{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:30:09Z","timestamp":1777876209205,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Shoulder &amp; Elbow"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anecdotally, upper truncal obesity and large breasts have often been associated with inferior outcomes from non-operative management of diaphyseal humerus fractures. However, this assertion is without basis in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To produce radiographic measurements of chest wall soft tissue thickness (STT) and determine association with non-union in diaphyseal humerus fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred and seventeen consecutive non-operative humeral shaft fractures were included. Radiographic STT measurements were taken at three standardised points (upper, middle and lower) using a simple reproducible method, with ratios derived (dividing these figures by the mid-humerus diameter). Bivariate and multivariable analyses were used to assess association with non-union.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 58 (26.7%) cases of non-union. On multivariable analysis, the middle (odds ratio (OR) 1.39, p\u2009&lt;\u2009 0.001) and lower (OR 1.23, p\u2009=\u20090.009) STT measurements were independently associated with non-union. Additionally, the middle (OR 1.85, p\u2009&lt;\u20090.001) and lower (OR 1.47, p\u2009&lt;\u20090.001) STT ratios were independently associated with non-union. A receiver operating characteristic curve determined a threshold value of a middle STT ratio of\u2005\u2265\u20093 (OR 3.73, p\u2009&lt;\u20090.001, sensitivity 69.0%, specificity 62.3%), which was independently associated with non-union.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Chest wall STT is independently associated with humeral shaft non-union. Threshold values can assist in decision making for these fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17585732231190325","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T02:15:36Z","timestamp":1690942536000},"page":"611-620","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Chest wall soft tissue thickness is associated with humeral shaft non-union: A radiographic study"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0403-3454","authenticated-orcid":false,"given":"Alex","family":"Chowdhury","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, Hampshire Hospitals Foundation Trust, Winchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kizzie A","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Hampshire Hospitals Foundation Trust, Winchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry B","family":"Cola\u00e7o","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Hampshire Hospitals Foundation Trust, Winchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iain AR","family":"MacLeod","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Hampshire Hospitals Foundation Trust, Winchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"bibr1-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.04.130"},{"key":"bibr2-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1302\/2058-5241.6.200033"},{"key":"bibr3-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.01.029"},{"key":"bibr4-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.07.001"},{"key":"bibr5-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-022-06317-6"},{"key":"bibr6-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-019-3576-0"},{"key":"bibr7-17585732231190325","unstructured":"National Institute for Health and Care Research. The HUmeral SHaft fracture trial (HUSH). 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Treasure Island, FL: StatPearls Publishing, 2022."},{"key":"bibr18-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001173"},{"key":"bibr19-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318182afd0"},{"key":"bibr20-17585732231190325","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200407000-00002"},{"key":"bibr21-17585732231190325","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197759050-00004"},{"key":"bibr22-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.09.041"},{"key":"bibr23-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.0906"},{"key":"bibr24-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.01.072"},{"key":"bibr25-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2019.06.014"},{"key":"bibr26-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.37.BJO-2022-0047.R1"},{"key":"bibr27-17585732231190325","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.12.014"},{"key":"bibr28-17585732231190325","volume":"44","author":"Devers BN","year":"2015","journal-title":"Am J Orthop (Belle Mead, NJ)"}],"container-title":["Shoulder &amp; Elbow"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17585732231190325","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17585732231190325","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17585732231190325","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:17:25Z","timestamp":1777587445000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17585732231190325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1177\/17585732231190325"],"URL":"https:\/\/doi.org\/10.1177\/17585732231190325","relation":{},"ISSN":["1758-5732","1758-5740"],"issn-type":[{"value":"1758-5732","type":"print"},{"value":"1758-5740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,1]]}}}