We reviewed prospectively, after skeletal maturity, a series of 24 patients (25 hips) with severe acute-on-chronic slipped capital femoral epiphysis which had been treated by subcapital cuneiform osteotomy. Patients were followed up for a mean of 8 years, 3 months (2 years, 5 months to 16 years, 4 months). Bedrest with 'slings and springs' had been used for a mean of 22 days (19 to 35) in 22 patients, and bedrest alone in two, before definitive surgery. The Iowa hip score, the Harris hip score and Boyer's radiological classification for degenerative disease were used. The mean Iowa hip score at follow-up was 93.7 (69 to 100) and the mean Harris hip score 95.6 (78 to 100). Degenerative joint changes were graded as 0 in 19 hips, grade 1 in four and grade 2 in two. The rate of avascular necrosis was 12% (3 of 25) and the rate of chondrolysis was 16% (4 of 25). We conclude that after a period of bed rest with slings and springs for three weeks to gain stability, subcapital cuneiform osteotomy for severe acute-on-chronic slipped capital femoral epiphysis is a satisfactory method of treatment with an acceptable rate of complication.
[Show abstract][Hide abstract] ABSTRACT: Frontal "depowered" air bag systems are underdesign today to be even more effective than current air bags in saving lives, while at the same time reducing the potential of causing an air bag induced serious injury or death. Stereovision real-time occupant sensing systems (airbag suppression) have been developed at Delphi Automotive Systems for use in comercial vehicle applications. One of the issues in such a system is that the irrelevant non-stationary background information within the field of view of the cameras results in less robust occupant classifications. In this paper, a disparity-based image segmentation method is provided. The input images are first segmented according to a pre-determined disparity threshold map and the real-time disparities of the occupants. Binary image processing techniques are used to reject noise introduced into the segmented images through low- resolution disparity calculations. The segmented images are then used for image feature extraction for a neural network classifier. For comparison, two neural network classifiers were created with and without the infrared image segmentation. Our experiements on segemnted images shown an increase of the classifier performance by at least 23% on a large database of IR images collected in extreme outdoor conditions.
[Show abstract][Hide abstract] ABSTRACT: Estimating the probability distribution of deformation is essential in the performance-based design. As for composite breakwaters, the most significant performance requirement is usually the stability against sliding. Several criteria, such as the expected sliding distance and the exceedance probability for certain sliding distance during its lifetime, are proposed in order to optimize the design from an economical standpoint. In this paper, the verification procedures of the sliding stability are described and the most rational thresholds of these criteria according to the significance of the structures are proposed. This design method guarantees the structures for same stability irrespective of design conditions, such as extreme wave statistics, water depth, and tidal range. This procedure can be applicable not only to composite breakwaters, but also to other coastal structures.
[Show abstract][Hide abstract] ABSTRACT: The incidence of slipped upper femoral epiphysis is 10 per 100 000 in the age groups most at risk. The commonest presenting features include groin, thigh, or knee pain, with limp, hip ‘irritability’, external rotation, and restriction of flexion and abduction. In girls the peak incidence is between 10 and 13 and in boys between the ages of 12 and 15. Most cases are idiopathic and associated with a high body mass index. Slips usually occur through the proliferative and hypertrophic zones of the growth plate. The chief complications are avascular necrosis and chondrolysis. The treatment of a slip is usually by pinning in situ. A severe slip is very disabling, even if AVN is avoided. Surgery to correct the deformity is either by some variant of intra-capsular neck osteotomy, or by an extra-capsular osteotomy. In the past, intra-capsular osteotomy was blamed for causing AVN, but recent experience suggests that it is the setting in which it is considered [severe, often unstable slips] which is the cause of the AVN, not the procedure itself.
Orthopaedics and Trauma 06/2009; 23(3):169-174. DOI:10.1016/j.mporth.2009.05.005
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