Outcomes of Intramedullary Nail Fixation Through the Olecranon Apophysis in Skeletally Immature Forearm Fractures
Bibliographic record
Abstract
The objective of this study was to quantitatively investigate the long-term radiologic and functional outcomes of antegrade intramedullary (IM) nailing through the olecranon apophysis for ulnar fractures in skeletally immature patients. A retrospective review was conducted of skeletally immature patients with ulnar fractures that had antegrade IM nail fixation through the olecranon apophysis. Patients were excluded if they had a previous forearm fracture or a fracture of the contralateral forearm. Functional measures included the Activities Scale for Kids (ASK) questionnaire for patients younger than 15 years of age and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for patients older than 15 years of age. Forearm range-of-motion measurements were collected from the fractured forearm and the contralateral control forearm. Radiologic outcomes were evaluated for ulnar, olecranon, coronoid, and trochlear notch proportions. Nineteen patients were evaluated. The average age at operation was 10.8 years (range 1.6-15.9) and the mean follow-up time was 3.4 years (range 1.2-7.2). Nine patients completed the ASK questionnaire, with a mean score of 93.9 (range 68.9-100), and 10 patients completed the DASH questionnaire, with a mean score of 6.0 (range 0-35). The mean fractured forearm supination was 103.2 degrees compared with 109.2 degrees on the control forearm (P < 0.05). Furthermore, the mean fractured forearm trochlear notch width was 17.7 mm compared with 17.1 mm on the control forearm (P < 0.05). Similarly, the mean fractured forearm trochlear notch height was 16.5 mm compared with 17.0 mm on the control forearm (P < 0.05). This retrospective review suggests that antegrade IM nail fixation through the olecranon apophysis for ulnar fractures in skeletally immature patients is a safe procedure. There is no significant ulnar length disruption or functional limitations, despite the differences in trochlear notch measurements and supination between the fractured and control forearms. Overall, IM nail fixation through the olecranon apophysis for surgically indicated ulnar fractures has minimal outcome limitations, with no evidence of prospective growth disruption. A larger randomized prospective trial should be conducted to strengthen the evidence of this study.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".