Greater Arc Perilunate Injury Through a Lunotriquetral Carpal Coalition
Bibliographic record
Abstract
CASE: A 31-year-old Caucasian man presented with a greater arc perilunate variant injury after falling from a friend's shoulders onto an outstretched hand. Imaging revealed a minimally displaced scaphoid waist fracture and a nondisplaced transverse fracture through a previously unrecognized lunotriquetral coalition. A volar intercalated segmental instability (VISI) deformity was present. Open reduction with osseous fixation (a headless compression screw for the scaphoid waist fracture and 3 Kirschner wires across the midcarpal joint) and repair of the torn volar ligaments partially restored the carpal alignment. At 1 year postoperatively, the patient had regained approximately 90% of grip and pinch strength, 70% of wrist flexion, and 80% of wrist extension when compared with the contralateral, uninjured side. Despite persistent VISI alignment, he was satisfied with the outcome and had returned to his preoperative employment and recreational activities. CONCLUSION: A high index of suspicion for a perilunate injury should be maintained for all scaphoid fractures, particularly when abnormal anatomy is present.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".