PROXIMAL HUMERAL FRACTURES TREATED WITH THE EVAN’S STAPLE
Bibliographic record
Abstract
Introduction: The Evan’s staple is an intramedullary device. It has two 20 cm tines connected by a horizontal bar with a hole mid-apex to facilitate insertion over a K-wire and enhance fixation to the humerus by means of a tension band. Aim: To perform a retrospective review of the results of using the Evan’s staple as a means of fixation for displaced proximal humeral fractures. Method: Between 1989 and 1997 at the Toronto East General Hospital, 56 patients with displaced proximal humeral fractures were treated with an Evans’ staple. This included 14 three-part and four four-part fractures and six fracture-dislocations. The age range at the time of operation was 18–94 years. The average duration of follow-up was 48.6 months, the range being 11–99 months. The study consisted of patient chart review, radiological review and use of the DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire. Results: Complete radiological data were available for 26 patients and these showed a 100% union rate. The majority (77%) healed in neutral, the remainder in varying degrees of varus. Twenty-one patients returned the DASH questionnaire, with an average functional score of 37.8 (0= no disability, 100= severe disability). The complications included eight cases of impingement that required staple removal and one fracture distal to a staple caused by a subsequent fall. Conclusion: The Evan’s staple is a viable means of fixation for displaced proximal humeral fractures.
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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 | 0.000 | 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) | 0.005 | 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".