A prospective study of operative results of intra-articular fractures of proximal tibia
Bibliographic record
Abstract
Introduction: Proximal tibial fracture is a common injury, with some of these fractures being caused by a strong impact such as a traffic accident and others being caused by the relatively weak impact of a fall in elderly people. Such fractures are frequently intraarticular and comminuted and it is likely that secondary osteoarthritis will occur due to residual malalignment of the lower extremity or irregularity of the articular surface, especially in patients with comminuted intraarticular fractures. To preserve normal knee function, surgeon must strive to maintain joint congruity, preserve normal mechanical axis, ensure joint stability and restore a full range of motion. Methods: We have studied 50 cases of fractures of upper end tibia with intraarticular extension, treated at our tertiary care institute with different modalities of fixation during the period of Jan 2017 to May 2017. We used Schatzker type I – VI classification. Surgical techniques used were external fixation, open reduction and internal fixation, ligament injury repair with condylar fracture and arthroscopically assisted reduction and fixation of tibial plateau. Results: We used knee society scores (max. 350) used for final follow up at 1 year. Functional was Excellent in 82% (41), good in 6% (3), Fair in 12% (6) patients. In type I fracture 3 patients had excellent result, 1 patient had fair result. In type II/III/IV fracture all patients having excellent result. In type V fracture patients treated with double plate (2) had excellent result and single plate (15), 12 had excellent, 2 patients had good and 1 had fair result. 1 patient with preexisting osteoarthritis treated with hybrid fixator complicated by infection had fair result. 1 patient treated with C.C. (Cannulated Cancellous) screw had fair result. In type VI fracture, 6 patients treated with plate had excellent result. Out of 4 patients treated with hybrid fixator 3 had excellent result and 1 had good result. One patient had excellent and one had fair result treated with external fixator. Conclusion: Open reduction and internal fixation (ORIF) is the gold standard treatment for these fractures. Complex articular fractures can be treated by ring external fixators and minimally-invasive osteosynthesis (EFMO) or by ORIF. EFMO can be related to suboptimal articular reduction; however, outcome analysis shows results that are equal to, or even superior to, ORIF. The ORIF strategy should also include the optimal reduction of the articular surface.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".