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. 2023 Aug 11;24(1):42.
doi: 10.1186/s10195-023-00724-4.

Carbon-fibre plates for traumatic and (impending) pathological fracture fixation: Where do we stand? A systematic review

Zeger Rijs #  1 , Amber Weekhout #  2 , Stef Daniel  2 , Jan W Schoones  3 , Olivier Q Groot  4 , Santiago A Lozano-Calderon  4 , Michiel A J van de Sande  2
Affiliations

Carbon-fibre plates for traumatic and (impending) pathological fracture fixation: Where do we stand? A systematic review

Zeger Rijs et al. J Orthop Traumatol. .

Abstract

Background: Carbon-fibre (CF) plates are increasingly used for fracture fixation. This systematic review evaluated complications associated with CF plate fixation. It also compared outcomes of patients treated with CF plates versus metal plates, aiming to determine if CF plates offered comparable results. The study hypothesized that CF plates display similar complication rates and clinical outcomes as metal plates for fracture fixation.

Methods: The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were searched from database inception until June 2023: PubMed, MEDLINE, Embase, Web of Science, Cochrane Library, Emcare, Academic Search Premier and Google Scholar. Studies reporting on clinical and radiological outcomes of patients treated with CF plates for traumatic fractures and (impending) pathological fractures were included. Study quality was assessed, and complications were documented as number and percentage per anatomic region.

Results: A total of 27 studies of moderate to very low quality of evidence were included. Of these, 22 studies (800 patients, median follow-up 12 months) focused on traumatic fractures, and 5 studies (102 patients, median follow-up 12 months) on (impending) pathological fractures. A total of 11 studies (497 patients, median follow-up 16 months) compared CF plates with metal plates. Regarding traumatic fractures, the following complications were mostly reported: soft tissue complications (52 out of 391; 13%) for the humerus, structural complications (6 out of 291; 2%) for the distal radius, nonunion and structural complication (1 out of 34; 3%) for the femur, and infection (4 out of 104; 4%) for the ankle. For (impending) pathological fractures, the most frequently reported complications were infections (2 out of 14; 14%) for the humerus and structural complication (6 out of 86; 7%) for the femur/tibia. Comparative studies reported mixed results, although the majority (7 out of 11; 64%) reported no significant differences in clinical or radiological outcomes between patients treated with CF or metal plates.

Conclusion: This systematic review did not reveal a concerning number of complications related to CF plate fixation. Comparative studies showed no significant differences between CF plates and metal plates for traumatic fracture fixation. Therefore, CF plates appear to be a viable alternative to metal plates. However, high-quality randomized controlled trials (RCTs) with long-term follow-up are strongly recommended to provide additional evidence supporting the use of CF plates.

Level of evidence: III, systematic review.

Keywords: CFR PEEK; Carbon-fibre plates; Complications; Fracture fixation.

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Conflict of interest statement

Disclosures SLC: Paid consultant ONKOS, paid consultant illuminOss, paid speaker Carbofix. All other authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study. CF Carbon-fibre
See this image and copyright information in PMC

References

    1. Gaspar N, Hawkins DS, Dirksen U, et al. Ewing sarcoma: current management and future approaches through collaboration. J Clin Oncol. 2015;33:3036–3046. doi: 10.1200/JCO.2014.59.5256. - DOI - PubMed
    1. Baidya KP, Ramakrishna S, Rahman M, et al. Quantitative radiographic analysis of fiber reinforced polymer composites. J Biomater Appl. 2001;15:279–289. doi: 10.1106/BKLQ-E2YG-D2LA-RG3R. - DOI - PubMed
    1. Feerick EM, Kennedy J, Mullett H, et al. Investigation of metallic and carbon fibre PEEK fracture fixation devices for three-part proximal humeral fractures. Med Eng Phys. 2013;35:712–722. doi: 10.1016/j.medengphy.2012.07.016. - DOI - PubMed
    1. Hak DJ, Mauffrey C, Seligson D, et al. Use of carbon-fiber-reinforced composite implants in orthopedic surgery. Orthopedics. 2014;37:825–830. doi: 10.3928/01477447-20141124-05. - DOI - PubMed
    1. Takayanagi A, Siddiqi I, Ghanchi H, et al. Radiolucent carbon fiber-reinforced implants for treatment of spinal tumors-clinical, radiographic, and dosimetric considerations. World Neurosurg. 2021;152:61–70. doi: 10.1016/j.wneu.2021.05.100. - DOI - PubMed

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