Outcomes of traumatic Vancouver type AG periprosthetic fractures treated nonoperatively
Bibliographic record
Abstract
Introduction: The optimal treatment for postoperative Vancouver AG fractures has not been established. This study is a case series investigating the outcomes of patients from a single, academic tertiary referral center with conservative management of postoperative, traumatic periprosthetic fractures, specifically Vancouver type AG fractures. Methods: This study was a retrospective review of 225 patients diagnosed with periprosthetic fracture at an academic, tertiary referral center from January 2007 to June 2023. Of these patients, 18 were identified as having Vancouver Type AG fractures and underwent conservative treatment with a walker. Radiographic fracture healing, patient reported pain, ambulatory status, and abductor strength were evaluated. Results: All 18 patients included in this case series suffered from traumatic postoperative periprosthetic fractures from falls, and none were noted to have any concomitant osteolytic changes. Mean age at the time of fracture of 81.4, range (62-96). Mean BMI at the time of fracture was 24.1, range (18-38.1). 1 patient passed away from unrelated medical problems 3 months after fracture onset, 2 were lost to follow-up after emergency department (ED) discharge, 3 demonstrated healing, but not yet fully healed fractures at their last follow-up, and 3 patients presented to the ED at a much later time for non-orthopaedic related issues and demonstrated healed fractures on radiographic. For the remaining 9 patients, mean length of time to heal after onset of fracture was 14.2 weeks, range (6-44). No weakness was noted during their last follow-up, and only 1 patient noted residual 1 of 10 pain. 5 patients noted to using walkers, 3 using canes, and 1 interchanging between a walker and cane during the last follow-up. Conclusion: Patients with minimally to nondisplaced Vancouver type AG can achieve fracture healing and pain resolution with conservative, protected weight-bearing management in the setting of postoperative trauma.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".