Alternate non-metallic implants in fracture care - A review

The use of implants in the treatment of fractures evolved over the last decades. Until today, most implant designs are based on metallic alloys such as Titanium or stainless steel. However, the global ageing population with increasing numbers of fragility and pathological fractures challenges current implant designs regarding stress shielding, fragile soft tissue and advanced demands like reduced imaging artefacts for radiotherapy planning. Therefore, alternative non-metallic implants that more closely resemble the mechanical properties of bone or provide additional stability as intramedullary augmentation have become available. This narrative-review summarizes the current available (2026) technology, biomechanical properties, clinical applications, outcomes and complications of CFR-PEEK implants and photodynamic bone stabilization implants in fracture management. In total n = 100 publications were taken into consideration for this narrative-review. Non-metallic-implants for fracture care are still a niche product in the treatment of fractures. However, with the ageing population and the increasing number of impaired bone quality and stability, these methods could help reduce stress shielding and force distribution comparable to physiological bone (CFR-PEEK implants) or allow additional augmentation (photodynamic bone stabilization) in reduced bone quality.