骨科英文书籍精读（372）｜踝部骨折的治疗
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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UNDISPLACED FRACTURES
The first step is to decide whether the injury is stable or unstable. An isolated, undisplaced Danis–Weber type A fracture is stable and will need minimal splintage: a firm bandage or stirrup brace is applied mainly for comfort until the fracture heals.
Undisplaced type B fractures are potentially unstable only if the tibiofibular ligament is torn or avulsed, or if there is a significant medial-sided injury. X-rays will show if the syndesmosis or mortise is intact; if it is, a below-knee cast is applied with the ankle in the neutral (anatomical) position. The plaster may need to be split and, if so, it must be completed or replaced when swelling has subsided. A check x-ray is taken at 2 weeks to confirm that the fracture remains undisplaced.
An overboot is fitted and the patient is taught to walk correctly as soon as possible. The cast can usually be discarded after 6–8 weeks. Ankle and foot movements are regained by active exercises when the plaster is removed. As with any lower limb fracture, the leg must not be allowed to dangle idly – it must be exercised and elevated.
Undisplaced type C fractures are deceivingly innocent-looking but are often accompanied by disruption of the medial joint structures as well as the tibiofibular syndesmosis and interosseous membrane. These defects may become apparent only when the fracture displaces in a cast; arguably, therefore, type C fractures are better fixed from the outset.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
syndesmosis /ˌsɪndesˈmoʊsɪs/n. [解剖] 韧带联合
overboot 高腰套靴
dangle /ˈdæŋɡl/v. （使）摇晃地悬挂着；提着；炫示；用……来诱惑（或激励）
idly /ˈaɪdli/adv. 无理由地，无目的地；无动于衷地，懒散地；无所事事地，空闲地；无益地
deceivingly innocent-looking差不多（貌似）看上去无害的
deceivingly欺骗性的；貌似
arguably, therefore, type C fractures are better fixed from the outset.因此，可以说，C型骨折最好从一开始就进行固定。
arguably, /ˈɑːrɡjuəbli/adv. 可论证地；可争辩地；正如可提出证据加以证明的那样地[广义用法]可能，大概
有道翻译（仅供参考，建议自己翻译）：
无移位骨折
第一步是确定损伤是稳定还是不稳定。孤立、未移位的Danis-Weber A型骨折是稳定的，需要最少的夹板： 坚固的绷带或马镫支撑主要用于舒适，直到骨折愈合。
未移位的B型骨折可能不稳定 只有当胫腓韧带撕裂或撕裂，或有明显的内侧损伤。X光可以显示联合或榫眼是否完好；如果是，则在踝关节处于中立（解剖）位置时应用膝下石膏。石膏可能需要裂开，如果是这样，必须在肿胀消退后完成或更换。两周后进行x光检查，以确认骨折未发生移位。
一个过足被安装，病人被教导 尽快正确行走。铸型通常可以在6-8周后丢弃。当石膏被移除时，脚踝和脚的运动会通过积极的锻炼恢复。就像下肢骨折一样，腿不能随意摆动，必须锻炼和抬高。
无移位的C型骨折看似无辜，但常伴有内侧关节结构、胫腓联合和骨间膜的破坏。只有当断裂在铸件中移位；因此，C型骨折从一开始就可以得到较好的固定。