Assessment and management of amputations distal to the wrist
Bibliographic record
Abstract
Hand amputation is a devastating injury which may result in permanent quality-of-life impairment. The goal of treatment is to anatomically restore the amputated limb in order to optimize sensation and range of motion of the injured structures. All cases should be emergently referred to a hand surgeon trained in microsurgery for assessment and management. Generally accepted indications for replantation include amputation at the level of the wrist or mid-palm, thumb or multiple digit amputation and single digit amputation when distal to flexor digitorum superficialis insertion. In addition, replantation should always be attempted for children. Appropriate primary care which includes wrapping the amputated part in saline-soaked gauze, sealing in a plastic bag, and immersing in an ice bath increases the viability of amputated tissue and facilitates replantation. This review explores hand amputation classification, indications for replantation, primary care of the amputated part, surgical replantation techniques, post-operative care, and complications following replantation surgery. Three cases, treated at the Halifax Infirmary, were identified to illustrate the clinical presentation and outcome of patients presenting with multiple digit, thumb, or mid-palm amputation.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".