Distal Clavicle Insufficiency: Reconstruction With Iliac Crest Autograft of the Distal Clavicle and Acromioclavicular‐Coracoclavicular Reconstruction
Bibliographic record
Abstract
Distal clavicle insufficiency, or a loss of the bony structure of the distal clavicle, generally after an injury or surgical procedure, may result in shoulder pain, dysfunction, scapular dyskinesia, and chronic acromioclavicular joint instability. If more than 15 to 20 mm of the distal clavicle is missing, chronic posterior instability of the distal clavicle may ensue and impinge on the deltotrapezial fascia and scapular spine. Although soft tissue reconstruction of the acromioclavicular-coracoclavicular (AC-CC) ligaments is a reliable procedure, if there is 15 to 20 mm or more of distal clavicle missing, it may be difficult to restore the mechanics of the scapular and glenohumeral joint. These can be seen after open or arthroscopic Mumford procedures (distal clavicle excision), AC-CC reconstructions with fracture, distal clavicle fractures, and other mechanisms. This technique article outlines an approach to distal clavicle insufficiency (>20 mm of missing distal clavicle bone) with iliac crest bone autograft reconstruction of the distal clavicle augmented with AC-CC soft tissue reconstruction.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".