{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T05:25:20Z","timestamp":1737696320129,"version":"3.33.0"},"reference-count":27,"publisher":"Universa BV","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>The aim of this study is to investigate whether not using the calcar screw in proximal humerus fractures affects functional and radiological outcomes.\n\nThirty patients (21 females and 9 males) who presented with proximal humerus fractures and were treated with plate- screw fixation were evaluated. The patients were divided into two groups: group 1 included patients with the use of the calcar screw, and group 2 included patients without the calcar screw. Radiological evaluation was performed by measuring the neck-shaft angle on postoperative day 1 and at 1 year in true anteroposterior radiographs. The groups were compared regarding demographic characteristics, functional outcomes, radiological scores, and complications.\n\nThe mean age was 60 (27-92) years. In group 1, a mean decrease of 5.2\u00b0 in the neck-shaft angle was observed (136.1\u00b0 on postoperative day 1 and 130.6\u00b0 at 1 year; p&lt;0.05). In group 2, a mean decrease of 3.1\u00b0 was observed (133.5\u00b0 on postoperative day 1 and 130.0\u00b0 at 1 year; p&gt;0.05). There was no significant difference in the change of the humerus neck- shaft angle between the two groups (p&gt;0.05). The mean Constant score was 70.8 in group 1 and 76.7 in group 2, (p&gt;0.05). There was no significant difference in varus displacement and functional outcomes between the groups using and not using the calcar screw in proximal humerus fractures. Good reduction, stable fixation with locking plates, and preservation of soft tissue integrity are crucial to avoid complications and promote healing in proximal humerus fractures.<\/jats:p>","DOI":"10.52628\/90.3.12777","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T20:53:08Z","timestamp":1737665588000},"page":"429-434","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of the varus displacement effect of calcar screw in proximal humerus fractures"],"prefix":"10.52628","volume":"90","author":[{"given":"C.Z.","family":"ESENYEL","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"KURT","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"TEKSAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2025,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Lind T, Kr\u00f8ner K, Jensen J. The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg. 1989;108(5):285-7.","DOI":"10.1007\/bf00932316"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Rose SH, Melton LJ 3rd, Morrey BF, Ilstrup DM, Riggs BL. Epidemiologic features of humeral fractures. Clin Orthop Relat Res. 1982 Aug;(168):24-30.","DOI":"10.1097\/00003086-198208000-00003"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Hohmann E, Keough N, Glatt V, Tetsworth K. Surgical treatment of proximal humerus fractures: a systematic review and meta- analysis. Eur J Orthop Surg Traumatol. 2023 Aug;33(6):2215- 2242.","DOI":"10.1007\/s00590-022-03436-3"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Kannus P, Palvanen M, Niemi S, Parkkari J, J\u00e4rvinen M, Vuori I. Osteoporotic fractures of the proximal humerus in elderly Finnish persons: sharp increase in 1970-1998 and alarming projections for the new millennium. Acta Orthop Scand. 2000 Oct;71(5):465-70.","DOI":"10.1080\/000164700317381144"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Egol KA, Ong CC, Walsh M, Jazrawi LM, Tejwani NC, Zuckerman JD. Early complications in proximal humerus fractures (OTA Types 11) treated with locked plates. J Orthop Trauma. 2008 Mar;22(3):159-64.","DOI":"10.1097\/bot.0b013e318169ef2a"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Chow RM, Begum F, Beaupre LA, Carey JP, Adeeb S, Bouliane MJ. Proximal humeral fracture fixation: locking plate construct \u00b1 intramedullary fibular allograft. J Shoulder Elbow Surg. 2012 Jul;21(7):894-901.","DOI":"10.1016\/j.jse.2011.04.015"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Bayrak A, Duramaz A, Koluman A, Kural C, Ziro\u011flu N, G\u00f6z\u00fcg\u00fcl K, Peker G. Does plate-screw density affect the functional outcomes in the treatment of proximal humerus fractures? Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):824-831.","DOI":"10.14744\/tjtes.2021.99078"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Namdari S, Voleti PB, Mehta S. Evaluation of the osteoporotic proximal humeral fracture and strategies for structural augmentation during surgical treatment. J Shoulder Elbow Surg. 2012 Dec;21(12):1787-95.","DOI":"10.1016\/j.jse.2012.04.003"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Kennedy J, Feerick E, McGarry P, FitzPatrick D, Mullett H. Effect of calcium triphosphate cement on proximal humeral fracture osteosynthesis: a finite element analysis. J Orthop Surg (Hong Kong). 2013 Aug;21(2):167-72.","DOI":"10.1177\/230949901302100210"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Neviaser AS, Hettrich CM, Beamer BS, Dines JS, Lorich DG. Endosteal strut augment reduces complications associated with proximal humeral locking plates. Clin Orthop Relat Res. 2011 Dec;469(12):3300-6.","DOI":"10.1007\/s11999-011-1949-0"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Egol KA, Sugi MT, Ong CC, Montero N, Davidovitch R, Zuckerman JD. Fracture site augmentation with calcium phosphate cement reduces screw penetration after open reduction-internal fixation of proximal humeral fractures. J Shoulder Elbow Surg. 2012 Jun;21(6):741-8.","DOI":"10.1016\/j.jse.2011.09.017"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Mehta S, Chin M, Sanville J, Namdari S, Hast MW. Calcar screw position in proximal humerus fracture fixation: Don\u2019t miss high! Injury. 2018 Mar;49(3):624-629.","DOI":"10.1016\/j.injury.2018.02.007"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Padegimas EM, Zmistowski B, Lawrence C, Palmquist A, Nicholson TA, Namdari S. Defining optimal calcar screw positioning in proximal humerus fracture fixation. J Shoulder Elbow Surg. 2017 Nov;26(11):1931-1937.","DOI":"10.1016\/j.jse.2017.05.003"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Solberg BD, Moon CN, Franco DP, Paiement GD. Surgical treatment of three and four-part proximal humeral fractures. J Bone Joint Surg Am. 2009 Jul;91(7):1689-97.","DOI":"10.2106\/jbjs.h.00133"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Sergent A, Rouleau DM, Beauvais \u00c9, M\u00e9nard J, Petit Y, Leduc S, Laflamme GY. Quantitative localization of the entry point of the lateral ascending branch of the anterior circumflex humeral artery: a high definition CT-scan radiological study. Surg Radiol Anat. 2020 Mar;42(3):233-237.","DOI":"10.1007\/s00276-019-02356-y"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Brooks CH, Revell WJ, Heatley FW. Vascularity of the humeral head after proximal humeral fractures. An anatomical cadaver study. J Bone Joint Surg Br. 1993 Jan;75(1):132-6.","DOI":"10.1302\/0301-620x.75b1.8421010"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Hertel R, Hempfing A, Stiehler M, Leunig M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg. 2004 Jul- Aug;13(4):427-33.","DOI":"10.1016\/j.jse.2004.01.034"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Lescheid J, Zdero R, Shah S, Kuzyk PR, Schemitsch EH. The biomechanics of locked plating for repairing proximal humerus fractures with or without medial cortical support. J Trauma. 2010 Nov;69(5):1235-42.","DOI":"10.1097\/ta.0b013e3181beed96"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Gardner MJ, Boraiah S, Helfet DL, Lorich DG. Indirect medial reduction and strut support of proximal humerus fractures using an endosteal implant. J Orthop Trauma. 2008 Mar;22(3):195- 200.","DOI":"10.1097\/bot.0b013e31815b3922"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Huttunen TT, Launonen AP, Pihlajam\u00e4ki H, Kannus P, Mattila VM. Trends in the surgical treatment of proximal humeral fractures - a nationwide 23-year study in Finland. BMC Musculoskelet Disord. 2012 Dec 29;13:261.","DOI":"10.1186\/1471-2474-13-261"},{"key":"ref20","unstructured":"Iannotti JP, Ramsey ML, Williams GR Jr, Warner JJ. Nonprosthetic management of proximal humeral fractures. Instr Course Lect. 2004;53:403-16."},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Gardner MJ, Weil Y, Barker JU, Kelly BT, Helfet DL, Lorich DG. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007 Mar;21(3):185-91.","DOI":"10.1097\/bot.0b013e3180333094"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Wang Q, Sheng N, Rui B, Chen Y. The neck-shaft angle is the key factor for the positioning of calcar screw when treating proximal humeral fractures with a locking plate. Bone Joint J. 2020 Dec;102-B(12):1629-1635.","DOI":"10.1302\/0301-620x.102b12.bjj-2020-0070.r1"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Agudelo J, Sch\u00fcrmann M, Stahel P, Helwig P, Morgan SJ, Zechel W, Bahrs C, Parekh A, Ziran B, Williams A, Smith W. Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Orthop Trauma. 2007 Nov- Dec;21(10):676-81.","DOI":"10.1097\/bot.0b013e31815bb09d"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Bai L, Fu Z, An S, Zhang P, Zhang D, Jiang B. Effect of Calcar Screw Use in Surgical Neck Fractures of the Proximal Humerus With Unstable Medial Support: A Biomechanical Study. J Orthop Trauma. 2014 Aug;28(8):452-7.","DOI":"10.1097\/bot.0000000000000057"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Yang P, Zhang Y, Liu J, Xiao J, Ma LM, Zhu CR. Biomechanical effect of medial cortical support and medial screw support on locking plate fixation in proximal humeral fractures with a medial gap: a finite element analysis. Acta Orthop Traumatol Turc. 2015;49(2):203-9.","DOI":"10.3944\/aott.2015.14.0204"},{"key":"ref26","unstructured":"Gardner MJ, Griffith MH, Dines JS, Lorich DG. A minimally invasive approach for plate fixation of the proximal humerus. Bull Hosp Jt Dis. 2004;62(1-2):18-23."}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T20:53:15Z","timestamp":1737665595000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actaorthopaedica.be\/archive\/volume-90\/issue-3\/original-studies\/comparison-of-the-varus-displacement-effect-of-calcar-screw-in-proximal-humerus-fractures\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,12]]},"published-print":{"date-parts":[[2024,9]]}},"URL":"https:\/\/doi.org\/10.52628\/90.3.12777","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9]]}}}