Biomechanical Analysis of Fixation of Middle Third Fractures of the Clavicle
Bibliographic record
Abstract
OBJECTIVE: This biomechanical study compares four different techniques of fixation of middle third clavicular fractures. METHODS: Twenty fresh-frozen clavicles were randomized into four groups. Each group used a different fixation device (3.5 Synthes reconstruction plate, 3.5 Synthes limited contact dynamic compression plate, 3.5 Synthes locking compression plate, and 4.5 DePuy Rockwood clavicular pin). All constructs were mechanically tested in bending and torque modes both with and without a simulated inferior cortical defect. Bending load to failure was also conducted. The four groups were compared using an analysis of variance test. RESULTS: The plate constructs were stiffer than the pin during both pure bending and torque loads with or without an inferior cortical defect. Bending load to failure with an inferior cortical defect revealed that the reconstruction plate was weaker compared with the other three groups. The limited contact and locking plates were stiffer than the reconstruction plate but demonstrated statistical significance only with the cortical defect. CONCLUSIONS: As hypothesized, the 3.5 limited contact dynamic compression plate and 3.5 locking compression plate demonstrated the greatest resistance to bending and torque loads, especially in the presence of simulated comminution of a middle third clavicular fracture. The reconstruction plate demonstrated lower stiffness and strength values compared with the other plates, especially with a cortical defect, whereas the pin showed poor resistance to bending and torque loads in all modes of testing. This information may help surgeons to choose the most appropriate method of fixation when treating fractures of the middle third of the clavicle.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".