骨科英文书籍精读（61）｜肩胸分离
SCAPULOTHORACIC DISSOCIATION
This is a high energy injury. The scapula and arm are wrenched away from the chest, rupturing the subclavian vessels and brachial plexus. Many patients die.
Clinical features
The limb is flail and ischaemic. The diagnosis is usually made on the chest x-ray. There is swelling above the clavicle from an expanding haematoma. A distraction of more than 1cm of a fractured clavicle should give rise to suspicion of this injury.
Treatment
The patient is resuscitated. The outcome for the upper limb is very poor. Neither vascular reconstruction nor brachial plexus exploration and repair are likely to give a functional limb.
---from 《Apley’s System of Orthopaedics and Fractures》P737
重点词汇整理：
scapulothoracic肩胛胸的;肩胸的
wrench /rentʃ/n. 扳手，扳钳；扭伤；痛苦；歪曲；猛扭vt. 扭伤；猛扭；曲解；折磨vi. 扭伤；猛扭；猛绞
rupture/ˈrʌptʃər/n. 破裂；决裂；疝气vt. 使破裂；断绝；发生疝
ischaemic缺血性
haematoma/,hi:mə'təumə, ,hem-/n. [病理] 血肿
distraction /dɪˈstrækʃn/n. 注意力分散；消遣；心烦意乱；分离
resuscitated使（某人或某物）恢复知觉;苏醒/rɪˈsʌsɪteɪt/vt. 使复苏；使复兴vi. 恢复；复兴
Neither vascular reconstruction nor brachial plexus exploration and repair are likely to give a functional limb.无论是血管重建还是臂丛探查和修复，都不可能使肢体功能恢复。
百度翻译：
肩胛胸分离
这是一个高能量的损伤。肩胛骨和手臂被扭开离开胸部，导致锁骨下血管和臂丛神经断裂。很多病人死了。
临床特征
四肢连枷，缺血。诊断通常是在胸片上作出的。锁骨上方有扩张性血肿引起的肿胀。锁骨骨折超过1厘米的分心会引起对这种损伤的怀疑。
治疗
病人已经苏醒。上肢的结果很差。无论是血管重建还是臂丛神经的探查和修复都不可能提供功能性肢体。