骨科英文书籍精读(337)|胫骨平台骨折临床特征

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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Clinical features

The knee is swollen and may be deformed. Bruising is usually extensive and the tissues feel 'doughy’ because of haemarthrosis. Examining the knee may suggest medial or lateral instability but this is usually painful and adds little to the x-ray diagnosis. More importantly, the leg and foot should be carefully examined for signs of vascular or neurological injury. Traction injury of the peroneal or tibial nerves is not uncommon and it is important to establish whether this is present at the time of admission and before operation.

Imaging

Anteroposterior, lateral and oblique x-rays will usually show the fracture, but the amount of comminution or plateau depression may not be appreciated without computer tomography (CT). This provides information on the location of the main fracture lines, the site and size of the portion of condyle that is depressed and the position of major parts of articular surface that have been displaced. Software-generated re-assembly of the axial images can provide sagittal and coronal views that aid in surgical planning (Fig. 30.18). It is important not to miss a posterior condylar component in high-energy fractures because this may require a separate posteromedial or posterolateral exposure for internal fixation.

With a crushed lateral condyle the medial ligament is often intact, but with a crushed medial condyle the lateral ligament is often torn.

---from 《Apley’s System of Orthopaedics and Fractures》


重点词汇整理:

the tissues feel 'doughy’ because of haemarthrosis.由于关节血肿,组织感觉“面团状”。

doughy /ˈdoʊi/adj. 面团似的;柔软的;苍白的;半熟的

vascular or neurological injury. 血管或神经损伤。

the peroneal or tibial nerves腓神经或胫神经

/,perə'ni:əl/adj. 腓骨的;腓侧的

CT: computer tomography 计算机断层摄影

tomography  /təˈmɑːɡrəfi/n. X线断层摄影术(等于laminography)

sagittal and coronal views矢状面和冠状面


有道翻译(仅供参考,建议自己翻译):

临床特征

膝盖肿胀,可能会变形。瘀伤通常是广泛的和组织感到'面团',因为血肿。检查膝盖可能提示内侧或外侧不稳定,但这通常是痛苦的

对x线诊断也没有什么帮助。更重要的是,应仔细检查腿部和足部是否有血管或神经损伤的迹象。腓神经或胫神经的牵拉损伤并不少见,重要的是要确定在入院时和手术前是否存在牵拉损伤。

成像

正位、侧位和斜位x光片通常会显示骨折,但如果没有计算机断层扫描(CT),粉碎或高原凹陷的程度可能无法被识别。这提供了关于主要骨折线的位置、髁突凹陷部分的位置和大小以及关节面主要部分移位的位置的信息。软件生成的轴向图像重新组装可以提供矢状面和冠状面视图,有助于外科规划(图30.18)。在高能量骨折中,不要错过后髁组件是很重要的,因为这可能需要单独的后内侧或后外侧暴露进行内固定。

外侧髁被压碎时,内侧韧带通常完好无损,但内侧髁被压碎时,外侧韧带经常撕裂。


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