{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:34:55Z","timestamp":1787754895378,"version":"build-2784847793"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In the setting of periprosthetic humeral fractures, the humeral stem of the implant represents a substantial challenge to the optimal method of proximal fixation. This study aimed to compare the initial biomechanical stability provided by cerclage cables with a locking plate insert versus bicortical locking screws (i.e., the gold standard for fixation) in fresh cadaveric humeri.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>After calculating the sample size, we utilized 10 sets of cadaveric specimens and created a 5-mm osteotomy gap 120 mm distal to the tip of the greater tuberosity, simulating a Wright and Cofield type-B periprosthetic humeral fracture on each specimen. Using 3 locking screws for distal fragment fixation, identical in all specimens, the specimens were assigned to Group A (3 cerclage cables with a plate insert) or Group B (3 locking bicortical screws) for proximal fragment fixation. Biomechanical tests included stiffness in varus and valgus bending, torsion, and axial compression, and a single load to failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No significant differences were observed in the biomechanical metrics between the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our study revealed that fixation with use of cerclage cables with a plate insert demonstrated biomechanical stability comparable with that of bicortical locking screw fixation when addressing the proximal fragment in Wright and Cofield type-B periprosthetic humeral fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>For proximal fragment fixation of periprosthetic humeral fractures, cerclage cables with a plate insert can be utilized as an effective fixation method that offers initial fixation strength that is comparable to the use of 3 locking bicortical screws.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.00830","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T14:02:30Z","timestamp":1708524150000},"page":"817-822","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Comparing the Biomechanical Stability of Cerclage Cable with Plate Insert Versus Locking Screw in Periprosthetic Humeral Fracture"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9760-5510","authenticated-orcid":false,"given":"Yong-Jun","family":"Lee","sequence":"first","affiliation":[{"name":"Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0123-7136","authenticated-orcid":false,"given":"Joon-Ryul","family":"Lim","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6732-9738","authenticated-orcid":false,"given":"Jee-Hoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2859-5240","authenticated-orcid":false,"given":"Tae-Hwan","family":"Yoon","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5197-3716","authenticated-orcid":false,"given":"Yun-Rak","family":"Choi","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8147-6136","authenticated-orcid":false,"given":"Yong-Min","family":"Chun","sequence":"additional","affiliation":[{"name":"Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,21]]},"reference":[{"issue":"4","key":"bib1-20250430","first-page":"CD012879","article-title":"Shoulder replacement surgery for osteoarthritis and rotator cuff tear arthropathy","volume":"4","author":"Craig","year":"2020","journal-title":"Cochrane Database Syst Rev."},{"issue":"24","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"2249","DOI":"10.2106\/JBJS.J.01994","article-title":"Increasing incidence of shoulder arthroplasty in the United States","volume":"93","author":"Kim","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"4","key":"bib3-20250430","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1302\/0301-620X.104B4.BJJ-2021-1334.R1","article-title":"Management of periprosthetic fractures 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