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Early Comparative Outcomes of Carbon Fiber–Reinforced Polymer Plate in the Fixation of Distal Femur Fractures

Mitchell, Phillip M. MD*; Lee, Adam K. MD; Collinge, Cory A. MD*; Ziran, Bruce H. MD, FACS; Hartley, Kate G. MD§; Jahangir, A. Alex MD, MMHC*

doi: 10.1097/BOT.0000000000001223
Original Article

Objective: To evaluate the early clinical results of distal femur fractures treated with carbon fiber–reinforced polyetheretherketone (CFR-PEEK) plates compared with stainless steel (SS) lateral locking plates.

Design: Retrospective comparative cohort study.

Setting: ACS Level I trauma center.

Patients/Participants: Twenty-two patients (11 SS, 11 CFR-PEEK) with closed distal femur fractures treated by a single surgeon over a 6-year period.

Main Outcome Measurements: Nonunion, hardware failure, reoperation, time to full weight-bearing, and time union were assessed.

Results: The CFR-PEEK cohort was on average older (71 vs. 57 years, P = 0.03) and more likely to have diabetes (P = 0.02). Nonunion was diagnosed in 4/11 (36%) patients in the SS group and 1/11 (9%) patients in the CFR-PEEK group (P = 0.12). Hardware failure occurred in 2 SS patients (18%) compared with none in the CFR-PEEK group (P = 0.14). Time to full weight–bearing was similar between groups, occurring at 9.9 and 12.4 weeks in the CFR-PEEK and SS groups, respectively (P = 0.23). Time to radiographic union averaged 12.4 weeks in the SS group and 18.7 weeks in the CFR-PEEK group (P = 0.26). There were 4 reoperations in the SS group and 1 in the CFR-PEEK group (P = 0.12).

Conclusions: CFR-PEEK plates show encouraging short-term results in the treatment of distal femur fractures with a comparable nonunion, reoperation, and hardware failure rates to those treated with SS plates. This data suggest that CFR-PEEK plates may be a viable alternative to SS plates in fixation of these fractures.

Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

*Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN;

Department of Orthopaedic Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA;

Department of Orthopaedic Trauma, The Hughston Clinic at Gwinnett Medical Center, Atlanta, GA; and

§Departments of Radiology, Orthopaedic Surgery, and Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.

Reprints: A. Alex Jahangir, MD, MMHC, Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt Orthopaedics, 1215 21st Avenue South, Medical Center East, Suite 4200, Nashville, TN 37232-8774 (e-mail:

C. A. Collinge receives royalties from Biomet, Smith & Nephew, and Advanced Orthopedic Systems, and is a consultant for Biomet and Smith & Nephew. B. H. Ziran is a consultant for Acumed, Citieffe, Synthes, and CarboFix and owns equity stake in Tekartis. A. A. Jahangir is a consultant for CarboFix and gets royalties from Springer. The remaining authors report no conflict of interest.

Presented at the Annual Meeting of the Orthopaedic Trauma Association, October 11–14, 2017, Vancouver, BC, Canada.

Accepted April 27, 2018

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