Posterolateral Rotatory Instability of the Elbow Following Radial Head Resection
Bibliographic record
Abstract
BACKGROUND: Resection is a common procedure for the treatment of comminuted fractures of the radial head. While radial head resection is associated with a high success rate when performed for appropriate indications, a number of well-defined biomechanical complications have been reported following this procedure, including proximal migration of the radius, the development of valgus deformity, and recurrent elbow instability in the acute setting. However, posterolateral rotatory instability has not previously been recognized as a complication of radial head resection. While the absence of the radial head makes the diagnosis difficult, we have identified a series of patients with posterolateral rotatory instability following radial head resection. We believe that this instability is secondary to unrecognized lateral ulnar collateral ligament deficiency. METHODS: Between November 1995 and September 2000, forty-two patients were evaluated because of elbow or forearm complaints following radial head resection. Seven patients (17%) were diagnosed with posterolateral rotatory instability on the basis of characteristic clinical and radiographic findings. RESULTS: The study group included five men and two women with a mean age of forty-two years. All seven patients had had radial head excision for the treatment of a comminuted radial head fracture at a mean of forty-four months (range, four months to sixteen years) prior to referral. All seven patients had lateral elbow pain, a sense of instability and/or weakness, and a positive lateral pivot-shift test. Posterolateral rotatory instability secondary to lateral ulnar collateral ligament insufficiency was confirmed intraoperatively in the four patients who were managed surgically. CONCLUSIONS: Clinicians should be aware that posterolateral rotatory instability may be a cause of unexplained elbow pain and instability following radial head resection. This diagnosis has implications for the prevention and treatment of this condition.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".