title: Proximal humeral fracture fixation: multicenter study with carbon fiber peek plate.
abstract: 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.
authors.affiliation: Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy. roberto.rotini@ior.it.
authors.forename: R
authors.initials: R
authors.lastname: Rotini
authors.affiliation: Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Cavaciocchi
authors.affiliation: Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Fabbri
authors.affiliation: Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Bettelli
authors.affiliation: Orthopedic Clinic, Modena University, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Catani
authors.affiliation: Orthopedic Clinic, Modena University, Modena, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Campochiaro
authors.affiliation: Orthopedic and Trauma Unit, Faenza Hospital, Faenza, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Fontana
authors.affiliation: Orthopedic and Trauma Unit, Faenza Hospital, Faenza, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Colozza
authors.affiliation: Orthopedic Clinic, Parma University, Parma, Italy.
authors.forename: C F
authors.initials: CF
authors.lastname: De Biase
authors.affiliation: Orthopedic Clinic, Parma University, Parma, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ziveri
authors.affiliation: Orthopedic and Trauma Unit, New Civil Hospital, Modena, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Zapparoli
authors.affiliation: Orthopedic and Trauma Unit, New Civil Hospital, Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Stacca
authors.affiliation: Orthopedic and Trauma Unit, San Giovanni di Dio Hospital, Agrigento, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Lupo
authors.affiliation: Orthopedic and Trauma Unit, San Giovanni di Dio Hospital, Agrigento, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Rapisarda
authors.affiliation: Shoulder and Elbow Unit, Rizzoli Orthopedic Institute, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Guerra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D002244:Carbon; D000077482:Carbon Fiber; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000077482:Carbon Fiber; D002244:Carbon
keywords: CFR-PEEK plate; Locking plate; Proximal humeral fracture