Byrd GD, Fitzpatrick DC, Madey SM (2009) A nonlocking end screw can decrease fracture risk caused by locked plating in the osteoporotic diaphysis. J Bone Joint Surg Am 91(3):620–627CrossRefPubMed
12.
Perren SM (2002) Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Joint Surg Br 84(8):1093–1110CrossRefPubMed
13.
Bottlang M, Lesser M, Koerber J, Doornink J, von Rechenberg B, Augat P, Fitzpatrick DC, Madey SM, Marsh JL (2010) Far cortical locking can improve healing of fractures stabilized with locking plates. J Bone Joint Surg Am 92(7):1652–1960CrossRefPubMedPubMedCentral
14.
Bottlang M, Tsai S, Bliven EK, von Rechenberg B, Kindt P, Augat P, Henschel J, Fitzpatrick DC, Madey SM (2017) Dynamic stabilization of simple fractures with active plates delivers stronger healing than conventional compression plating. J Orthop Trauma 31(2):71–77CrossRefPubMed
Metadata
Title
Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates
Authors
David J. Hak
Ryan Fader
Todd Baldini
Vivek B. S. Chadayammuri
Publication date
01-09-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 9/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-017-3562-7

Other articles of this Issue 9/2017

International Orthopaedics 9/2017 Go to the issue

Original Paper

Post-operative radiological predictors of satisfying outcomes occurring after intra-articular calcaneal fractures: a three dimensional CT quantitative evaluation

Original Paper

Fat emboli syndrome and the orthopaedic trauma surgeon: lessons learned and clinical recommendations

Original Paper

Orthopaedic surgeons’ opinions surrounding the management of proximal humerus fractures: an international survey

Original Paper

Biomechanical comparison of anatomical plating systems for comminuted distal humeral fractures

Original Paper

Late reconstruction of severe open-book deformities of the pelvis — tips and tricks

Original Paper

Implementation of a standardized protocol to manage elderly patients with low energy pelvic fractures: can service improvement be expected?