TWO-YEAR RESULTS OF A PROSPECTIVE STUDY ON THE NATURAL HISTORY OF NON-OPERATIVELY TREATED TYPE III ACROMIOCLAVICULAR JOINT DISLOCATIONS
Bibliographic record
Abstract
We present 2 year results of a prospective natural history study of Type III Acromioclaviclular joint dislocation (ACJD) treated non-operatively. Previous natural history studies are compromised by inconsistent definitions of the grade of injury and non-validated scoring tools; they do not identify which patients will have ongoing symptoms. This trial documents the strength and subjective recovery over time, and identifies risk factors for poor outcome and need for surgery. Patients with Rockwood Type III ACJD received a standardised rehabilitation protocol (6 sessions of physiotherapy). Clinical assessment was performed at presentation, 3, 6, 12 and 24 months after injury, including isometric strength testing, pain (VAS/10) and subjective scores – Subjective percentage of normal (SPON), American Shoulder and Elbow (ASES), Oxford Shoulder Score (OSS) and Quick Disabilities of Arm Shoulder and Hand (qDASH). 28 male patients were recruited, 26 reached 12, and 9 to 24 months follow up. Two required surgery and one emigrated. The mean age was 39 (15 to 67). Initial mean pain was 3/10, SPON 51% (6–95) and strength was 76% of the other side. By 3 months mean subjective recovery was 70% and strength 90%. Strength recovered to 99% of normal by 12 months but subjective scores remained at mean 90%; by 24 months subjective scores were mean 94%. 2 patients had subjective scores There was a wide range of initial subjective scores and weakness after Type III ACJD. 95% of strength had recovered by 6 months and subjective scores recovered to 94% of normal by 24 months. 4 patients (14%) did poorly with 2 requiring surgery. Low initial subjective score and inability to abduct the arm at presentation were risk factors for a poor outcome.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
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".