骨科英文书籍精读（280）｜股骨干骨折晚期并发症之骨不连
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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Delayed union and non-union
The time-scale for declaring a delayed or non-union can vary with the type of injury and the method of treatment. If there is failure to progress by 6 months, as judged by serial x-rays, then intervention may be needed. A common practiceis to remove locking screws from the intramedullary nail to enable the fracture to ‘collapse’ (‘dynamise’ in modern orthopaedic parlance). This can be successful in a small proportion of cases; more often it fails and results in pain as rotational control of the fracture is lost (the femur is often subject to torsional forces in walking). A better course is to remove the nail, ream the medullary canal and introduce a larger diameter nail – exchange nailing. Bone grafts should be added to the fracture site if there are gaps not closed at the revision procedure.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
A common practiceis to remove locking screws from the intramedullary nail to enable the fracture to ‘collapse’ (‘dynamise’ in modern orthopaedic parlance). 一种常见的做法是从髓内钉上取下锁定螺钉，使骨折“塌陷”(在现代矫形学术语中叫做“动力化”)。
common practice惯例；习惯作法
practice /ˈpræktɪs/n. 实践；练习；惯例
dynamise动力化
dynamic /daɪˈnæmɪk/n. 动态；动力adj. 动态的；动力的；动力学的；有活力的
parlance /ˈpɑːrləns/n. 说法；用语；语调；发言
torsional forces 扭转的力量
torsional /'tɔrʃənl/adj. 扭转的；扭力的
百度翻译：
晚期并发症
延迟愈合和不愈合
宣布延迟愈合或不愈合的时间尺度可能因损伤类型和治疗方法而异。如果连续x光片显示6个月内没有进展，那么可能需要进行干预。通常的做法是从髓内钉上取下锁定螺钉，使骨折“塌陷”（现代骨科术语中的“动力”）。这个在一小部分病例中可以成功；更常见的情况是失败并导致疼痛，因为骨折失去旋转控制（行走时股骨经常受到运动力）。更好的方法是拔除髓内钉，扩孔髓管，引入直径更大的髓内钉-交换钉。如果在翻修过程中有间隙未闭合，应在骨折部位添加骨移植物。