骨科英文书籍精读（133）｜其他腕骨骨折
FRACTURES OF OTHER CARPAL BONES
Triquetrum
Avulsion of the dorsal ligaments is not uncommon; analgesics and splintage for a few days are all that is required. Occasionally the body is fractured; it usually heals after 4–6 weeks in plaster.
Hamate
A fracture of the hook of hamate follows a direct blow to the palm of the hand. These fractures cannot be seen on routine x-rays; a carpal tunnel view, CT or MRI is needed. The fracture does not heal readily; if
symptoms are prolonged then the fragment is excised, taking care not to damage the ulnar nerve. Fractures of the body are rare. They are also difficult to define on plain x-rays. If the CT scan shows a fracture, fixation may occasionally be needed.
Trapezium
The body of the trapezium can be fractured if the shaft of the first metacarpal impacts onto it; the ridge (to which the transverse carpal ligament attaches) can be fractured by a direct blow. The latter fracture can usually be seen on a carpal tunnel view rather than standard x-rays. The body fracture may need open reduction and internal fixation if displaced; the ridge fracture usually settles with splintage for a week or two.
Capitate
The capitate is relatively protected within the carpus. However, in severe trauma the wrist can be fractured; the distal fragment can rotate, in which case open reduction and internal fixation is required.
Lunate
Fractures of the lunate are rare and follow a hyperextension injury to the wrist. There is a real risk of nonunion; undisplaced fractures should be immobilized in a cast for 6 weeks; displaced fractures should be reduced and fixed with a screw.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
Triquetrum /trai'kwetrʌm/adj. 三棱的；三角的 n.三角骨
Avulsion /əˈvʌlʃən/n. 扯开，撕裂；扯离的部分
analgesics /,ænəl'dʒi:ziks/n. [药] 镇痛药；止痛剂（analgesic的复数形式）
Hamate/ˈheɪmeɪt/n. 钩骨adj. 钩状的，具钩的
Trapezium/trəˈpiːziəm/n. （英）[数] 梯形（等于trapezoid）；（美）[数] 不规则四边形；大多角骨
Trapezoid /ˈtræpəzɔɪd/n. [数] 梯形；[数] 不规则四边形adj. 梯形的；[数] 不规则四边形的；小多角骨
ridge /rɪdʒ/n. 山脊；山脉；屋脊vt. 使成脊状；作垄
hyperextension /,haipərik'stenʃən/n. 过伸；伸展过度；腹背训练凳
百度翻译：
其他腕骨骨折
三角骨
背部韧带撕裂并不少见，止痛药和夹板固定几天就可以了。偶尔，身体会骨折，通常在敷石膏4-6周后愈合。
钩状骨
手掌受到直接打击后，钩状骨的钩子断裂。这些骨折在常规的x光片上看不到，需要进行腕管透视、CT或MRI检查。骨折不容易愈合；如果症状会延长，然后切除碎片，注意不要损伤尺神经。身体骨折很少见。在普通x射线上也很难定义。如果CT扫描显示骨折，偶尔可能需要固定。
多角骨
如果第一掌骨的骨干撞击到梯形体上，它的身体就可能骨折；脊骨（腕横韧带附着的）可以通过直接打击而骨折。后一种骨折通常可以在腕管内看到，而不是标准的x光片。如果身体骨折移位，可能需要切开复位内固定；脊柱骨折通常用夹板固定一两周。
头状骨
头状体在腕骨内相对受到保护。然而，在严重的创伤中，手腕可能骨折；远端的碎片可以旋转，在这种情况下需要切开复位和内固定。
月骨
月骨骨折是罕见的，并伴随着手腕的张力损伤。确实存在不愈合的风险；未移位的骨折应在石膏中固定6周；移位的骨折应复位并用螺钉固定。