Symptomatic Bunionette Deformity in Adolescents
Bibliographic record
Abstract
BACKGROUND: Bunionette deformity is a painful osseous prominence on the lateral aspect of the head of the fifth metatarsal. The purpose of this study is to evaluate the results of a fifth metatarsal sliding osteotomy for the treatment of this deformity in patients under 18 years of age. METHODS: We retrospectively evaluated 13 feet in 11 consecutive patients with bunionette deformity treated from January 2003 to January 2008 at 2 referral centers. Mean age was 14.8 years (95% confidence limit, SD 1.5 y); mean follow-up was 32.2 months (95% confidence limit, SD 11.7 mo); and clinical evaluation was made according to the modified American Orthopaedic Foot and Ankle Society (AOFAS) score and the Coughlin score. The IV-V intermetatarsal angle ( IV-V IMA), the width of the forefoot (WF), lateral deviation angle (LDA), and fifth metatarsophalangeal angle (5 MPA) were also measured preoperatively and postoperatively. RESULTS: The average postoperative AOFAS score was 91 ± 4.1 points. Seven patients (8 feet) had an excellent outcome and 4 patients (5 feet) a good outcome according to the Coughlin scoring rate. The IV-V IMA averaged 12.29 degrees ± 1.5 degrees preoperatively, while postoperatively it was 6.18 degrees ± 1.4 degrees (P<0.0001). The LDA improved from 7.74 degrees ± 1.7 degrees preoperatively to 4.25 degrees ± 1 degree after surgery (P<0.0001). The WF decreased from 8.01 ± 1.3 mm to 7.05 ± 1.3 mm (P<0.0001). The mean 5 MPA decreased from 21.7 degrees ± 4.1 degrees preoperatively to 7.63 degrees ± 3.4 degrees at final follow-up (P<0.0001). One patient developed a superficial infection around a K-wire. CONCLUSIONS: Metatarsal sliding osteotomy is a safe and effective method for the correction of symptomatic bunionette in patients below 18 years of age. Further research is required to compare this approach with other treatment methods in this specific age group. STUDY DESIGN: Case series (Level of evidence, IV).
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.003 | 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 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".