{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:16:16Z","timestamp":1790774176612,"version":"4.1.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007308","name":"Arthrex GmbH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007308","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Traumatol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Plate osteosynthesis with implants made of carbon-fibre-reinforced polyetheretherketone (CFR-PEEK) has recently been introduced for the treatment of fractures of the proximal humerus (PHFs). The advantages of the CFR-PEEK plate are considered to be its radiolucency, its favourable modulus of elasticity, and the polyaxial placement of the screws with high variability of the angle. The primary aim of this study is to investigate the influence of calcar screw positioning on the complication and revision rates after CFR-PEEK plating of PHFs. The secondary aim is to assess its influence on functional outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and methods<\/jats:title>\n                <jats:p>Patients were identified retrospectively. Minimum follow-up was 12 months. The cohort was divided into two groups depending on the distance of the calcar screw to the calcar (group I: &lt; 12\u00a0mm, group II: \u2265 12\u00a0mm). The range of motion (ROM), Subjective Shoulder Value Score (SSV) and Constant\u2013Murley Score (CS) were analysed at follow-up examination. Subjective complaints, complications (e.g. humeral head necrosis, varus dislocation) and the revision rate were evaluated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>51 patients (33 female, 18 male) with an average age of 68.6\u00a0years were included after a period of 26.6 months (group I: 32 patients, group II: 19 patients). Apart from the gender distribution, no significant differences were seen in the patient characteristics. The outcome scores showed significantly better clinical results in group I: SSV 83.4 vs 71.2, <jats:italic>p<\/jats:italic> = 0.007; CS 79.1 vs 67.8, <jats:italic>p<\/jats:italic> = 0.013. Complications were seen less frequently in group I (18.8 % vs 47.4 %, <jats:italic>p<\/jats:italic> = 0.030).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This study shows that the positioning of the calcar screw is relevant for CFR-PEEK plate osteosynthesis in PHFs with a good reduction of the fracture. Optimal positioning of the calcar screw close to the calcar (&lt; 12\u00a0mm) is associated with\u00a0a lower rate of complications, resulting in significantly superior functional outcomes.<\/jats:p>\n                <jats:p><jats:italic>Level of evidence<\/jats:italic>: III, retrospective cohort study<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s10195-023-00733-3","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T16:02:02Z","timestamp":1696953722000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Correct positioning of the calcar screw leads to superior results in proximal humerus fractures treated with carbon-fibre-reinforced polyetheretherketone plate osteosynthesis with polyaxial locking screws"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6666-633X","authenticated-orcid":false,"given":"Michael","family":"Kimmeyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Schmalzl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Rentschler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schieffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Macken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gerhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars-Johannes","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"issue":"8","key":"733_CR1","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1097\/BOT.0000000000000057","volume":"28","author":"L Bai","year":"2014","unstructured":"Bai L, Fu Z, An S, Zhang P, Zhang D, Jiang B (2014) Effect of calcar screw use in surgical neck fractures of the proximal humerus with unstable medial support: a biomechanical study. 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Written informed consent was obtained from all patients. The ethics approval number is 2019-755N. The conducted experiments respect the ethical standards in the Helsinki Declaration of 1975, as revised in 2000, as well as the national law.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All subjects have been informed about the open access publication of this work. A declaration of informed consent to publication was signed by each subject.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Lars-Johannes Lehmann and Christian Gerhardt are consultants for Arthrex and DJO. Michael Kimmeyer, Jonas Schmalzl, Verena Rentschler and Arno Macken have no competing interest to disclose. The research foundation received financial payments from Fa. Arthrex (Munich, Germany) for the conduct of this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"54"}}