Comadoll SM, Matuszewski PE, Liu B, et al. - Researchers conducted a retrospective study with the aim to investigate the factors linked with fixation failure in patients treated with superior intramedullary ramus screws. The analysis was performed including a total of 285 fractures in 211 patients (age 44, 95% confidence interval 40.8%–46.4%, 59.3% women, 55.1% retrograde screws). Outcomes revealed correlation of superior ramus screws with a low failure rate (4.9%), which is lower than previously reported. Predictors of failure included retrograde screw insertion, distance from the symphysis, increasing age, increasing BMI, reduced distance from the symphysis, and ipsilateral inferior ramus fractures. In these patients, they suggest considering alternative modalities, although low rates of failure can still be expected.