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1.
PLoS One ; 15(10): e0241141, 2020.
Article in English | MEDLINE | ID: mdl-33091091

ABSTRACT

The transfibular approach is a common procedure for tibiotalar fusion. However, this technique has several concerns: inadequate stability to resist rotational and shearing forces, a fibula is suboptimal for bone grafting, and an onlay fibular graft that might prevent impacting and cause distraction. We present a modified transfibular technique using partial fibular resection and onlay bone graft, which may address these potential problems. This study aimed to evaluate whether the ankle joint is well fused with neutral alignment and functionally improved at the final follow-up. For this study, 27 consecutive patients (mean age, 68.5 years; range, 58-83) who underwent tibiotalar fusion with a follow-up period of >1 year were retrospectively included. A modified transfibular lateral approach was performed, in which the distal anterior half fibula was resected and fixed as an onlay graft to achieve fusion between the tibia, fibula, talus, and fibular onlay graft simultaneously. Radiographic outcomes were assessed using computed tomography at 4 months after operation and serial follow-up radiographs. Functional outcomes were assessed using the American Orthopedic Foot and Ankle Society hindfoot scale and Foot and Ankle Outcome Score. The mean follow-up period was 17.3 (range, 12-32) months. Four months after operation, complete union was achieved in 13 patients, near-complete union in 8 patients, and partial union in the remaining 6 patients. At the final follow-up, all the patients achieved complete union and maintained neutral ankle alignment. The functional outcome showed a significant increase between the preoperative and postoperative periods. One minor complication occurred, in which medial side ankle pain was relieved after screw removal. This modified technique is safe and effective, and has several merits, including saving the soft tissue of the anterior ankle, saving the course of the peroneal tendons by leaving the posterior half of the fibula, resected fibula serving as a good bone stock, and reducing the likelihood of valgus deformity after fibulectomy.


Subject(s)
Ankle Joint/surgery , Arthrodesis/methods , Bone Transplantation/methods , Aged , Aged, 80 and over , Ankle Joint/diagnostic imaging , Ankle Joint/pathology , Arthrodesis/adverse effects , Bone Screws/adverse effects , Bone Transplantation/adverse effects , Female , Humans , Male , Middle Aged , Retrospective Studies , Tomography, X-Ray Computed , Treatment Outcome
2.
Article in English | MEDLINE | ID: mdl-29416294

ABSTRACT

The adoption of "human-in-the-loop" paradigms in computer vision and machine learning is leading to various applications where the actual data acquisition (e.g., human supervision) and the underlying inference algorithms are closely interwined. While classical work in active learning provides effective solutions when the learning module involves classification and regression tasks, many practical issues such as partially observed measurements, financial constraints and even additional distributional or structural aspects of the data typically fall outside the scope of this treatment. For instance, with sequential acquisition of partial measurements of data that manifest as a matrix (or tensor), novel strategies for completion (or collaborative filtering) of the remaining entries have only been studied recently. Motivated by vision problems where we seek to annotate a large dataset of images via a crowdsourced platform or alternatively, complement results from a state-of-the-art object detector using human feedback, we study the "completion" problem defined on graphs, where requests for additional measurements must be made sequentially. We design the optimization model in the Fourier domain of the graph describing how ideas based on adaptive submodularity provide algorithms that work well in practice. On a large set of images collected from Imgur, we see promising results on images that are otherwise difficult to categorize. We also show applications to an experimental design problem in neuroimaging.

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