346 Elbow Contracture Severity at Hospital Discharge in Patients with Heterotopic Ossification
Bibliographic record
Abstract
Heterotopic ossification (HO), the development of abnormal bone in soft tissue, is an uncommon but significant complication of burn injury. HO most often affects the elbow joint and is associated with reduced range of motion (ROM), pain, and disability. The purpose of this study is to evaluate the association between the presence of HO and severity of elbow contractures. Data was obtained from the Burn Model System National Database. Contracture data was recorded between 1994 and 2003. All patients over 18 years with an elbow contracture at acute discharge were included. Elbow ROM was compared for those with and without radiological evidence of HO. Contracture severity was reported as both mean absolute loss of ROM in degrees and relative percent loss of normal ROM. Elbow ROM was further stratified by total body surface area (TBSA) subgroups (<20, 20–40, >40%) and comparisons were made between the HO and non-HO groups using two-sample t-tests. A p-value of < 0.05 was considered statistically significant. The database included 207 patients (22 with HO, 185 without HO) with 407 instances of elbow contracture. The population was 85.5% male, had a mean (SD) age of 40.2 (14.4) years, and a mean (SD) burn size of 30.1 (19.0)% total body surface area. Elbow contractures in those with HO demonstrated worse elbow flexion compared to those without HO in the whole population (mean absolute loss: 50 vs. 30 degrees, p < 0.0001). Significantly worse elbow flexion outcomes were also noted in the 20–40% TBSA group (62 vs. 28 degrees, p = 0.0003). There were no significant differences between groups (unstratified and stratified by TBSA) in elbow extension. (Table) HO is associated with worse elbow ROM for burn survivors. This study improves our understanding of the impact of HO on elbow contracture severity and association with elbow flexion contractures. The findings of this study highlight the need for additional treatment strategies for those with HO and elbow contractures.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.003 | 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".