Bibliographic record
Abstract
A 7-year-old girl presented 3 years after a large tip amputation, which had been treated with an attempt at closure. The eventual outcome was a painful finger with a rounded or “hook” nail deformity (Fig. 1). During this closure, the treating physician had mobilized the volar surface with a midaxial incision (small arrows in Fig. 1). One treatment for this is an Atasoy or antennae procedure. Several variants of the actual procedure are in usage. The figures represent one option. FIG. 1. Typical hook nail deformity. The large arrows represent the nail that now has grown around the tip of the finger. Small arrows indicate the location of the midaxial incision. We removed the nail, liberated the excess nail matrix from the underlying bone and trimmed to limit it to the top of the finger. We used k-wire(s) to support the matrix in position. We incised the volar skin and brought the pulp area around to meet the matrix. We used a full-thickness skin graft to fill the resultant defect (Fig. 2). FIG. 2. Diagram showing the placement of the k-wire and the placement of the skin graft. We harvested a full-thickness skin graft from the hypothenar eminence and placed it into the defect on the volar surface (Fig. 3). In a pediatric patient, this option is better than a cross finger flap. Figure 4 shows the final surgical result with the skin graft in place and the k-wire holding the transposed pulp in place as well as supporting the newly reconstructed matrix. FIG. 3. Full-thickness skin graft harvested from the hypothenar eminence (small arrows), placed into the defect on the volar surface (large arrows). FIG. 4. Skin graft (large arrow) and the k-wire holding the transposed pulp in place as well as supporting the newly reconstructed matrix.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.032 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".