Traumatic Volar Carpal Instability Nondissociative: A Case Series
Bibliographic record
Abstract
Carpal instability nondissociative (CIND) involves disruption between carpal rows from injury to extrinsic and intrinsic wrist ligaments. CIND traumatic (CINDT) highlights the posttraumatic etiology of some of these cases and has been gaining increasing attention in the literature. We present four cases of CINDT-volar intercalated segmental instability (VISI). We diagnosed two adults with distal radius fractures and two adolescents with Galeazzi fractures, all treated surgically, who developed CINDT-VISI with radiolunate angles greater than 15° at 2 weeks after surgery. One adult had progressive deformity but was asymptomatic at 33 months. The other underwent volar capsular release at 1 year to improve alignment. One adolescent with a fixed deformity required soft tissue releases and temporary pinning to restore alignment at 7 months. We treated the other successfully with early physiotherapy. No patient had radiographic signs of arthritis at 1-2 years. This is the first reported association between Galeazzi fractures and CINDT-VISI. Contrary to existing literature, we report successful outcomes with nonsurgical and delayed nonfusion surgery of CINDT-VISI.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".