Avoidance of external fixation pin induced rotational stiffness in the forearm; a cadaver study of soft tissue displacement relative to the varying position of radius and ulna fixation
Bibliographic record
Abstract
INTRODUCTION: Stiffness of forearm rotation secondary to transfixion pin sites is a frequent complication of external fixation. Conventional surgical atlases do not consider the effect of rotation on skin displacement and thus do not provide a comprehensive answer. We asked: (1) in what locations in the forearm is soft tissue displacement relative to the ulna and radius least during rotation; (2) in what positions are major neurovascular structures absent; and (3) what maximal range of rotation can be expected in forearm external fixation. METHODS: Thirty-four matched cadaver arms were used to assess displacement of soft tissues at 10°, 30° and 70° of pronation and supination in relation to a testing frame. The results of these were correlated with positions in which neurovascular structures were absent and deemed insertional "Reference Positions (RP)". RESULTS: Expected range of rotation in diaphyseal fractures of different levels of both forearm bones was found with RP for the ulna occurring along the length of the forearm. Reference positions for the radius which provide full forearm rotation are situated only in the distal third; positions which provide partial rotation are located in the proximal and middle third. DISCUSSION: Full range of rotation may be maintained in the case of isolated external fixation of ulnar diaphyseal fractures. In isolated external fixation of the radius a reduced range of forearm rotation may be expected.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".