Carbon Fiber-Reinforced Polyetheretherketone (PEEK) vs. Titanium Plates for Upper Limb Fractures: A Systematic Review

Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates have emerged as alternatives to titanium locking plates for fixation of upper-limb fractures. Advantages may include an elastic modulus closer to bone, fewer imaging artefacts, and reduced stress shielding. This systematic review synthesizes comparative clinical evidence. We analyzed data from five comparative studies (n = 210 patients; CFR-PEEK = 108, titanium = 102) provided in the dataset. Searches of PubMed and the Cochrane Library identified relevant trials. Data were extracted for demographics, interventions, functional outcomes, complications, and imaging findings, following PRISMA-style methodology. Five studies (three proximal humerus, two distal radius) were included. Overall complication rates were lower with CFR-PEEK compared to titanium. Functional outcomes were generally comparable, though one study showed improved Constant and OSS scores for CFR-PEEK. Imaging clarity was consistently superior with CFR-PEEK. CFR-PEEK plates demonstrate similar or superior clinical outcomes compared with titanium plates in upper limb fractures, with fewer complications and superior radiographic visibility. Evidence remains limited, requiring larger RCTs.