Stern L, et al. - Researchers aimed at investigating the utility of preoperative computed tomography (CT) scans for measuring the thickness of the center of the humeral head to determine the patients at a higher risk of screw cutout after open reduction–internal fixation. At an academic medical center, they retrospectively reviewed 94 patients (aged ≥ 18 years) who had sustained a proximal humeral fracture that was managed with open reduction–internal fixation between January 1, 2005, and December 31, 2014, and who underwent preoperative shoulder CT. Seventeen patients (17.7%) developed screw cutout. These patients with screw cutout had significantly smaller mean humeral head thickness on the axial (18 mm vs 21 mm), coronal (18 mm vs 21 mm), and sagittal (18 mm vs 21 mm) sections. Findings suggest that valuable information could be gained with calculating the thickness of the center of the humeral head that may aid in preoperative planning and counseling. They suggest predictive value of a smaller thickness of the center of the humeral head on preoperative CT for screw cutout following locked plating of proximal humeral fractures. They suggest highly protective value of a measurement of > 25 mm in any one plane against cutout; however, they emphasize taking great caution and consideration of supplemental fixation methods when the measurements in all planes are < 15 mm. This information may aid in counseling patients concerning the possibility of postoperative screw cutout.