骨科英文书籍精读(201)|骨盆骨折的治疗(2)
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Open-book injuries
Provided the anterior gap is less than 2 cm and it is certain that there are no displaced posterior disruptions, these injuries can usually be treated satisfactorily by bed rest; a posterior sling or a pelvic binder helps to ‘close the book’.
The most efficient way of maintaining reduction is by external fixation with pins in both iliac blades connected by an anterior bar; ‘closing the book’ may also reduce the amount of bleeding. Placing the pins is made easier if two temporary pins are first inserted hugging the medial and lateral surfaces of each iliac blade and then directing the fixing pins between them. Internal fixation by attaching a plate across the symphysis should be performed: (1) during the first few days after injury only if the patient needs a laparotomy; and (2) later on if the gap cannot be closed by less radical methods.
Fractures of the iliac blade can often be treated with bed rest. However, if displacement is marked, or if there is an associated anterior ring fracture or symphysis separation, then open reduction and internal fixation with plates and screws will need to be considered (e.g. in displaced LC-II injuries causing a leg length discrepancy greater than 1.5 cm). It is also possible to reduce and hold some of these fractures by external fixation.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理:
Provided /prəˈvaɪdɪd/conj. 假如,倘若v. 提供,给予(provide 的过去式和过去分词)
iliac blades 髂骨翼
laparotomy /ˌlæpəˈrɑːtəmi/n. 剖腹手术
radical/ˈrædɪkl/n. 基础;激进分子;[物化] 原子团;[数] 根数adj. 激进的;根本的;彻底的
百度翻译:
开书样损伤
如果前面的间隙小于2厘米,并且确定没有移位的后部破裂,这些损伤通常可以通过卧床休息得到满意的治疗;后部吊带或骨盆固定器有助于“合上书本”。
保持复位最有效的方法是在两侧髂骨刀片上用针外固定,用前杆连接;“合书”也可以减少出血量。如果先插入两个临时的固定针,将其固定在髂骨刀片的内侧和外侧表面,然后将固定销固定在两个刀片之间,则放置固定针更容易。在损伤后的头几天,只有当病人需要开腹手术时,才应在损伤后的头几天内进行内固定;以及(2)如果不能用较彻底的方法闭合缝隙,则应在以后进行。
髂骨刀片骨折通常可用卧床休息来治疗。然而,如果移位明显,或有相关的前环骨折或联合分离,则需要考虑切开复位和钢板和螺钉内固定(例如,在造成腿部长度差异大于1.5 cm的LC-II损伤中)。也可以通过外固定架来减少和固定这些骨折。