Surgical Options in Periprosthetic Fractures
Bibliographic record
Abstract
Abstract Purpose. The periprosthetic fractures are a more and more often encountered type of pathology, in which the main problem is the indication for surgery. The most important thing is the choice of the best therapeutic option in order to get a solid fixation of the fracture and, in the end, to allow an early patient’s mobilization. Materials and method. 38 cases of periprosthetic fractures have been treated in the Orthopedics and Traumatology Department of University Emergency Hospital in Bucharest, between 2010 and 2016. International Vancouver classification was used for all cases. The osteosynthesis saving the femoral stem was preferred in 22 cases, as its stability was not affected. Stem revision was performed in 16 cases, as this was unstable due to the fracture. Acetabular component was also revised in 4 cases, as the PE insert presented severe wear. The patients were aged 52 to 84 years old and sex ratio M/ F = 13/ 25. Osteosynthesis was performed using Dall-Miles plates and molded plates, with braided cables or wire cerclage. Long stems, uncemented with or without distal locking, were used in 16 cases. Results. Postoperatively, the bone repair was efficient regarding the stability in most of the cases. The patients’ mobilization was early in most of the cases, except for the very old patients with associated comorbidities and limited biological resources. Conclusions. An appropriate surgical indication, adapted on each type of peri-implant fracture, leads to a good result, with early mobilization and the best consolidation of the fracture.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".