Soft tissue complications following extensile lateral compared with minimally invasive surgical approaches in the operative treatment of calcaneus fractures
Bibliographic record
Abstract
BACKGROUND: Extensile lateral (ELA) and minimally invasive surgical (MIS) approaches are commonly used in the operative fixation of calcaneus fractures. The ELA has been the standard of care, but is associated with a high risk of wound complications. Minimally invasive surgical approaches have been developed to reduce these complications. METHODS: We completed a retrospective chart review of 201 patients with calcaneus fractures repaired by either ELA or MIS approaches between 2011 and 2018. We compared the incidence of soft tissue complications, including wound infections (requiring no surgical treatment) and deep infections (requiring surgical intervention), and performed multivariate regression analysis to determine independent risk factors associated with soft tissue complications and reoperation. RESULTS: = 0.003). Risk factors of soft tissue complications included the presence of an open fracture (odds ratio [OR] 11.59, 95% confidence intervals [CI] 3.25-44.25) and use of ELA (OR 4.22, 95% CI 1.67-10.90). Risk factors for a deep infection requiring reoperation included the use of ELA (OR 4.43, 95% CI 1.51-13.64) and the presence of an open fracture (OR 4.00, 95% CI 0.91-15.3). CONCLUSION: The ELA is associated with an increased incidence of soft tissue complications and reoperation when compared with the MIS approach. The ELA and open fractures were found to be independent risk factors of soft tissue complications and reoperation. Surgeons treating calcaneus fractures should consider using a MIS technique, provided they are able to achieve the goals of surgical management without the ELA.
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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) | 0.001 | 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".