Short versus long intramedullary nails for intertrochanteric hip fracture: Meta-analysis
Bibliographic record
Abstract
Objetivo: Comparar el clavo intramedular corto frente al clavo largo en las fracturas intertrocantéricas de cadera en términos de eficacia y seguridad. Métodos: Se incluyeron estudios de cohortes y ensayos clínicos aleatorizados. La calidad metodológica de los estudios se evaluó mediante la escala Newcastle-Ottawa. El metanálisis se realizó mediante el Review Manager 5.4. La heterogeneidad se comprobó con la prueba I2. Se adoptó un modelo de efectos fijos si no existía heterogeneidad. Resultados: Se incluyeron doce estudios. La tasa de reoperaciones fue inferior en el grupo de clavo corto (OR 0,58; IC del 95%: 0,38-0,88) y no existieron diferencias en cuanto a la tasa de fractura peri-implante (OR 1,77; IC del 95%: 0,68-4,60). El tiempo de cirugía y la pérdida de sangre fueron significativamente mayores en el grupo de clavo largo (DM -12,44; IC del 95%: -14,60-(-10,28)) (DM -19,36; IC del 95%: -27,24-(-11,48)). No existieron diferencias respecto a los resultados funcionales. Conclusiones: El clavo largo mostró una mayor tasa de reoperación, pérdida de sangre y tiempo quirúrgico en comparación con el clavo corto. Nivel de evidencia: III. Objective: To compare short versus long intramedullary nails for intertrochanteric hip fractures in terms of efficacy and safety. Methods: We included cohort studies and randomized clinical trials. The methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. The meta-analysis was performed using the Review Manager 5.4. Heterogeneity was checked with the I2 test. A fixed effects model was adopted if there was no heterogeneity. Results: Twelve studies were included. The reoperations rate was lower in the short nail group (OR 0.58, 95%CI 0.38-0.88) and there were no differences regarding the peri-implant fracture rate (OR 1.77, 95%CI 0.68-4.60). Surgery time and blood loss was significantly higher in the long nail group (MD -12.44, 95%CI -14.60-(-10.28)) (MD -19.36, 95%CI -27.24-(-11.48)). There were no differences in functional outcomes. Conclusions: The long nail showed a higher reoperation rate, blood loss and surgery time compared to the short nail. Level of evidence: III.
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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 | 0.011 | 0.016 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.033 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".