AB088. SOH22ABS155. Cement-in-cement revision for selected Vancouver B for proximal femur periprosthetic fractures
Bibliographic record
Abstract
Background: The incidence of periprosthetic proximal femoral fractures is increasing with the increase in arthroplasty being performed as well as aging populations. Traditionally cement has been removed as part of revision. We describe a cement-in-cement technique utilising a well-fixed cement mantle. The advantages of this allow for a shorter operative time, reduction in risk of iatrogenic femoral fracture and reduction in blood loss. Methods: This was a retrospective study reviewing 20 patients that underwent this technique for periprosthetic fracture. This novel technique involved reducing the fracture and the cement mantle with Dall-Miles cables, cementing a new stem into the pre-existing mantle and bypassing the fracture site with extramedullary fixation. Results: All bar one fracture united uneventfully. Six patients underwent subsequent surgery for complications. Three were for revision of the liner to a constrained liner for dislocation. One was for refracture at the fracture site, one was for stem pull out after an attempted reduction and one was for a femoral stem fracture. Conclusions: This technique offers a successful operative option that can allow for shorter operative times and a lower physiological insult in reducible periprosthetic proximal femur fractures with a stable cement mantle.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".