531 OUTCOMES OF HIGH-ENERGY TIBIAL PLATEAU FRACTURES: A RETROSPECTIVE REVIEW.
Bibliographic record
Abstract
Purpose To evaluate perioperative complications and long-term quality of life outcomes in patients having undergone immediate open reduction and internal fixation of acute high-energy tibial plateau fractures (AO C3). Materials and Methods Retrospective review of 70 AO C3 tibial plateau fractures managed with immediate open reduction and internal fixation at the Vancouver General Hospital from December 1987 to April 2004. Chart and database review was conducted for early and late perioperative complications, and patients were surveyed using three quality of life instruments: SF36v, SMFA, and WOMAC. Results 3 (4.3%) patients had died at the time of follow-up. Of the remaining 67, 49 (73%) could be located and were contacted for follow-up. 28 of the 49 subjects (57%) completed the mail-out surveys (20 M, 8 F). Mean age of respondents at time of follow-up was 45.2 ± 9.0 years. 10 (36%) patients were pedestrians or cyclists struck by cars, 9 (32%) were injured as a result of a fall, 5 (18%) were motor vehicle collisions, 2 (7%) were sustained by a direct blow, and 2 (7%) were sustained by twisting mechanisms. Mean time from injury to OR was 56.0 ± 84.3 hours. Duration of follow-up was 8.9 ± 5.3 years. 4 (14%) patients had open fractures. Fixation methods included immediate ORIF with a single plate in 24 (86%) cases, dual plating in 3 (11%) cases, and screws alone in one (3%) case. ISS and LOS scores were 11.4 ± 6.8 and 15.7 ± 8.0 respectively. One patient (3%) experienced an early perioperative complication of excessive soft tissue tension post ORIF requiring delayed skin closure. Late perioperative complications included 9 (32%) cases of painful hardware, 2 (7%) nonunions, 2 (7%) superficial infections, 1 (3%) osteomyelitis, and 1 (3%) malunion. SMFA and WOMAC scores were 55.3 ± 9.6 and 29.44 ± 23.22. SF36v scores were 40.6 ± 10.4 (PCS) and 45.1 ± 15.8 (MCS). Conclusions Overall rates of complications were comparable to management with external fixation and delayed ORIF in literature. Immediate ORIF with careful attention to soft tissues can be a viable management option with good results in many cases of high-energy tibial plateau fractures.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| 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) | 0.001 | 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".