Selective Fascicular Coaptation of Free Functioning Gracilis Transfer for Restoration of Independent Thumb and Finger Flexion Following Volkmann Ischemic Contracture
Bibliographic record
Abstract
Children are prone to developing moderate to severe Volkmann ischemic contracture following a supracondylar fracture of the humerus or its treatment. Given the variable extent of forearm muscle damage, tendon transfers and tenodeses are often unavailable. To address these contractures, intensive hand therapy and a free functioning muscle transfer are required. Despite functional improvement following free muscle transplantation, reconstructed patients with severe Volkmann ischemic contracture tend to have persistent difficulty with fine motor activities owing to the losses of intrinsic muscle function and independence of thumb and finger flexion. The authors demonstrate how selective coaptation of separate fascicular territories of the gracilis nerve branches to the branches of the anterior interosseous nerve that innervate flexor pollicis longus and flexor digitorum profundus may be performed to establish a degree of independent thumb and finger flexion with a single free gracilis transfer. This technical refinement as well as its long-term outcomes in a series of three patients is presented.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".