{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:41:52Z","timestamp":1788414112816,"version":"build-2803163510"},"reference-count":45,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jshoulderelbow.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Shoulder and Elbow Surgery"],"published-print":{"date-parts":[[2023,11]]},"DOI":"10.1016\/j.jse.2023.04.023","type":"journal-article","created":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T02:16:08Z","timestamp":1685412968000},"page":"2286-2295","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"title":["Titanium vs. carbon fiber\u2013reinforced intramedullary nailing for humeral bone tumors"],"prefix":"10.1016","volume":"32","author":[{"given":"Abhiram R.","family":"Bhashyam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caleb","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Sodhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raylin F.","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5091-3110","authenticated-orcid":false,"given":"Olivier Q.","family":"Groot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4254-9504","authenticated-orcid":false,"given":"Sean","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Lozano-Calderon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jse.2023.04.023_bib1","doi-asserted-by":"crossref","first-page":"396","DOI":"10.3944\/AOTT.2014.13.0056","article-title":"The learning curve of proximal femoral nailing","volume":"48","author":"Altintas","year":"2014","journal-title":"Acta Orthop Traumatol Turc"},{"key":"10.1016\/j.jse.2023.04.023_bib2","first-page":"410","article-title":"Surgical simulation in orthopaedic skills training","volume":"20","author":"Atesok","year":"2012","journal-title":"J Am Acad Orthop Surg"},{"key":"10.1016\/j.jse.2023.04.023_bib3","doi-asserted-by":"crossref","first-page":"S277","DOI":"10.1097\/00007632-199106001-00020","article-title":"A carbon fiber implant to aid interbody lumbar fusion. Mechanical testing","volume":"16","author":"Brantigan","year":"1991","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.1016\/j.jse.2023.04.023_bib4","article-title":"Complications of patients with bone tumors treated with carbon-fiber plates: an international multicenter study","volume":"12","year":"2022","journal-title":"Sci Rep"},{"key":"10.1016\/j.jse.2023.04.023_bib5","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.injury.2010.10.012","article-title":"The invisible nail: a technique report of treatment of a pathological humerus fracture with a radiolucent intramedullary nail","volume":"42","author":"Collis","year":"2011","journal-title":"Injury"},{"key":"10.1016\/j.jse.2023.04.023_bib6","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/00003086-199906000-00031","article-title":"Biomechanical analysis of prophylactic fixation for middle third humeral impending pathologic fractures","volume":"363","author":"Damron","year":"1999","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/00003086-199603000-00029","article-title":"Intercalary spacers in the treatment of segmentally destructive diaphyseal humeral lesions in disseminated malignancies","volume":"324","author":"Damron","year":"1996","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib8","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.jbiomech.2011.11.042","article-title":"The influence of acetabular cup material on pelvis cortex surface strains, measured using digital image correlation","volume":"45","author":"Dickinson","year":"2012","journal-title":"J Biomech"},{"key":"10.1016\/j.jse.2023.04.023_bib9","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet"},{"key":"10.1016\/j.jse.2023.04.023_bib10","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00586-006-0064-5","article-title":"The interobserver-validated relevance of intervertebral spacer materials in MRI artifacting","volume":"16","author":"Ernstberger","year":"2007","journal-title":"Eur Spine J"},{"key":"10.1016\/j.jse.2023.04.023_bib11","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1016\/j.ejso.2007.11.010","article-title":"Intercalary segmental reconstruction after bone tumor resection","volume":"34","author":"Fuchs","year":"2008","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.jse.2023.04.023_bib12","doi-asserted-by":"crossref","first-page":"3877","DOI":"10.1016\/j.biomaterials.2003.10.050","article-title":"Feasibility of knitted carbon\/PEEK composites for orthopedic bone plates","volume":"25","author":"Fujihara","year":"2004","journal-title":"Biomaterials"},{"key":"10.1016\/j.jse.2023.04.023_bib13","doi-asserted-by":"crossref","first-page":"2661","DOI":"10.1016\/S0142-9612(03)00065-6","article-title":"Performance study of braided carbon\/PEEK composite compression bone plates","volume":"24","author":"Fujihara","year":"2003","journal-title":"Biomaterials"},{"key":"10.1016\/j.jse.2023.04.023_bib14","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.medengphy.2019.03.006","article-title":"Finite element investigation into the use of carbon fibre reinforced PEEK laminated composites for distal radius fracture fixation implants","volume":"67","author":"Gallagher","year":"2019","journal-title":"Med Eng Phys"},{"key":"10.1016\/j.jse.2023.04.023_bib15","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.2106\/00004623-199611000-00008","article-title":"Alternative operative exposures of the posterior aspect of the humeral diaphysis with reference to the radial nerve","volume":"78","author":"Gerwin","year":"1996","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2023.04.023_bib16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.2106\/JBJS.21.00711","article-title":"Clinical outcome differences in the treatment of impending versus completed pathological long-bone fractures","volume":"104","author":"Groot","year":"2022","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2023.04.023_bib17","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1097\/CORR.0000000000000463","article-title":"High risk of venous thromboembolism after surgery for long bone Metastases: a retrospective study of 682 patients","volume":"476","author":"Groot","year":"2018","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib18","doi-asserted-by":"crossref","first-page":"825","DOI":"10.3928\/01477447-20141124-05","article-title":"Use of carbon-fiber-reinforced composite implants in orthopedic surgery","volume":"37","author":"Hak","year":"2014","journal-title":"Orthopedics"},{"key":"10.1016\/j.jse.2023.04.023_bib19","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.2106\/00004623-197658080-00001","article-title":"Methylmethacrylate as an adjunct in internal fixation of pathological fractures. Experience with three hundred and seventy-five cases","volume":"58","author":"Harrington","year":"1976","journal-title":"J Bone Joint Surg Am"},{"key":"10.1016\/j.jse.2023.04.023_bib20","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/00003086-200203000-00034","article-title":"Biomechanical analysis of humeral diaphyseal segmental defect fixation","volume":"396","author":"Henry","year":"2002","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib21","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.jse.2015.08.009","article-title":"Complications after surgery for metastatic humeral lesions","volume":"25","author":"Janssen","year":"2016","journal-title":"J Shoulder Elbow Surg"},{"key":"10.1016\/j.jse.2023.04.023_bib22","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1002\/jbm.820260202","article-title":"Biological response to chopped-carbon-fiber-reinforced peek","volume":"26","author":"Jockisch","year":"1992","journal-title":"J Biomed Mater Res"},{"key":"10.1016\/j.jse.2023.04.023_bib23","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1002\/cam4.292","article-title":"New prognostic factors and scoring system for patients with skeletal metastasis","volume":"3","author":"Katagiri","year":"2014","journal-title":"Cancer Med"},{"key":"10.1016\/j.jse.2023.04.023_bib24","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1007\/s11999-011-1811-4","article-title":"A complication-based learning curve from 200 reverse shoulder arthroplasties","volume":"469","author":"Kempton","year":"2011","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib25","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/S0020-1383(17)30731-3","article-title":"Carbon-Fibre-Reinforced PEEK radiolucent intramedullary nail for humeral shaft fracture fixation: technical features and a pilot clinical study","volume":"48","author":"Kojic","year":"2017","journal-title":"Injury"},{"key":"10.1016\/j.jse.2023.04.023_bib26","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1097\/00003086-198409000-00023","article-title":"Closed intramedullary rodding of pathologic fractures with supplemental cement","volume":"188","author":"Kunec","year":"1984","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib27","doi-asserted-by":"crossref","first-page":"4845","DOI":"10.1016\/j.biomaterials.2007.07.013","article-title":"PEEK biomaterials in trauma, orthopedic, and spinal implants","volume":"28","author":"Kurtz","year":"2007","journal-title":"Biomaterials"},{"key":"10.1016\/j.jse.2023.04.023_bib28","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/s12957-018-1545-9","article-title":"Carbon fibre\/polyether ether ketone (CF\/PEEK) implants in orthopaedic oncology","volume":"16","author":"Laux","year":"2018","journal-title":"World J Surg Oncol"},{"key":"10.1016\/j.jse.2023.04.023_bib29","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/00003086-198206000-00034","article-title":"Treatment of pathologic fractures or impending fractures of the humerus with Rush rods and methylmethacrylate. Experience with 55 cases in 54 patients, 1968-1977","volume":"166","author":"Lewallen","year":"1982","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib30","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4137\/CMAMD.S20354","article-title":"The use of carbon-fiber-reinforced (CFR) PEEK material in orthopedic implants: a systematic review","volume":"8","author":"Li","year":"2015","journal-title":"Clin Med Insights Arthritis Musculoskelet Disord"},{"key":"10.1016\/j.jse.2023.04.023_bib31","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1002\/jor.1100080420","article-title":"A reduced-modulus acrylic bone cement: preliminary results","volume":"8","author":"Litsky","year":"1990","journal-title":"J Orthop Res"},{"key":"10.1016\/j.jse.2023.04.023_bib32","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.2106\/JBJS.CC.18.00096","article-title":"Catastrophic failure of a carbon-fiber-reinforced polyetheretherketone tibial intramedullary nail: a case report","volume":"8","author":"Loeb","year":"2018","journal-title":"JBJS Case Connect"},{"key":"10.1016\/j.jse.2023.04.023_bib33","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1097\/BRS.0b013e3181b4f7e8","article-title":"Thoracic pedicle screw instrumentation: the learning curve and evolution in technique in the treatment of adolescent idiopathic scoliosis","volume":"34","author":"Lonner","year":"2009","journal-title":"Spine"},{"key":"10.1016\/j.jse.2023.04.023_bib34","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/00003086-198912000-00027","article-title":"Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures","volume":"249","author":"Mirels","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"10.1016\/j.jse.2023.04.023_bib35","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s00590-017-1985-x","article-title":"Intercalary reconstructions after bone tumor resections: a review of treatments","volume":"27","author":"Panagopoulos","year":"2017","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"10.1016\/j.jse.2023.04.023_bib36","doi-asserted-by":"crossref","first-page":"S55","DOI":"10.1016\/S0020-1383(17)30659-9","article-title":"Carbon-fiber reinforced intramedullary nailing in musculoskeletal tumor surgery: a national multicentric experience of the Italian Orthopaedic Society (SIOT) Bone Metastasis Study Group","volume":"48","author":"Piccioli","year":"2017","journal-title":"Injury"},{"key":"10.1016\/j.jse.2023.04.023_bib37","first-page":"1","article-title":"The carbon fiber intramedullary nail in pathological humeral shaft fractures: two case reports","volume":"1","author":"Pietro","year":"2015","journal-title":"Jacobs J Orthop Rheumatol"},{"key":"10.1016\/j.jse.2023.04.023_bib38","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.jse.2023.04.023_bib39","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1123\/jab.28.5.568","article-title":"Comparison of four reconstructive methods for diaphyseal defects of the humerus after tumor resection","volume":"28","author":"Sakellariou","year":"2012","journal-title":"J Appl Biomech"},{"key":"10.1016\/j.jse.2023.04.023_bib40","series-title":"Engineering formulas interactive: conversions, definitions, and tables","author":"Sims","year":"1999"},{"key":"10.1016\/j.jse.2023.04.023_bib41","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.jmbbm.2012.09.013","article-title":"Carbon fiber reinforced PEEK Optima--a composite material biomechanical properties and wear\/debris characteristics of CF-PEEK composites for orthopedic trauma implants","volume":"17","author":"Steinberg","year":"2013","journal-title":"J Mech Behav Biomed Mater"},{"key":"10.1016\/j.jse.2023.04.023_bib42","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/S0748-7983(97)92460-4","article-title":"Treatment of humeral pathological fractures by internal fixation and methylmetacrylate injection","volume":"23","author":"Vandeweyer","year":"1997","journal-title":"Eur J Surg Oncol"},{"key":"10.1016\/j.jse.2023.04.023_bib43","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1177\/1071100715625291","article-title":"Torsional failure of carbon fiber composite plates versus stainless steel plates for comminuted distal fibula fractures","volume":"37","author":"Wilson","year":"2016","journal-title":"Foot Ankle Int"},{"key":"10.1016\/j.jse.2023.04.023_bib44","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1302\/2633-1462.38.BJO-2022-0092.R1","article-title":"Comparison of carbon fibre and titanium intramedullary nails in orthopaedic oncology","volume":"3","author":"Yeung","year":"2022","journal-title":"Bone Jt Open"},{"key":"10.1016\/j.jse.2023.04.023_bib45","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.clinbiomech.2019.02.004","article-title":"Mechanical analysis of femoral stress-riser fractures","volume":"63","author":"Zhou","year":"2019","journal-title":"Clin Biomech"}],"container-title":["Journal of Shoulder and Elbow Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1058274623004184?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1058274623004184?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:59:52Z","timestamp":1761008392000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1058274623004184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["S1058274623004184"],"URL":"https:\/\/doi.org\/10.1016\/j.jse.2023.04.023","relation":{},"ISSN":["1058-2746"],"issn-type":[{"value":"1058-2746","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Titanium vs. carbon fiber\u2013reinforced intramedullary nailing for humeral bone tumors","name":"articletitle","label":"Article Title"},{"value":"Journal of Shoulder and Elbow Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jse.2023.04.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.","name":"copyright","label":"Copyright"}]}}