Fracturas periprotésicas del fémur en los reemplazos de cadera
Bibliographic record
Abstract
Background: these injuries can occur intraoperatively or postoperatively, although they are more frequent in revision surgery. With the use of biological fixation implants this kind of complications has increased. With respect to post-op fractures, (the purpose of this paper), in primary procedures the rate is about 1% while in revisions it increases to 4%. We use the Vancouver Classification, which focuses on the kind of fracture, implant stability, and bone stock Methods: we present our experience in B1 postoperative periprosthetic fractures, all treated with plate-cable. Our series includes 20 cases, of which 13 were female, 16 primary surgeries (one partial, 7 non-cemented and 8 cemented), and 4 revisions (3 cemented and 1 treated with the Link technique). In one case only cables were placed while a B3 case was treated with cortical allograft associated to plate-cable. Results: all the cases treated with plate-cable healed in 5 months and 15 days average. The case treated only with cables (osteopenic patient) refractured half a month later, requiring the use of a platecable that led to final consolidation. The patient in whom structural allograft was associated with plate-cable (B3 fracture) healed 6 months later, but suffered a refracture distal to the graft, at the level of the distal cable, which healed with non-invasive treatment. Conclusions: we believe that the use of plate-cable is a valid surgical alternative for periprosthetic fractures, especially B1. The presence of osteopenia poses the risk of compression or stress fractures at the level of the cables; in these cases structural allograft should also be used. We do not recommend the use of cables alone to stabilize periprosthetic fractures because of the risk of refractures, especially in patients with poor bone quality.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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 | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".