Révision de Prothèse Totale de Hanche pour Fracture Périprothétique du Fémur : À Propos de Deux cas
Bibliographic record
Abstract
RÉSUMÉ L’objectif de ce travail était de partager à travers deux observations cliniques les alternatives possibles de révision prothétique pour fracture périprothétique du fémur dans un contexte de ressources limitées. Il s’agissait patients porteurs de prothèses totales de hanche de première intention réalisée 10 ans et 12 ans au paravent. Ils ont présenté des fractures périprothétiques du fémur classées Vancouver C et B3 respectivement. Un patient avait un descellement cotyloïdien associé. Le traitement a consisté au changement des implants fémoraux et à l’ostéosynthèse de la fracture. L’implant fémoral était constitué d’une tige standard encastrée en bilboquet dans un clou AO scié et amputé de sa partie proximale. Cette technique permettait avoir une tige de la longueur d’une tige de révision ou de reconstruction avec une possibilité de verrouillage. La stabilité de l’ensemble était assurée par une cémentation et le verrouillage distal. La cicatrisation cutanée a été effective dans les 2 cas dans un délai de 21 jours. La consolidation osseuse a été obtenue en 4 mois et 5 mois. Au recul de 18 mois et de 25 mois, le score PMA était de 11 et 12. ABSTRACT The aim of this study was to share, through two clinical cases, possible prosthetic revision alternatives for periprosthetic femoral fractures in a resource-limited setting. The patients had undergone primary total hip arthroplasty 10 and 12 years earlier, respectively. They presented with periprosthetic fractures classified as Vancouver C and B3, with one patient also experiencing acetabular loosening. Treatment involved replacing the femoral implants and stabilizing the fractures. The femoral implant consisted of a standard stem inserted into a modified AO nail with the proximal portion removed, providing a length comparable to a revision or reconstructive stem, with the option for locking. Stability was achieved through cementation and distal locking. Both cases achieved successful wound healing within 21 days. Bone union was achieved at 4 and 5 months postoperatively. At follow-up of 18 and 25 months, the PMA (Postoperative Morbidity Index) scores were 11 and 12, respectively.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.007 | 0.003 |
| 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".