A NEW TELESCOPIC FEMUR NAIL FOR THE TREATMENT OF OSTEOGENESIS IMPERFECTA
Bibliographic record
Abstract
Purpose: The use of telescopic nails has enabled a reduction in the rate of re-operation during growth from 51% observed with non-telescopic nails to 27%. This difference is less pronounced in the long term due to mechanical complications and secondary joint problems. We report our experience with the telescopic nail developed for osteogenesis imperfecta of the femur. This nail is inserted antegrade via a small superior incision, avoiding the problems associated with surgical approach via the knee joint. The distal and proximal fixation are achieved by screwing the nail into the epiphysis. Material and methods: The telescopic nail was used for 43 femurs and 1 humerus in 29 children (osteogenesis imperfecta in 28, skeletal dysplasia in 1) who were reviewed at a mean 34 months. Mean age at surgery was 47 months (range 13 months – 11 years). Results: The telescopic nail deployed normally in 93.2% of the children. Complications not requiring re-operation were observed in 20.5% of the patients: migration of the proximal part of the nail (n=3), material deformation or stress fracture (n=4), loss of distal epiphyseal fixation (n=1). Surgery was required because of complications in three children: intra-articular protrusion of the male part of the nail requiring repositioning, proximal migration of the female part of the nail into the buttocks subsequent to weight-bearing too early, and loss of distal epiphyseal fixation due to inappropriate intra-operative manipulation. Discussion: These early results (follow-up less than three years) demonstrate that this new implant is useful in osteogenesis imperfecta. It enables minimally invasive treatment and reduces the rate of complications without the risk of knee arthrotomy.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.002 | 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".