Prise en charge des fractures Vancouver B péri hémiarthroplastie de hanche autour d'une tige conique polie miroir : une étude rétrospective à propos de 92 cas
Bibliographic record
Abstract
Introduction: Periprosthetic hip fracture is a serious complication associated with increased mortality and impaired mobility. When the implant is loosened, the standard treatment involves prosthetic revision. The aim of this study is to determine whether, in the low demand elderly population presenting with a periprosthetic fracture around a polished tapered stem hemiarthroplasty, there is a difference in postoperative complications between osteosynthesis alone and prosthetic revision. Materials and Methods: In a single-center, retrospective observational study, all patients treated between 2005 and 2024 for periprosthetic fractures after hemiarthroplasty were included. Demographic, anesthetic, and surgical data were collected retrospectively. Group comparability was established using a propensity score. The primary outcome was a composite criterion including the occurrence of a complication requiring death within one month postoperatively or surgical reintervention. Results: A total of 92 patients were included in the study, with an average age of 88.7 years. There was no significant difference between the two groups for the primary outcome. The 1-year mortality rate was 29%. The reoperation rate was 27% (48% for dislocations and 40% for infections). Osteosynthesis provided benefits in terms of shorter operative time, reduced blood loss, reduce the stays in hospital, and preserved mobility. Discussion: Our results support the idea that, in elderly, frail patients with low functional demands, the Vancouver-SOFCOT revision recommendations can be adapted. For all type B fractures, if the fracture is reducible and the cement mantle is well-fixed to the bone and of good quality, osteosynthesis is a reliable treatment option.
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| 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".