122 ISAKOS subclassification of Rockwood type III AC joint dislocations in a stable and an unstable type is not clinically relevant
Bibliographic record
Abstract
Background ISAKOS upper extremity committee has suggested a subclassification of Rockwood type III acromioclavicular(AC) joint dislocations in a stable type A recommended non-surgical treatment and an unstable type B recommended surgical treatment. The objective of this prospective cohort study was to investigate if this subclassification is clinically relevant. Methods Inclusion criteria were patients aged 18–60 with acute AC joint dislocation and >50% superior displacement of the clavicle. Patients were treated non-surgically with 3m of home-based training and the option of delayed surgical intervention. Assessment was at baseline and 6w, 3m, 6m and 1y after the injury. At 6w, patients were classified as stable if they presented with no scapular dyskinesis (SD) and no overriding of the clavicle to the acromion on radiographs, and unstable if they presented with any of the two. The primary outcome was the Western Ontario Shoulder Instability Index(WOSI). Results Eighty-eight patients contributed data for the subclassificaton at 6w; 20 patients were classified as stable and 68 as unstable. There was a statistically significant but not clinically relevant difference in WOSI between the two groups at 6m (p=0.03), but not at 3m and 1y. No patients from the stable group had surgery. From the unstable group, 9/68 (13%) had surgery. Patients presenting with SD had worse WOSI at all time-points compared to those without SD. Conclusion The ISAKOS subclassification of Rockwood type III in a stable type A and an unstable type B is not clinically applicable. The presence of SD was associated with a worse result.
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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) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".