Treatment of periprosthetic fracture Vancouver B2-B3 in cementless total hip arthroplasty: are we able to predict stem mobilization?
Bibliographic record
Abstract
BACKGROUND: In common clinical practice a definitive statement on stem mobilization in periprosthetic fracture (PPF) Vancouver B2-B3 is only possible during surgery. The aim of this work was to identify preoperative Radiological Index of stem mobilization and report outcome at mid-term follow-up of patients with PPF.METHODS: Inclusion criteria were: patients with a femoral PPF classified as Vancouver B2 or B3, age >18 years, previous implant of cementless total hip arthroplasty or hemiarthroplasty, capability of giving informed consent, complete clinical and radiological follow-up of minimum 1 year, surgical treatment with osteosynthesis (ORIF) or stem revision (SR). All the preoperative X-rays were analyzed using the Gruen system in antero-posterior (AP) and latero-lateral (LL) views and the proximal femur was divided into 3 zones in both projections. The preoperative blinded measurement of interested Gruen zones was investigated to search if it can predict intraoperative verified stem mobilization.RESULTS: A total of 104 patients were included in the study. A total of 61 patients underwent ORIF and 43 patients underwent SR. All the 43 patients who showed a stem mobilization showed a minimum of three zones interested by fracture. This preoperative quantification of fractured femoral zone showed a 100% sensibility and 64% specificity if we considered a threshold of minimum three involved zones, and 67% sensibility and 98% specificity if we considered a threshold of minimum four involved zones.CONCLUSIONS: A preoperative evaluation and stadiation of Gruen zones involved in PPF could help in planning the correct surgical procedure for these fractures.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | high |
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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".