Intraoperative periprothetische Femurfrakturen – wann reicht die Cerclage?
Bibliographic record
Abstract
BACKGROUND AND PLANNING: Intraoperative periprosthetic femoral fractures are among the most serious complications in both primary and revision arthroplasty. They are often not detected, despite intraoperative radiological control. Since an unnoticed intraoperative fracture often requires revision surgery, which has been associated with increased mortality rates, intraoperative diagnosis and corresponding direct and sufficient treatment are crucial. There are patient-, surgery-, and implant-specific risk factors that increase the possibilities of intraoperative fractures. The most common risk factors on the patient side are age, gender, and various pre-existing conditions, such as osteoporosis or rheumatic diseases. A minimally invasive approach and a cementless press-fit fixation are the most significant surgery- and implant-specific risk factors. The Vancouver classification or the modified Mallory classification are available for the classification of intraoperative periprosthetic femoral fractures. Based on these classifications, treatment recommendations can be derived. Different strategies are available for fracture management. THERAPY: Generally, if the stem is stable, osteosynthesis can be performed with preservation of the implant. This procedure can be applied to the majority of cases with non-displaced fractures by using cerclages as fixation. An unstable implant may require replacement of the stem. In higher grade fractures, stabilisation by using plate osteosynthesis may be necessary. The aim is to achieve the most anatomical reposition possible for the best possible bony consolidation. The ultimate goal is high implant stability and restoration of the biomechanics.
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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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.005 | 0.004 |
| Meta-epidemiology (broad) | 0.009 | 0.004 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.007 |
| Insufficient payload (model declined to judge) | 0.006 | 0.032 |
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; both teacher heads agree on what is shown here.
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".