骨科英文书籍精读（281）｜股骨干骨折晚期并发症之畸形愈合
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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Malunion
Fractures treated by traction and bracing often develop some deformity; no more than 15 degrees of angulation should be accepted (Figure 29.29). Even if the initial reduction was satisfactory, until the x-ray shows solid union the fracture is too insecure to permit weightbearing; the bone will bend and what previously seemed a satisfactory reduction may end up with lateral or anterior bowing.
Malunion is much less likely in those treated with static interlocked nails; yet it does still occur – especially malrotation – and this can be prevented only by meticulous intra-operative and post-operative assessment followed, where necessary, by immediate correction. Shortening is seldom a major problem unless there was bone loss; if it does occur, treatment will depend on the amount and its clinical impact – sometimes all that is needed is a built-up shoe.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
Even if the initial reduction was satisfactory, until the x-ray shows solid union the fracture is too insecure to permit weightbearing.
即使初期复位满意，在x线片显示骨折牢固愈合前，因骨折太不安全而不允许负重。
what previously seemed a satisfactory reduction may end up with lateral or anterior bowing.
先前看似满意的复位，结果可能是侧弯或前弯畸形。
static interlocked nails静态交锁钉
meticulous /məˈtɪkjələs/adj. 一丝不苟的；小心翼翼的；拘泥小节的
百度翻译：
畸形愈合
通过牵引和支撑治疗的骨折通常会出现一些畸形；角度不应超过15度（图29.29）。即使最初的复位是令人满意的，直到x光片显示骨折牢固愈合，骨折是太不安全，不允许负重；骨头会弯曲，以前似乎是令人满意的复位可能会结束横向或前弓。
在使用静态交锁钉治疗的患者中，骨折不愈合的可能性要小得多；但仍然会发生骨折不愈合，尤其是旋转不良，只有在术中和术后进行细致的评估，然后在必要时立即纠正，才能防止骨折不愈合。除非有骨质流失，否则短缩很少是一个主要问题；如果真的发生了，治疗将取决于数量及其临床影响-有时所需要的只是一个组合鞋。