Evidence map›Paper›PMID 39991246›Full record

ArticleHeliyon2025

Comparative analysis of unicortical vs. subchondral locking screws in osteoporotic proximal humerus fractures.

Mohammad Khak, Jeffrey J Olson, Patrick Williamson, Mohammad Javad Shariyate, Ahmad Hedayatzadeh Razavi, Kaveh Momenzadeh, Mohammadreza Abbasian, Nadim Kheir, Edward K Rodriguez, Ara Nazarian

Abstract read
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In one paragraph

Article in Heliyon, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mohammad KhakMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Jeffrey J OlsonMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Patrick WilliamsonMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Mohammad Javad ShariyateMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Ahmad Hedayatzadeh RazaviMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Kaveh MomenzadehMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Mohammadreza AbbasianMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Nadim KheirMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Edward K RodriguezMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Ara NazarianMusculoskeletal Translational Innovation Initiative, Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Proximal humerus fractures are common in adults aged 65 and older and provide challenges for osteoporotic patients due to the risk of suboptimal fixation and complications. Locking plates are often utilized to treat two-part fractures; however, ongoing concerns about their stability exist. This pilot study investigates the biomechanical impact of subchondral locking screws compared to unicortical screws in osteoporotic two-part cadaveric proximal humerus fractures. Methods: Using dual-energy X-ray absorptiometry (DXA), cadaveric shoulder specimens from eight female Caucasian donors with comparable bone mineral densities were used for the study. Either unicortical or bicortical locking screws (the latter representing subchondral screws in real surgeries) were utilized to fix locking plates. Axial load to failure and cyclic physiologic abduction moments were applied in biomechanical testing. Findings: The study found no statistically significant difference in interfragmentary displacement between the unicortical and bicortical groups (p = 0.78). The mechanical properties of both groups were found to be comparable in terms of yield (p = 0.59), ultimate (p = 0.86), and fracture strengths (p = 0.70). Furthermore, rigidity analysis did not identify any significant difference between the two groups (p = 0.22). Interpretation: Our findings indicate that there is little to no difference in the stability of the construct for osteoporotic two-part proximal humerus fractures, in contrast to general recommendations against unicortical screws. This pilot study suggests that the choice between unicortical and subchondral locking screws may not significantly affect biomechanical characteristics in osteoporotic two-part proximal humerus fractures, despite the study's limitations.

Indexed as

BiomechanicsFracture stabilityOsteoporosisProximal humerus fractureScrewSubchondralUnicortical

Identifiers

PMID39991246
PMCPMC11847220

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.