ArticleGeriatric orthopaedic surgery & rehabilitation2021
How Many Proximal Screws Are Needed for a Stable Proximal Humerus Fracture Fixation?
Article in Geriatric orthopaedic surgery & rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Antegrade intramedullary nail and plate combination technique for proximal humeral non-union: A case report.Trauma case reports · 2026Article
- Locking plate fixation for proximal humerus fractures: are four proximal screws adequate? A clinical and radiological analysis of 105 consecutive cases.Archives of orthopaedic and trauma surgery · 2026Article
- Using medial column support instead of screw density to predict radiological failure requiring revision in osteoporotic proximal humerus fractures.Journal of orthopaedic surgery and research · 2026Article
- Clinical and radiographic results of locking plate with medial support screw in Proximal Humerus fracture - the more, the better?BMC musculoskeletal disorders · 2024Article
- Mid- to long-term outcomes of proximal humerus fractures treated with open reduction, plate fixation, and iliac bone autograft augmentation.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Article
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Authors and funding
7 authors.
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Abstract
purposeThis biomechanical study investigates the optimal number of proximal screws for stable fixation of a 2-part proximal humerus fracture model with a locking plate.
methodsTwenty-four proximal humerus fracture models were included in the study. An unstable 2-part fracture was created and fixed by a locking plate. Cyclic loading and load-to-failure tests were used for the following 4 groups based on the number of screws used: 4-screw, 6-screw, 7-screw, and 9-screw groups. Interfragmentary gaps were measured following cyclic loading and compared. Consequently, the load to failure, maximum displacement, stiffness, and mode of failure at failure point were compared.
resultsThe interfragmentary gaps for the 4-screw, 6-screw, 7-screw, and 9-screw groups were significantly reduced by 0.24 ± 0.09 mm, 0.08 ± 0.06 mm, 0.05 ± 0.01 mm, and 0.03 ± 0.01 mm following 1000 cyclic loading, respectively. The loads to failure were significantly different between the groups with the 7-screw group showing the highest load to failure. The stiffness of the 7-screw group was superior compared with the 6-screw, 9-screw, and 4-screw groups. The maximum displacement before failure showed a significant difference between the comparative groups with the 4-screw group having the lowest value. The 7-screw group had the least structural failure rate (33.3%).
conclusionAt least 7 screws would be optimal for proximal fragment fixation of proximal humerus fractures with medial comminution to minimize secondary varus collapse or fixation failure. LEVEL OF EVIDENCE: Basic science study.
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