Comparison of stable and unstable pertrochanteric femur fractures managed with 2- and 4-hole side plates
Bibliographic record
Abstract
BACKGROUND: Sliding hip screw (SHS) fixation traditionally involves the use of 4-hole side plates; however, 4-hole plates have disadvantages, including longer surgery and greater postoperative pain, and there is little evidence that they provide increased stability. We compared 2- and 4-hole side plates in stable and unstable pertrochanteric fractures. METHODS: We prospectively enrolled consecutive patients with pertrochanteric femoral fractures treated between Jan. 1, 2004, and Apr. 30, 2009, with a 135° SHS using either a 2- or 4-hole side plate, based on surgeon preference. RESULTS: A total of 327 patients were managed with an SHS device (252 women, 75 men). There were 208 stable fracture patterns (AO/OTA 31 A1, A2.1) and 119 unstable (AO/OTA 31 A2.2, A2.3, A3). We managed 172 patients with 2-hole plates and 155 with 4-hole plates. The average duration of surgery (30.44 v. 51.45 min), blood loss (26.0 v. 31.3 g/L) and transfusion requirements (43% v. 31. 60% transfusion) were significantly lower with the 2-hole than the 4-hole plate. There was no significant difference in length of stay (19 v. 16 d). With stable fractures there was no significant difference in failure rate (6.3% v. 4.9%). In unstable fractures there was a significantly higher rate of failure using 2-hole side plates (24.4% v. 10.8%). CONCLUSION: In stable fractures, use of an SHS with a 2-hole side plate results in shorter surgery and less blood loss/transfusion than a 4-hole side plate, with equivalent survival. In unstable fractures, there is a greater than 2-fold rate of failure when a 2-hole side plate is used.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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".