骨科英文书籍精读(230)|股骨颈骨折分型(1)
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Pathological anatomy and classification
The most useful classification is that of Garden, which is based on the amount of displacement apparent in the pre-reduction x-rays (Garden 1961). Once fractured, the head and neck become displaced in progressively severe stages. Stage I is an incomplete impacted fracture, including the so-called abduction fracture in which the femoral head is tilted into valgus in relation to the neck. Stage II is a complete but undisplaced fracture. Stage III is a complete fracture with moderate displacement. And Stage IV is a severely displaced fracture. This is essentially a radiographic classification; the distinctive x-ray features are described below.
Garden I and II fractures, which are only slightly displaced, have a much better prognosis for union and for viability of the femoral head than the more severely displaced Garden III and IV fractures (Barnes, Brown et al. 1976). This has an important influence on the choice of treatment for the various stages. However, there is little room for complacency with any of these fractures; left untreated, a comparatively benign-looking Stage I fracture may rapidly disintegrate to Stage IV.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理:
Pathological /ˌpæθəˈlɑːdʒɪkl/adj. 病理学的;病态的;由疾病引起的(等于pathologic)
abduction fracture外展性骨折
abduction /æbˈdʌkʃn/n. 诱拐,外展,绑架;诱导
valgus /vælɡəs/n. 外翻足的人;外翻足adj. 外翻的
distinctive /dɪˈstɪŋktɪv/adj. 独特的,有特色的;与众不同的
prognosis/prɑːɡˈnoʊsɪs/n. [医] 预后;预知
viability /ˌvaɪəˈbɪləti/n. 生存能力,发育能力;可行性
complacency /kəmˈpleɪsnsi/n. 自满;满足;自鸣得意
disintegrate /dɪsˈɪntɪɡreɪt/vi. 瓦解;碎裂;衰变vt. 使分解;使碎裂;使崩溃;使衰变
百度翻译:
病理解剖与分类
最有用的分类是Garden,这是基于在还原前的x光片中明显的位移量(Garden 1961)。一旦破裂,头颈部在严重程度上会移位。第一阶段是不完全的嵌顿性骨折,包括所谓的外展性骨折,股骨头相对于颈部向外翻倾斜。第二阶段是完全但不移位的骨折。Ⅲ期为完全性骨折,中度移位。第四阶段是严重移位的骨折。这基本上是一种射线照相分类法;其独特的x射线特征如下所述。
Garden I和II型骨折,仅轻微移位,其骨折愈合和股骨头存活率的预后比严重移位的Garden III和IV型骨折好得多(Barnes,Brown等人,1976)。这对不同阶段的治疗选择有重要影响。然而,对于这些骨折几乎没有自满的余地;如果不进行治疗,一个相对良性的Ⅰ期骨折可能很快就不整合到Ⅳ期。