Safety and Efficacy of the Avanti Polyetheretherketone Fixation System for Distal Radius Fractures

Ann Plast Surg. 2026 Feb 13. doi: 10.1097/SAP.0000000000004691. Online ahead of print.

Abstract

Background: Distal radius fractures are common and are frequently treated with volar locking plates. Polyether ether ketone (PEEK) implants offer benefits including radiolucency and biocompatibility. However, data on the Avanti PEEK system for distal radius fractures are limited. This study analyzes a large cohort to assess clinical and demographic factors associated with the system.

Methods: We conducted a retrospective review of 397 patients who underwent distal radius fracture fixation with the Avanti PEEK system between 2020 and 2024. Demographics, surgical details, functional outcomes (Disabilities of the Arm, Shoulder and Hand [QuickDASH], Patient-Rated Wrist/Hand Evaluation [PRWHE], range of motion [ROM]), and complications were analyzed.

Results: The average patient age was 59.6 years, with 25.4% male and 74.6% female. Most patients were right-handed (89.7%), and occupations included desk jobs (25.2%) and manual labor (24.1%). The majority of patients were White (82.1%). Common comorbidities included hypertension (35.9%), diabetes (10.4%), immunosuppression (1.6%), and hepatitis (1.6%). The mean operative time was 68 minutes, with an average tourniquet time of 60 minutes. Complications included carpal tunnel syndrome (1.64%), pain requiring hardware removal (1.10%), extensor tendon rupture (0.82%), loss of reduction (0.55%), tenosynovitis (0.27%), and flexor tendon rupture (0.27%); no infections were reported. The mean functional outcomes were as follows: PRWHE, 26.8; functional subscore, 19.4; pain subscore, 17.0; and QuickDASH, 30.4. ROM at 6 weeks, 3 months, and 6 months demonstrated appropriate recovery (wrist flexion: 43.7°, 46.6°, and 41.4°; wrist extension: 49.2°, 53.5°, and 46.7°, respectively).

Conclusions: The Avanti PEEK system demonstrates favorable functional outcomes and low complication rates, supporting its safety and efficacy as an alternative to traditional all metallic fixation systems for distal radius fractures. Patients exhibited solid recovery of wrist motion and function with minimal postoperative complications. Additionally, the implant's simplified instrumentation facilitates intraoperative handling and ease of use for the operative team, making it a practical and efficient fixation option.

Keywords: Avanti Wrist and Forearm System; Complication rates, Radiolucent implants; Disabilities of the Arm; Distal radius fracture; Functional outcomes; Open reduction and internal fixation (ORIF); Patient-Rated Wrist and Hand Evaluation (PRWHE); Polyetheretherketone (PEEK); Range of motion (ROM); Shoulder and Hand (QuickDASH); Volar locking plate; Wrist fracture fixation.