<strong>Introduction:</strong> Purpose to study prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the ...<strong>Introduction:</strong> Purpose to study prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the injury. <strong>Methods:</strong> Cross sectional study of 32 patients diagnosed with ankle fracture and undergone open reduction and internal fixation with arthroscopic assessment performed stimultaneously. The mechanism of injury, patterns of injury and intraarticular chondral injury were documented. <strong>Results:</strong> Mean age was 38 years (SD = 14.1, range 18 - 68 years). Eighteen were female and 14 were male. Fifteen involved syndesmostic distruption, 22 had Danis-Weber B injury and 16 had supination external rotation (SER). Ten (31.2%) had positive intraoperative cartilage injury. Significant correlation between the Lauge-Hansen classifications with positive findings with 6 had SER, 2 had pronation adduction and 2 had pronation external rotation.<strong> Conclusion: </strong>The prevalence of chondral injury in ankle fracture was quite high and may leads to poor outcome. Arthroscopy procedure allow surgeon to assess intraarticular surface and reduction of the ankle fracture which prompt further intervention that may improve the clinical outcomes and prognosis of the patients.展开更多
<strong>Background:</strong> We report a rare case of congenital bilateral testicular agenesis who presented with a suicide attempt. We pose the question of testosterone therapy could improve his mental he...<strong>Background:</strong> We report a rare case of congenital bilateral testicular agenesis who presented with a suicide attempt. We pose the question of testosterone therapy could improve his mental health. <strong>Case Report: </strong>A 36-year-old man was admitted to a psychiatric ward after the suicide attempt. An endocrinology consult is requested to address if hormone replacement therapy could improve his depression and future suicide attempts. His past medical history is significant for gonadal agenesis, testicular implants placement at age 16, bipolar type 1 diagnosed 2 years ago before the presentation. The patient received testosterone replacement treatment at age 13 - 15 years. Since that time, he has not been placed on any testosterone therapy. Physical exam revealed minimal axillary and pubic hair, testicular implants with a microphallus. Laboratory values reflect hypergonadotropic hypogonadism consistent with testicular agenesis. He was suicidal and testosterone treatment was deferred. <strong>Discussion:</strong> It is a rare case of congenital testicular agenesis with bipolar disorder which was resistant to therapy. The patient had profound hypogonadism, which needed testosterone replacement therapy. However, the therapy was deferred because of an acute psychotic condition. This case also highlights that there is no strong evidence of the effect of hormonal therapy on mental health in this group.展开更多
文摘<strong>Introduction:</strong> Purpose to study prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the injury. <strong>Methods:</strong> Cross sectional study of 32 patients diagnosed with ankle fracture and undergone open reduction and internal fixation with arthroscopic assessment performed stimultaneously. The mechanism of injury, patterns of injury and intraarticular chondral injury were documented. <strong>Results:</strong> Mean age was 38 years (SD = 14.1, range 18 - 68 years). Eighteen were female and 14 were male. Fifteen involved syndesmostic distruption, 22 had Danis-Weber B injury and 16 had supination external rotation (SER). Ten (31.2%) had positive intraoperative cartilage injury. Significant correlation between the Lauge-Hansen classifications with positive findings with 6 had SER, 2 had pronation adduction and 2 had pronation external rotation.<strong> Conclusion: </strong>The prevalence of chondral injury in ankle fracture was quite high and may leads to poor outcome. Arthroscopy procedure allow surgeon to assess intraarticular surface and reduction of the ankle fracture which prompt further intervention that may improve the clinical outcomes and prognosis of the patients.
文摘<strong>Background:</strong> We report a rare case of congenital bilateral testicular agenesis who presented with a suicide attempt. We pose the question of testosterone therapy could improve his mental health. <strong>Case Report: </strong>A 36-year-old man was admitted to a psychiatric ward after the suicide attempt. An endocrinology consult is requested to address if hormone replacement therapy could improve his depression and future suicide attempts. His past medical history is significant for gonadal agenesis, testicular implants placement at age 16, bipolar type 1 diagnosed 2 years ago before the presentation. The patient received testosterone replacement treatment at age 13 - 15 years. Since that time, he has not been placed on any testosterone therapy. Physical exam revealed minimal axillary and pubic hair, testicular implants with a microphallus. Laboratory values reflect hypergonadotropic hypogonadism consistent with testicular agenesis. He was suicidal and testosterone treatment was deferred. <strong>Discussion:</strong> It is a rare case of congenital testicular agenesis with bipolar disorder which was resistant to therapy. The patient had profound hypogonadism, which needed testosterone replacement therapy. However, the therapy was deferred because of an acute psychotic condition. This case also highlights that there is no strong evidence of the effect of hormonal therapy on mental health in this group.
