{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:57:35Z","timestamp":1774594655973,"version":"3.50.1"},"reference-count":17,"publisher":"Universa BV","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>While many humeral shaft fractures can be successfully treated with nonoperative management, compression plating techniques using at least three or four screws on either side of the fracture are the current gold standard. We hypothesized that a less rigid construct using compression with only two screws on either side of the fracture can provide adequate strength for uneventful fracture union.\n\nThis is a retrospective review of all the patients who underwent open reduction and compression plate fixation for acute diaphyseal humerus fractures (ADHFs) at an academic Level-1 urban trauma center between 2018 and 2023. Patients treated with compression plating using only two screws and three or four plate-holes on either side of the fracture (Group 1) were matched one-to-one with patients treated using the conventional number of screws (three or more on either side of the fracture \u2013 Group 2). The incidence of nonunion\/malunion, infection, and implant failure was compared among the two groups.\nThere were eleven matched patients in both groups. The nonunion, infection complications, and hardware failure rates were 0% and 9.1% for the control group (Group 2) and four-screw group (Group 1) respectively. This difference was not statistically significant (p = 1.00).\n\nAlthough convention dictates the use of six or more bicortical screws (at least three bicortical screws on each side of the fracture), four-screw bicortical fixation may be a feasible option for ADHFs treated with large fragment compression plating techniques.<\/jats:p>","DOI":"10.52628\/90.2.12459","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T19:19:26Z","timestamp":1729624766000},"page":"229-232","source":"Crossref","is-referenced-by-count":1,"title":["Four-screw compression plate fixation for diaphyseal humerus fractures"],"prefix":"10.52628","volume":"90","author":[{"given":"N","family":"KANNEGANTI","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"GAO","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"GUPTA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.C.","family":"SAGI","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2024,10]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Updegrove GF, Mourad W, Abboud JA. Humeral shaft fractures. J Shoulder Elbow Surg. 2018;27(4):e87-e97. doi:10.1016\/j.jse.2017.10.028","DOI":"10.1016\/j.jse.2017.10.028"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Attum B, Obremskey W. Treatment of Humeral Shaft Fractures: A Critical Analysis Review. JBJS Rev. 2015;3(9):e5. doi:10.2106\/JBJS.RVW.N.00119","DOI":"10.2106\/jbjs.rvw.n.00119"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Orapiriyakul W, Apivatthakakul V, Theppariyapol B, Apivatthakakul T. Humerus shaft fractures, approaches and management. J Clin Orthop Trauma. 2023;43:102230. Published 2023 Aug 6. doi:10.1016\/j.jcot.2023.102230","DOI":"10.1016\/j.jcot.2023.102230"},{"key":"ref3","unstructured":"Schoch BS, Padegimas EM, Maltenfort M, Krieg J, Namdari"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Humeral shaft fractures: national trends in management. 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J Orthop Trauma. 2010;24(4):207-211. doi:10.1097\/BOT.0b013e3181bdd1da","DOI":"10.1097\/bot.0b013e3181bdd1da"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"T\u00f6rnkvist H, Hearn TC, Schatzker J. The strength of plate fixation in relation to the number and spacing of bone screws. J Orthop Trauma. 1996;10(3):204-208. doi:10.1097\/00005131-199604000-00009","DOI":"10.1097\/00005131-199604000-00009"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Gomes GS, Zderic I, Ahrend MD, et al. Is Bridge Plating of Comminuted Humeral Shaft Fractures Advantageous When Using Compression Plates with Three versus Two Screws per Fragment? A Biomechanical Cadaveric Study. Biomed Res Int. 2021;2021:6649712. Published 2021 Mar 6. doi:10.1155\/2021\/6649712","DOI":"10.1155\/2021\/6649712"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Mehdi Nasab SA, Sarrafan N, Sabahi S. Four-Screw Plate Fixation vs Conventional Fixation for Diaphyseal Fractures of the Forearm. Trauma Mon. 2012;17(1):245-249. doi:10.5812\/ traumamon.4497","DOI":"10.5812\/traumamon.4497"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Augustin G, Zigman T, Davila S, et al. Cortical bone drilling and thermal osteonecrosis. Clin Biomech (Bristol, Avon). 2012;27(4):313-325. doi:10.1016\/j.clinbiomech.2011.10.010","DOI":"10.1016\/j.clinbiomech.2011.10.010"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18(8):488-493. doi:10.1097\/00005131-200409000-00003","DOI":"10.1097\/00005131-200409000-00003"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Glatt V, O\u2019Toole R, Mehta S, et al. Great debates in trauma biomechanics. OTA Int. 2023;6(2 Suppl):e249. 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