The Missed Scaphoid Fracture–Outcomes of Delayed Cast Treatment
Bibliographic record
Abstract
Background The purpose of this study is to evaluate outcomes (report union rates and times based on CT) for subacute scaphoid fractures, defined as those presenting between 6 weeks and 6 months from injury. Questions 1) What are the expected union rates for subacute scaphoid fractures? 2) What are the expected union times for subacute scaphoid fractures? 3) Is it worth trialing a period of cast immobilization for these patients? Methods All isolated sub-acute scaphoid fractures that presented at our institution between 2006 and 2010 were identified. Each subject's health record, CT scans and X-rays were retrospectively reviewed. Results There were 20 males and 8 females, with a mean age of 30, treated with casting alone. There were 20 waist, 7 proximal and 1 distal pole fracture. The mean casting time was 11 (waist) and 14 (proximal pole) weeks with a union rate of 82% (23/28). Diabetes, comminution and a humpback deformity increased the non-union risk in this cohort. Exclusion of these cases resulted in a 96% union rate (23/24). Conclusion Subacute scaphoid fractures (presenting within 6 months from injury) can be expected to successfully heal with casting alone, even if the initial diagnosis is delayed. The expected time frame for union with cast treatment is shorter than previously reported. Level of Evidence 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 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".