Preliminary Experience of Carbon Fiber Buttress Plating: A Case Series

Metal has long been the basis for implants used in orthopedic surgery. The first metals used were stainless steel and cobalt-chrome based alloys with progression through the years to include titanium, nickel, and most recently, carbon fiber.[1] Multiple previous studies describe carbon fiber as a safe, biocompatible material that can be used in problematic fractures. [2-6] However to our knowledge, no study has examined the use of carbon fiber specifically in buttress plate application. Compared to conventional metal implants, carbon fiber offers several potential benefits. It provides a modulus of elasticity closer to that of bone, improved fatigue strength, and more complete imaging compatibility. [3-6] In addition, carbon fiber has a large elastic deformation phase with little to no plastic deformation, and it is this distinctive quality that would seem to make carbon fiber potentially ideal for buttress plate fracture fixation. The objective of this case series was to outline the preliminary experience of carbon fiber buttress plating in ankle fractures. This study was performed at a level II trauma center and includes four patients that underwent open reduction and internal fixation with carbon fiber buttress plating for either a bimalleolar equivalent fracture, bimalleolar ankle fracture, or trimalleolar ankle fracture. The main outcome measure included radiographic fracture visualization of healing, adverse tissue reaction, infection, subsequent fracture, or hardware failure. Overall, all patients achieved union with no adverse effects, drawing to the conclusion that carbon fiber is a safe and effective alternative when used in a buttress plate fashion,