The Effect of Scaphoid Morphology After Surgical Fixation of Scaphoid Nonunions on Long-term Functional Outcomes and Scaphoid Union Rates
Bibliographic record
Abstract
Abstract Scaphoid nonunion can progress to wrist pain, stiffness and an established pattern of wrist arthritis. The effect of scaphoid malunion on clinical outcomes is largely unknown. In this study, the effect of scaphoid morphology on union rates and clinical outcomes is explored using a prospectively collected database of surgeries. The primary aim of the study is to understand the effect of initial post-surgical scaphoid morphology on union. The secondary aim examines the effect of final scaphoid morphology on long-term functional outcomes among patients that underwent surgical fixation for scaphoid nonunion and ultimately went on to union. 84 participants were included in this study. 74 (88.1%) nonunions went to union, and 10 (11.9%) remained persistent nonunions after surgery. After nonunion surgery, the initial post-operative height-to-length (H/L) ratio was predictive of scaphoid union. For every 0.1 increase in H/L ratio, odds of union were reduced by 53.7%. Of the patients who progressed to union, there was a significant relationship (p=0.019) between initial post-operative H/L ratio and final DASH scores. It was found that there was a 35.9% increase in DASH score for every 0.1 increase in H/L ratio. Similarly, there was a significant relationship (p=0.013) between final post-operative H/L ratio and final DASH scores where an increase of 0.l in H/L ratio translated to a 33.5% increase in DASH. The authors propose that the restoration of initial post-operative H/L ratio can predict odds of union after surgical fixation of an established scaphoid nonunion. Improved morphology at union as measured by H/L ratio also demonstrated improved functional outcomes, such as DASH score.
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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 | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| 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".