To Analyze the Outcomes of Various Methods of Treatment of Periprosthetic Fracture Following Hip Arthroplasty- A Retrospective Study to Form the Optimal Treatment Guidelines
Bibliographic record
Abstract
Background: Periprosthetic fracture of femur after total hip arthroplasty (THA) is a well-known complication. Mayo clinic joint registry has reported 1.1% incidence of periprosthetic femoral fractures after primary THA and 4% incidence after revision THA. This study was conducted to analyse the results of various methods of treatment of periprosthetic fractures following THA and to form the optimal treatment guidelines for fixation or revision surgeries. Material and Methods: Out of 4790 primary hip arthroplasty cases, a total of 51 fractures in 48 patients were enrolled. The previous records and radiographs of the patients were retrieved and the type of periprosthetic fracture classified according to Vancouver classification developed by Duncan and Masri. Sequential x-rays of the hip were taken to assess union, osteolysis, implant loosening and subsidence. The time to union was recorded. Results: Vancouver Type B1 and type C fractures, managed with open reduction and internal fixation (ORIF) using 4.5mm, titanium, broad, locking compression plate (LCP) system. All the fractures of Vancouver B2 and B3 Type were managed with revision total hip arthroplasty using standard posterior approach to the hip. There was no increment seen in the pre-op and post-op HHS in Type B1 & C fractures. An increase in post-op HHS values was seen in revision group which increased around 6 points in B2 fractures and 9 points in B3 fractures. None of the patients improved their ability of walking after these fractures. 23 patients (48%) had not regained their pre-fracture walking status at the 6-month follow-up. Conclusion: If the prosthesis is stable, osteosynthesis with long LCP plate is superior to conventional plate. For loose prosthesis, revision surgery with long uncemented distally fitting stem is the preferred treatment.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| 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, 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".