Arthroscopy‐Assisted Closed Reduction and Percutaneous Nail Fixation of Unstable Ankle Fractures: Description of a Minimally Invasive Procedure
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Bibliographic record
Abstract
When one is surgically managing an unstable ankle fracture, anatomic reduction of the syndesmosis is typically accomplished using an open surgical approach. We propose an arthroscopically assisted technique that restores normal anatomy while using a percutaneously placed intramedullary nail to fix the fibula. The patient is positioned supine, and the ankle is placed under traction by use of a tensor bandage. Standard anteromedial and anterolateral arthroscopy portals are used. The joint is examined for bony, ligamentous, and chondral injury. Lateral malleolus fracture reduction is accomplished with pointed reduction forceps to apply traction and rotation to the tip of the distal fibula fragment. A retrograde fibular intramedullary nail (Acumed, Hillsboro, OR) is inserted under fluoroscopic guidance. Arthroscopy is then used to guide the reduction of the fibula and rotation of the fibula with placement of the arthroscope in the lateral gutter. Syndesmosis screws are placed once the fracture and syndesmosis reductions are confirmed through both fluoroscopy and arthroscopy.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 it