Complications of Microsurgical Reconstruction of Obstetrical Brachial Plexus Palsy
Bibliographic record
Abstract
The charts of the 173 consecutive patients who underwent microsurgical reconstruction for obstetrical brachial plexus palsy from 1988 to 1999 (inclusive) in the Division of Plastic Surgery at the Hospital for Sick Children were analyzed. The overall complication rate was 33.5 percent, and there was no mortality in this series. The most significant intraoperative complication was accidental extubation, which occurred five times in the first 84 patients (6 percent of this early group; 2.9 percent of the whole series). This complication was addressed by suturing the endotracheal tube to the membranous septum and by using a transparent drape to allow direct visualization of the tube in all 89 subsequent patients. There have been no further accidental extubations. Postoperative fluid overload occurred in 14 patients (8.1 percent), three (1.7 percent) of whom developed pulmonary edema. Intensive care unit admission was required in two of those patients. Diuretic treatment was required in seven patients. No patient receiving less than or equal to 4 ml/kg/hour developed fluid overload, whereas 50 percent of the patients receiving greater than or equal to 10 ml/kg/hour did. Currently, the authors' policy is to strictly limit intravenous maintenance fluids to 4 ml/kg/hour or less. Despite the long and complex procedure required to reconstruct obstetrical brachial plexus palsy, the incidence of significant complications can be minimized with simple precautions, such as suturing the endotracheal tube to the septum or reducing the amount of fluids administered during the operation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".