Medial Column Fusion for Type 2 Posterior Tibial Tendon Deficiency: The Navicular Cuneiform Fusion to Correct Forefoot Varus
Bibliographic record
Abstract
The following article describes the role of navicular cuneiform fusion in flatfoot reconstruction. Forefoot varus is a consistent deformity present in symptomatic adult flatfoot. The navicular cuneiform fusion will correct forefoot varus on the hindfoot. A mild degree of flexible hindfoot valgus will correct after the forefoot has been reduced. We therefore use the navicular cuneiform fusion as the initial procedure for adult flatfoot reconstruction. The navicular cuneiform fusion is performed in isolation when the main deformity is forefoot varus, and the hindfoot is mobile. This can be determined by a reverse Coleman block test. By correcting the foot to a neutral position, the tension symptoms on the medial border of the foot (tibialis posterior tendonitis) and the impingement symptoms on the lateral border of the foot are resolved. Other concomitant procedures may be required to resolve other components of the flatfoot deformity, such as a medializing calcaneal osteotomy or subtalar fusion for residual hindfoot valgus. A heel cord lengthening is almost always required.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 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 | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".