骨科英文书籍精读（250）｜儿童股骨近端骨折（2）
我们正在精读国外经典骨科书籍《Apley’s System of Orthopaedics and Fractures》，想要对于骨科英文形成系统认识，为以后无障碍阅读英文文献打下基础，请持续关注。
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Classification
The most useful classification is that of Delbet, which is based on the level of the fracture (Hughes and Beaty 1994). Type I is a fracture-separation of the epiphysis; sometimes the epiphyseal fragment is dislocated from the acetabulum. Type II is a transcervical fracture of the femoral neck; this is the commonest variety, accounting for almost half of the injuries. Type III is a basal (cervico-trochanteric) fracture, the second most common injury. Type IV is an intertrochanteric fracture (Figure 29.16).
Clinical features
Diagnosis can be difficult, especially in infants where the epiphysis is not easily defined on x-ray. Type I fractures are easily mistaken for hip dislocation. Ultrasonography, MRI and arthrography may help. In older children the diagnosis is usually obvious on plain x-ray examination.
It is important to establish whether the fracture is displaced or undisplaced; the former carries a much higher risk of complications. Type IV fractures are the least likely to give rise to complications.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
variety /vəˈraɪəti/n. 多样；种类；杂耍；变化，多样化
this is the commonest variety, accounting for almost half of the injuries.这是最常见的一种，占了几乎一半的伤害。
basal (cervico-trochanteric) fracture基底(股骨颈-转子)骨折
Ultrasonography /,ʌltrəsə'nɑɡrəfi/n. 超声波检查法；超声波扫描术
give rise to complications.引起并发症。
百度翻译：
分类
最有用的分类是基于骨折程度的Delbet分类（Hughes和Beaty 1994）。I型是骨骺分离骨折，有时骨骺碎片从髋臼脱臼。II型是股骨颈经颈骨折；这是最常见的类型，几乎占损伤的一半。Ⅲ型是基底部（颈粗隆）骨折，是第二常见的损伤。IV型是股骨转子间骨折（图29.16）。
临床特征
诊断可能是困难的，尤其是在婴儿骨骺是不容易界定的x光。Ⅰ型骨折易误诊为髋关节脱位。超声波、核磁共振和关节造影可能会有所帮助。在较大的儿童中，x线平片检查的诊断通常很明显。
确定骨折是移位还是未移位是很重要的；前者有更高的并发症风险。IV型骨折是最不可能引起并发症的。