Scaphoid Nonunions in Children and Adolescents
Bibliographic record
Abstract
PURPOSE: Scaphoid nonunions are extremely uncommon injuries in children. On account of the rarity of the injury, there is no agreement about the standard method of treatment. The purpose of this study was to evaluate the clinical and radiologic outcomes after surgical treatment with bone grafting and internal fixation. METHODS: We retrospectively analyzed 23 patients aged 18 years or less with unstable scaphoid nonunions who underwent bone grafting and internal fixation. Mean age at the time of surgery was 15.1 years and the average duration of clinical follow-up was 5.2 years (range, 1-17 y). Scaphoid Outcome Score was used to assess clinical results. Radiographic evaluation included preoperative and postoperative scapholunate angle, radiolunate angle, and the scaphoid length. RESULTS: Twenty-two of 23 patients (95.6%) achieved clinical and radiographic union in an average time of 10.3 weeks (8-14 wk). One patient required a second bone grafting to heal. Functional outcomes were excellent in 17 cases, and good in 6 cases. The average scapholunate angle was 53.4+/-5 degrees preoperatively and 51.2+/-7 degrees at the final follow-up. The mean radiolunate angle was 7.4+/-5 degrees preoperatively and 4.9+/-3.9 degrees at the final follow-up. Scaphoid length increased from 21.9+/-1.1 to 23.1+/-1.2 mm (P>0.05). There were no perioperative complications. CONCLUSIONS: Clinical and radiologic outcomes are encouraging to recommend this method for scaphoid nonunions in children and adolescents. STUDY DESIGN: Case series (level of evidence, IV).
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 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 | 0.001 |
| 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 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".