骨科英文书籍精读（367）｜三角韧带撕裂
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DELTOID LIGAMENT TEARS
Rupture of the deltoid ligament is usually associated with either a fracture of the distal end of the fibula or tearing of the distal tibiofibular ligaments (or both). The effect is to destabilize the talus and allow it to move into eversion and external rotation. The diagnosis is made by x-ray: there is widening of the medial joint space in the mortise view; sometimes the talus is tilted, and diastasis of the tibiofibular joint may be obvious.
When there is a deltoid ligament or medial malleolar injury but no apparent lateral disruption at the ankle, it is important to look for a fracture or dislocation of the proximal fibula – the highly unstable Maissoneue injury.
Treatment
Provided the medial joint space is completely reduced, the ligament will heal. The fibular fracture or diastasis must be accurately reduced, if necessary by open operation and internal fixation. Occasionally the medial joint space cannot be reduced; it should then be explored in order to free any soft tissue trapped in the joint. A below-knee cast is applied with the foot plantigrade and is retained for 8 weeks.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
deltoid/ˈdeltɔɪd/n. 三角肌adj. 三角形的
The effect is to destabilize the talus and allow it to move into eversion and external rotation.其作用是使距骨不稳定，使其向外翻和外旋方向移动。
destabilize /ˌdiːˈsteɪbəlaɪz/vt. 使动摇
inversion内翻
eversion外翻
diastasis of the tibiofibular joint胫腓联合分离
diastasis /dai'æstəsis/n. 脱骱；心休息期
malleolar /mə'li:ələ/adj. 踝的
A below-knee cast is applied with the foot plantigrade and is retained for 8 weeks.在脚底下应用膝下石膏，并保持8周。
plantigrade /ˈplæntəˌɡreɪd/adj. 踯行的；踯行类的n. 踯行动物
有道翻译（仅供参考，建议自己翻译）：
三角韧带撕裂
三角肌韧带断裂通常与腓骨远端骨折或胫腓骨远端韧带撕裂（或两者兼有）有关。其效果是破坏距骨的稳定性，使其进入外翻和外旋。x线诊断：榫切面内侧关节间隙增宽；有时距骨倾斜，胫腓关节分离明显。
当踝关节有三角肌韧带或内踝损伤，但没有明显的外侧断裂时，寻找腓骨近端骨折或脱位是很重要的，这是一种高度不稳定的踝关节损伤。
治疗
如果内侧关节间隙完全缩小，韧带就会愈合。腓骨骨折或分离必须准确复位，如有必要，可采用开放手术和内固定。有时内侧关节间隙不能缩小；然后应进行探查，以释放关节中的任何软组织。膝下石膏与足部plantigrade一起应用，保留8周。