Current Concepts in Treatment of Fracture-Dislocations of the Proximal Interphalangeal Joint
Bibliographic record
Abstract
Sir: We are very pleased to see your recent publication regarding proximal interphalangeal joint fractures. Your excellent review of techniques for this very challenging hand surgery problem is very informative. We also agree with your conclusion that “the consensus appears to favor less invasive techniques whenever possible.” We would like to draw your attention to a publication in Techniques in Hand and Upper Extremity Surgery.1,2 In this article by Siddiqui, Hossain, and Huq, 12 patients were treated using a completely noninvasive traction device system in which no Kirschner wires were required (Fig. 1). A final arc of the proximal interphalangeal joint fractures in this study averaged 89 degrees (range, 25 to 111 degrees).Fig. 1: (Left) Lateral radiograph of a patient at presentation. Note the volar lip fracture with dorsal dislocation of the proximal interphalangeal joint. (Right) Lateral radiograph of the same patient at final follow-up. (Reproduced with permission. Siddiqui F, Hossain S, Huq NS. Nail hooks and elastic bands external dynamic traction for fractures of the proximal interphalangeal joint. Tech Hand Up Extrem Surg. 2012;16:148–152. Wolters Kluwer Health Lippincott Williams & Wilkins©.)The advantages of the nail hooks and elastic band external dynamic traction system is that it involves no risk of pin-site infections and no need to remove any type of Kirschner wire or fixation system. The system is similar to that of a Kleinert-type elastic traction system. The complication rate was very reasonable, in keeping with other described techniques. Perhaps this technique should be included by surgeons for treatment of intraarticular proximal interphalangeal joint fractures. DISCLOSURE None of the authors has a financial interest in any of the products or devices mentioned in this communication. Nasim S. Huq, M.D., M.Sc. Farhaj Siddiqui, M.B.B.S. Shahan Hossain, B.Sc. Niagara Plastic Surgery Centre Niagra Falls, Ontario, Canada
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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 | 0.007 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.005 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.005 | 0.007 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".