The Complex Triplane Fracture: Ipsilateral Tibial Shaft and Distal Triplane Fracture
Bibliographic record
Abstract
BACKGROUND: The complex triplane fracture (ipsilateral tibial shaft and distal tibial triplane fracture) is a rare combination. It has not previously been described in the literature. This combination can be easily overlooked and has the potential for serious sequelae if it is missed. METHODS: Six patients, having sustained this combined injury, were reviewed at a tertiary children's hospital. Clinical assessment, radiographs, computed tomographic scans, bone age, and scanogram assessment of leg length at maturity were completed. RESULTS: Average age at injury was 14 years. Tibial fractures were midshaft or short oblique. There were 3 three-part and 3 two-part intra-articular distal tibial triplane fractures. Diagnosis of the distal triplane fracture was delayed in two cases. Treatment involved application of a long leg cast. No patients required open reduction. At follow-up (average, 22 months), all patients were asymptomatic. All fractures were well healed and there was no evidence of joint incongruity, or angular or rotational deformity. Leg length discrepancy averaged 6.8 mm. CONCLUSION: A high index of suspicion should be maintained to avoid missing this rare combination, as it has the potential for long-term sequelae.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 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".