Variation of Syndesmosis Anatomy With Growth
Bibliographic record
Abstract
BACKGROUND: Syndesmosis injury is common in trauma and in the sport medicine population. Diagnosis and treatment of this pathology is controversial in adult population and almost unknown in a growing and immature ankle. The objective of this study was to describe the relationship between the distal tibia and fibula in immature, growing, and mature children. METHODS: A retrospective imaging study was performed on ankle magnetic resonance images (MRI), which were divided into 3 groups according to age: immature, growing, or mature. The syndesmosis anatomy was described in 3 planes following an established measurement system. The measurement system was also validated (intraobserver and interobserver reproducibility) on a subgroup of 30 MRIs with 4 surgeons. RESULTS: The measurement system, previously described on CT scans, is valid when used on MRIs. The mediolateral translation significantly increases with growth and external rotation of fibula decreases. The anteroposterior position is also significantly different between groups but the ratios are similar. CONCLUSIONS: This study reported differences in distal tibiofibular relationship in a growing population. This information will be crucial in future development of diagnostic and follow-up criteria of syndesmosis injury. It also presented a valid and precise measurement system to describe syndesmotic anatomy in 3 planes. LEVEL OF EVIDENCE: Level IV.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".