Factors influencing results and complications in proximal periprosthetic femoral fractures: a retrospective study at 1- to 8-year follow-up.
Bibliographic record
Abstract
BACKGROUND AND AIM: Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing and surgical management is often associated to high risk of complications, due to elderly population and associated comorbidities. We retrospectively assessed 79 patients at 1- to 8-years follow-up, focusing on factors that may have affected results and complications. METHODS: Seventy-nine PPFFs were classified according to Vancouver classification in: 4 type B1, 22 type B2, 29 type B3, 24 type C. The average age of the patients was 81.5 year-old (61-95). 37 PPFFs (12 type B2 and 25 type B3) were treated with uncemented tapered fluted revision stems (Link MP Recostruction Stem, Waldermar Link GmbH) and 42 patients with open reduction and internal fixation (ORIF). Patients were clinically and radiographically assessed at a mean 5-year follow-up (1-8 years). Elixhauser Comorbidity index was analysed. RESULTS: All PPFFs, except two, healed within 10 months. Harris Hip score at follow-up was 65.6 in ORIF group and 79.8 in revision hip group (p<0.05). 35.7% and 32.4% had blood transfusions in ORIF and revision hip group respectively (p> 0.05). 5 patients in ORIF group and 2 patients in revision hip group died within 12 months from surgery (p<0.05). CONCLUSIONS: Both ORIF and hip revision arthroplasty with modular uncemented tapered fluted stems are valid procedures for Vancouver B2 and B3 PPFFs. Restricted weight-bearing, high number of comorbidities with elevated Elixhauser Comorbidity Index and ORIF are associated to high 12-month mortality.
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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 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| 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".