Functional Impact of Tibial Malrotation Following Intramedullary Nailing of Tibial Shaft Fractures
Bibliographic record
Abstract
BACKGROUND: Tibial malrotation is a complication that is seen in approximately 30% of patients following locked intramedullary nailing. In this cohort study, we evaluated the hypothesis that tibial malrotation would lead to impaired functional outcomes. METHODS: Patients with a unilateral tibial shaft fracture who were managed with intramedullary nailing between 2003 and 2007 were identified with use of ICD-10 (International Classification of Diseases, 10th Revision) codes. After institutional review board approval and written informed consent had been obtained, specific assessment of eligible patients was achieved with use of computed tomography, functional measures (Lower Extremity Functional Scale, Olerud-Molander Score, six-minute walk test), and physical examination. Measures were compared between patients with and without tibial malrotation (defined as tibial rotation of ≥ 10°) on imaging studies. RESULTS: Of the 288 patients who were identified, 100 were eligible for the study and seventy consented to participate. The mean duration of follow-up (and standard deviation) for these seventy patients was 58 ± 11 months. Twenty-nine patients (41%) had tibial malrotation. Lower Extremity Functional Scale scores were similar between the groups with and without malrotation (mean, 70.8 ± 8.6 points compared with 72.6 ± 8.7 points; p = 0.41). The results for the other functional tests were also similar. CONCLUSIONS: Despite high rates of tibial malrotation following locked intramedullary nailing of isolated tibial diaphyseal fractures, this finding does not have a significant intermediate-term functional impact.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 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) | 0.000 | 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".