Posterior Capitellum Impaction Fracture Associated With Posterolateral Instability of the Elbow
Bibliographic record
Abstract
Posterolateral rotary elbow instability is one of the most frequently missed causes of recurrent elbow problems and is associated with transient rotary instability and periodic elbow dislocations. We present the case of a 19-year-old young woman who, 8 years previously, dislocated her elbow due to a fall on an outstretched hand and required closed reduction. Posterolateral rotary elbow instability diagnosis was made because she was able to actively sublux her radial head in a posterolateral direction and had a positive pivot shift test, and radiographic evaluation revealed a notch in the capitellum. The patient consented to surgery. Under anesthesia, a positive pivot shift to the elbow was again demonstrated. The ipsilateral palmaris longus tendon was used to reconstruct the lateral ulnar collateral ligament. Arthroscopy was performed on the right knee, and a 10-mm osteochondral graft was taken from the lateral femoral notch and press-fit into the defect of the capitellum. Two-year follow-up revealed a range of motion of 5 degrees of hyperextension to 145 degrees of flexion with full pronation-supination. At 3 years, Disability of Arm, Shoulder and Hand questionnaire revealed no disability, and magnetic resonance imaging indicated that osteochondral autograft transfer system incorporation had restored the capitallar articular surface. To our knowledge, this is the first reported case of posterolateral rotary elbow instability with treatment of the combined pathology performed.
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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 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".