骨科英文书籍精读（331）｜髌骨脱位（1）
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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DISLOCATION OF PATELLA
Because the knee is normally angled in slight valgus, there is a natural tendency for the patella to pull towards the lateral side when the quadriceps muscle contracts. Lateral deviation of the patella during knee extension is prevented by a number of factors: the patella is seated in the intercondylar groove, which has a high lateral 'embankment’; the force of extensor muscle contraction pulls it firmly into the groove; and the extensor retinacula and patellofemoral ligaments guide it centrally as it tracks along the intercondylar runway. The most important static checkrein on the medial side is the medial patellofemoral ligament, a more or less distinct structure extending from the superomedial border of the patella towards the medial femoral condyle deep to vastus medialis (Conlan et al., 1993). Additional restraint is provided by the medial patellomeniscal and patellotibial ligaments and the associated medial retinacular fibres. In the normal knee, considerable force is required to wrench the patella out of its track. However, if the intercondylar groove is unusually shallow, or the patella seated higher than usual, or the ligaments are abnormally lax, dislocation is not that difficult.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
deviation /ˌdiːviˈeɪʃn/n. 偏差；误差；背离
embankment /ɪmˈbæŋkmənt/n. 路堤；堤防
runway/ˈrʌnweɪ/n. 跑道；河床；滑道
static checkrein静态控制结构
static/ˈstætɪk/adj. 静态的；静电的；静力的n. 静电；静电干扰
checkrein /ˈtʃekˌreɪn/控制
a more or less distinct structure extending from the superomedial border of the patella towards the medial femoral condyle deep to vastus medialis 一个或多或少不同的结构，从髌骨上内侧边缘延伸到股内侧髁深至股内侧肌
distinct /dɪˈstɪŋkt/adj. 明显的；独特的；清楚的；有区别的
restraint /rɪˈstreɪnt/n. 抑制，克制；约束
patellomeniscal髌半月板
patellotibial ligaments 髌胫韧带
wrench /rentʃ/n. 扳手，扳钳；扭伤
有道翻译（仅供参考，建议自己翻译）：
髌骨脱位
因为膝关节通常呈轻微外翻的角度，当股四头肌收缩时，髌骨有向外侧拉的自然趋势。膝部伸展时髌骨的侧偏是由许多因素防止的:髌骨位于具有高侧“堤”的髁间沟;伸肌收缩的力量将其牢牢地拉入沟内;伸肌支持韧带和髌股韧带引导它沿着髁间跑道运动。内侧最重要的静态约束是髌股内侧韧带，这是一个或多或少不同的结构，从髌骨上内侧边界延伸至股内侧髁深至股内侧内侧肌(Conlan et al.， 1993)。内侧髌月韧带和髌骨胫骨韧带以及相关的内侧支持韧带提供了额外的约束。在正常的膝关节，需要相当大的力量来将髌骨拉出其轨道。然而，如果髁间沟异常浅，或髌骨坐位高于正常，或韧带异常松弛，脱位就不是那么困难。