Early mobilization for suspected scaphoid injuries in children: a feasibility study
Bibliographic record
Abstract
BACKGROUND: The optimal management of children with a suspected scaphoid fracture and normal radiographs is unclear. Traditionally, children have been treated with empiric cast immobilization or with early CT or MRI to avoid missing an occult fracture. An early range of motion (ROM) protocol for these children may be an alternative strategy. METHODS: We conducted a prospective study to test the feasibility and potential benefits of an early ROM protocol for children with a clinically suspected scaphoid fracture but normal radiographs. Participants were evaluated at 6 weeks and, for those with a confirmed fracture on CT, at 26 weeks after injury. RESULTS: Of the 39 children (median age 12.2 years; interquartile range 10.6 to 13.8 years), 15 had a scaphoid fracture confirmed on CT. Participant retention rate was 36 of 39 (92%; 95% CI: 80 to 97%) at 6 weeks, and 12 of 15 (80%; 95% CI: 55 to 93%) at 26 weeks. Participants tolerated the protocol without concerns. There were no instances of non-union, avascular necrosis, or other adverse events. CONCLUSION: An early ROM protocol for children with suspected scaphoid fractures but normal radiographs may reduce overtreatment and dependence on advanced imaging. Further study is feasible and required. LEVEL OF EVIDENCE: III.
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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 | 0.008 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".