CASE REPORT Intra-arterial Thrombolysis for Postoperative Digital Ischemia: A Case Report
Bibliographic record
Abstract
Objective: Surgical repair of digital flexion deformities can result in vascular injuries threatening the viability of the affected digit. While uncommon, these injuries are re-ported to have a rate as high as 0.8 % following palmo-digital fasciectomy forDupuytren’s disease. Late presentation of such vascular events pose a challenge, since taking the pa-tient to the operating room does not guarantee success. Methods: We report a case of subacute digital ischemia that presented 10 days following correction of a bou-tonniere deformity treated with intra-arterial thrombolysis. There were no particular intraoperative complications. The thrombolytic regimen consisted of Alteplase (Roche, Mississauga, Canada) 2 mg bolus and 1mg per hour (total 30 mg received over 28 hours) and intravenous heparin with a subtherapeutic target partial thromboplastin time of 40 to 50 seconds.Results: Thirty hours after the initiation of thrombolysis, an angiography confirmed complete reperfusion of the digital arteries at the distal interphalangeal joint that correlated with the clinical appearance of the digit. Thrombolysis was interrupted and therapeutic intravenous heparin was maintained. Bridging to warfarin was started 6 days postthrombolysis with a target international normalized ratio of 2 to 3. Unfortu-
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.010 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
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".