A biomechanical matched-pair comparison of two different locking plates for tibial diaphyseal comminuted fracture: carbon fiber-reinforced poly-ether-ether-ketone (CF-PEEK) versus titanium plates

Abstract

Background Several methods have been proposed to reduce plate construct stiffness and promote secondary bone healing. In this study, we explored the stiffness and strength of the new carbon fiber-reinforced poly-ether-ether-ketone (CF 50) plate compared with the titanium alloy plate (Ti6Al4V). Methods Titanium and CF-PEEK locking plates were tested in a tibial non-osteoporotic diaphyseal comminuted fracture model to determine construct stiffness in axial compression, torsion, and bending. Subsequently, constructs were loaded until construct failure to determine construct strength. Results Relative to the titanium locking plate, the stiffness of the CF-PEEK locking plate was 6.8% and 30.8% lower in 200 N and 700 N axial compression, respectively (P < 0.05), 64.9% lower in torsion (P < 0.05), and 48.9% lower in bending (P < 0.05). The strength of the CF-PEEK locking plate was only 2.6% lower under axial compression, 7.8% lower in torsion, and 4.8% lower in bending than the titanium locking plate (P > 0.05). Conclusions The CF-PEEK locking plate significantly reduced axial, torsion, and bending stiffness compared with the titanium locking plate. Nonetheless, axial, torsional, and bending strength showed only a modest reduction. Considering its other advantages, which include radiolucency and artifact-free imaging, the CF-PEEK locking plate therefore deserves further clinical investigation.

Patient perspective on the use of carbon fibre plates for extremity fracture fixation

“…In recruiting to a trial fears regarding durability could be allayed with current biomechanical evidence suggesting that carbon plates have peak failure energies and lower rates of permanent deformation compared to stainless steel implants [ 13 ]. Compared to titanium implants, carbon implants have again been demonstrated to have similar strength in axial, bending and torsional deformation; though with lower stiffness [ 14 ]. The Young’s modulus of CFR-PEEK implants can be modulated through alteration of the carbon fibre and is actually closer to that of cortical bone when compared to titanium or steel implants [ 15 ].…”

Feasibility of 3D-Printed Locking Compression Plates with Polyether Ether Ketone (PEEK) in Tibial Comminuted Diaphyseal Fractures

“…A titanium alloy plate and a PEEK plate were fixed to a pre-manufactured sawbones tibia (#3401, Sawbones, Pacific Research Laboratories, Inc., Vashon, WA, USA) using six locking screws. Similar to the previous experiment, a 10-millimeter fracture gap was created in the tibial diaphysis under comminuted fracture conditions [ 28 , 29 ]. Two holes in the middle, which were close to the fracture gap, were emptied, and locking screws were fastened to the remaining six holes using a torque driver with a force of 4 N-m.…”

“…The titanium alloy plate and the 3D-printed PEEK plate were fixed under comminuted fracture conditions to examine the mechanical properties of the commercial titanium alloy LCP and the 3D-printed PEEK LCP under tibial non-osteoporotic comminuted diaphyseal fracture conditions, which was similar to the conditions of previous studies. Next, the results of bending, axial compression, and axial torsion tests were obtained [ 27 , 28 ]. Locking screws, which were provided by a commercial LCP manufacturer, were used to fix the LCP to the sawbone tibia.…”

Modification of polyether ether ketone for the repairing of bone defects

“…The elastic modulus of CF-PEEK is closer to cortical bone, and its stiffness and strength are significantly improved. Bone screws and fracture plates have been made from CF-PEEK, which can firmly support the fractures without losing the original advantages of PEEK [29]. Additionally, CF-PEEK can also be used as the spinal substitute and joint replacement material in clinical practice and implanted permanently in vivo [23,[30][31][32].…”