Total Hip Replacement after a Failed Trochanteric Fracture Fixation: A Case Report
Bibliographic record
Abstract
Abstract Intertrochanteric fractures are common in the elderly, with high mortality (15%–20% annually). Internal fixation is the standard treatment, but failures may require revision with total hip arthroplasty (THA), where the stem choice is controversial due to challenges like scar adhesion and implant stabilityA 58-year-old woman with a right intertrochanteric fracture from a road accident initially treated with proximal femoral nailing developed nonunion and lag screw backout. After uncemented THA, she experienced dislocation and an iatrogenic periprosthetic fracture (Vancouver B2) during closed reduction. Revision THA via a posterior approach involved careful dissection due to adhesions. A shorter stem and a long distal femur anatomical plate stabilized the fracture. A recurrent dislocation was managed with open reduction and capsular closure. Postoperative care included a broomstick cast, followed by progressive mobilization. At 6 months, she ambulated independently with excellent recovery. This case illustrates the complexities of failed trochanteric fracture management, emphasizing individualized surgical approaches. Successful revision THA with a shorter stem and additional fixation offers valuable insights for similar cases.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.011 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".