Bridging and non‐bridging external fixation in the treatment of unstable fractures of the distal radius: A retrospective study of 588 patients
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: Bridging external fixation is used more frequently than non-bridging fixation in the management of unstable distal radius fractures, despite evidence from randomized controlled trials of better outcome with the latter technique. This study was designed to investigate the generalizability of the technique of non-bridging external fixation, and to define the indications for the use of each technique and their complications. METHODS: 641 patients with unstable displaced fractures of the distal radius were treated with bridging or non-bridging external fixation. Non-bridging external fixation was used where there was space for pins in the distal fragment. 52 patients were lost to follow-up, leaving 588 patients available for study. Complete data from radiographic measurements after fracture healing were available for 546 patients. 59 % of fractures were treated with the non-bridging technique. RESULTS: Fractures treated with bridging external fixation had a 6 times increased risk of dorsal malunion (p < 0.001) and a 2.5 times increased risk of radial shortening (p < 0.001) after adjusting for confounding factors (95% CI for odds ratio: 3-13 and 1.5-4, respectively) compared to non-bridging techniques. Minor pin tract infections were more common in the non-bridging group. INTERPRETATION: Non-bridging external fixation of the distal radius is a generalizable technique, and reduces the risk of dorsal malunion compared with bridging external fixation. Major complication rates are low and the technique is applicable to most unstable fractures of the distal radius. We recommend that non-bridging external fixation be used where there is space for the pins in the distal fragment.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".