骨科英文书籍精读（140）｜手部损伤
Hand injuries
Hand injuries – the commonest of all injuries – are important out of all proportion to their apparent severity, because of the need for perfect function. Nowhere else do painstaking evaluation, meticulous care and dedicated rehabilitation yield greater rewards. The outcome is often dependent upon the judgement of the doctor who first sees the patient.
If there is skin damage the patient should be examined in a clean environment with the hand displayed on sterile drapes.
A brief but searching history is obtained; often the mechanism of injury will suggest the type and severity of the trauma. The patient’s age, occupation and ‘handedness’ should be recorded.
Superficial injuries and severe fractures are obvious, but deeper injuries are often poorly disclosed. It is important in the initial examination to assess the circulation, soft-tissue cover, bones, joints, nerves and tendons.
X-rays should include at least three views (posteroanterior, lateral and oblique), and with finger injuries the individual digit must be x-rayed.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
painstaking /ˈpeɪnzteɪkɪŋ/n. 辛苦；勤勉adj. 艰苦的；勤勉的；小心的
meticulous 美 /məˈtɪkjələs/adj. 一丝不苟的；小心翼翼的；拘泥小节的
dedicated rehabilitation 专门的康复
dedicated /ˈdedɪkeɪtɪd/adj. 专用的；专注的；献身的v. 以…奉献；把…用于（dedicate的过去式和过去分词）
yield /jiːld/v. 出产（产品或作物）；产出（效果、收益等）；生息；屈服；放弃；停止争论；给（车辆）让路；（在外力、重压等下）屈曲n. 产量；利润，红利率
sterile drapes无菌洞巾
sterile /ˈsterəl/adj. 不育的；无菌的；贫瘠的；不毛的；枯燥乏味的
drape /dreɪp/vt. 用布帘覆盖；使呈褶裥状vi. 成褶皱状垂下n. 窗帘；褶裥；手术洞巾
occupation /ˌɑːkjuˈpeɪʃn/n. 职业；占有；消遣；占有期
‘handedness /ˈhændɪdnəs/n. 左撇子（或右撇子）倾向；不对称
digit /ˈdɪdʒɪt/n. 数字；手指或足趾；一指宽
百度翻译：
手部受伤
手部损伤是所有损伤中最常见的一种，由于需要完美的功能，它与明显的严重程度不成比例。在其他任何地方，艰苦的评估、细致的护理和专注的康复都不会带来更大的回报。结果往往取决于第一次看病人的医生的判断。
如果有皮肤损伤，患者应在干净的环境中进行检查，手放在无菌窗帘上。
一个简短但有搜索性的病史；通常损伤机制会提示创伤的类型和严重程度。应记录患者的年龄、职业和“利手习惯”。
表面损伤和严重骨折是明显的，但较深的损伤往往很少被发现。在初步检查中，评估循环、软组织覆盖、骨骼、关节、神经和肌腱是很重要的。
X光片应至少包括三个角度（前、侧和斜位），手指受伤时，必须对单个手指进行X光检查。