Restoration of Sensation and Thumb Opposition Using Nerve Transfers Following Resection of a Synovial Sarcoma of the Median Nerve
Bibliographic record
Abstract
Synovial sarcomas of peripheral nerves are rare and often leave major functional deficits after wide excision. We present a case of median nerve reconstruction using nerve transfers after resection of a synovial sarcoma of the median nerve. Sensation was restored by transferring the fourth common digital nerve to the first and second common digital nerves. Thumb opposition was restored by transferring the abductor digiti minimi branch to the recurrent motor branch. The soft tissue defect was reconstructed with a free gracilis muscle flap. Fifteen months after surgery, there was Medical Research Council grade 4+ opposition strength with co-contraction of the abductor digiti minimi. Sensation recovered slowly over time. The Disabilities of the Arm, Shoulder, and Hand score decreased from 47.4 before surgery to 13.3 afterward. The patient was able to use the right hand for writing and crafting pottery. Distal nerve transfers are a reliable option for reconstruction of complete median nerve defects.
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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 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".