Management of Vancouver type B1 periprosthetic femoral shaft fracture by reversed contralateral distal femur locking plate
Bibliographic record
Abstract
Background:Vancouver B1 periprosthetic femoral fractures are described as fractures occurring around the stem tip in which the prosthesis is stable. Treatment options include Mennen plates (CMW Laboratories, Exeter, England), the Dall-Miles plate and cable system (Stryker Howmedica, Rutherford, New Jersey), dynamic compression plates, conventional plates, cerclage cables, locking compression plates, and strut allografts with or without plating. The aim of this study was to describe the efficacy of contralateral distal femur locking plate used in reverse for the management of type B1 periprosthetic femur fracture when used in conjunction with intra-operative demonstration of prosthesis stability and correct classification of these fractures. Methods: Total 9 patients with Vancouver Type B1 periprosthetic fractures were enrolled in the study. Average age of all patients was 57.6 years with 8 male and 1 female. All patients were managed by open reduction and internal fixation by reversed contralateral distal femur locking plate and cables/circlage wiring and followed up for a minimum of 12 months. Patients were evaluated both clinically and radiologically. Results: All fractures were united at an average of 14.5 weeks. Harris hip score at final follow-up was 86. One patient had superficial wound infection. The infection was successfully treated by irrigation and debridement of wound and intravenous antibiotics. Conclusion: We observed good functional outcome in patient treated with reversed contralateral distal femur locking plate. We conclude that reversed contralateral distal femur locking plate is a reliable, effective and relatively cheaper option for management of Vancouver B1 periprosthetic femoral shaft fracture.
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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 | 0.000 | 0.001 |
| 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) | 0.001 | 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 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".