骨科英文书籍精读（382）｜距骨骨折分类
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
Fractures of the neck of the talus
These fractures are classified according to the system devised by Hawkins (1970) and modified by Canale (1978):
· Group I – undisplaced
· Group II – displaced (however little) and associated with subluxation or dislocation of the subtalar joint
· Group III – displaced, with dislocation of the body of the talus from the ankle joint
· Type IV – displaced vertical talar neck fracture with associated talonavicular joint disruption.
Fractures of the head of the talus
This is a rare injury; the fracture usually involves the talonavicular joint.
Fractures of the body of the talus
These are also uncommon. The fracture is often displaced and may cause distortion of the talocalcaneal joint. Rotational malalignment of the fragments is difficult to diagnose on plain x-ray examination; the deformity is best visualized by three-dimensional CT reconstruction.
Fractures of the lateral and posterior processes
These are usually associated with ankle ligament strains. It is sometimes difficult to distinguish between a fracture of the posterior process and a normal os trigonum. A simple rule is 'if it’s not causing symptoms it doesn’t really matter’.
Osteochondral fractures
Osteochondral fractures following acute trauma usually occur on the lateral part of the dome of the talus. The diagnosis is often missed when the patient is first seen and may come to light only after CT or MRI scan.
拓展链接：https://www.51wendang.com/doc/7c951054f5478d4fe1f0fd35/24
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
the subtalar joint距下关节
distortion/dɪˈstɔːrʃn/n. 变形；[物] 失真；扭曲；曲解
rotation /roʊˈteɪʃn/n. 旋转；循环，轮流
torture /ˈtɔːrtʃər/ n. 折磨；拷问；歪曲v. 折磨；拷问；歪曲
Rotational malalignment旋转不良
come to light 暴露；真相大白；众所周知
DeepL翻译（仅供参考，建议自己翻译）：
分类
距骨颈部的骨折
这些骨折根据Hawkins(1970)设计的系统进行分类，并由Canale(1978)修改。
- 第一组--未移位
- 第二组--移位（无论多么小），并伴有副踝关节的半脱位或脱位
- 第三类--移位，伴有距骨体与踝关节的脱位
- 第四类--移位的垂直距骨颈骨折，并伴有距骨关节断裂。
距骨头部的骨折
这是一种罕见的损伤；骨折通常涉及距骨关节。
距骨体的骨折
这也是不常见的。骨折通常是移位的，可能导致距骨关节的变形。碎片的旋转错位在普通X线检查中很难诊断出来；这种畸形最好通过三维CT重建来观察。
外侧和后突的骨折
这些通常与踝关节韧带拉伤有关。有时很难区分后突的骨折和正常的三叉骨骨折。一个简单的规则是 "如果它没有引起症状，那就没有什么关系"。
骨软骨断裂
急性外伤后的骨软骨骨折通常发生在距骨圆顶的外侧部分。当病人首次就诊时，往往漏诊，可能在CT或MRI扫描后才发现。
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