Anteromedial coronoid fractures: technical description of an extensile surgical approach and outcomes from a small series using this technique
Bibliographic record
Abstract
BackgroundVarus posteromedial rotatory instability is a difficult clinical problem to diagnose and treat. Fixation of the anteromedial coronoid fracture is often necessary to achieve elbow stability. We describe an extensile surgical approach to the anteromedial coronoid.MethodsA retrospective review was performed of all patients at our institution who had anteromedial coronoid fracture fixed with this approach between 2012 and 2020.ResultsSix patients were identified. They all achieved a stable elbow. Four of 6 developed heterotopic ossification and 2/6 required further surgery for this. Only 1 patient had a transient ulnar sensory loss.ConclusionWe describe an approach to the coronoid that allows great visualization of the joint and access to large coronoid fractures. The approach is extensile and does not require extensive dissection or work around the ulnar nerve. Access to fracture and for fixation can be improved by release of the common flexor pronator origin and the medial collateral ligament. Varus posteromedial rotatory instability is a difficult clinical problem to diagnose and treat. Fixation of the anteromedial coronoid fracture is often necessary to achieve elbow stability. We describe an extensile surgical approach to the anteromedial coronoid. A retrospective review was performed of all patients at our institution who had anteromedial coronoid fracture fixed with this approach between 2012 and 2020. Six patients were identified. They all achieved a stable elbow. Four of 6 developed heterotopic ossification and 2/6 required further surgery for this. Only 1 patient had a transient ulnar sensory loss. We describe an approach to the coronoid that allows great visualization of the joint and access to large coronoid fractures. The approach is extensile and does not require extensive dissection or work around the ulnar nerve. Access to fracture and for fixation can be improved by release of the common flexor pronator origin and the medial collateral ligament.
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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 | 0.001 | 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".