骨科英文书籍精读（368）｜腓骨肌腱脱位
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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DISLOCATION OF PERONEAL TENDONS
Acute dislocation of the peroneal tendons may accompany – or may be mistaken for – a lateral ligament strain. Tell-tale signs on x-ray are an oblique fracture of the lateral malleolus (the so-called 'rim fracture’) or a small flake of bone lying lateral to the lateral malleolus (avulsion of the retinaculum). Treatment in a belowknee cast for 6 weeks will help in a proportion of cases; the remainder will complain of residual symptoms.
Recurrent subluxation or dislocation is unmistakable; the patient can demonstrate that the peroneal tendons dislocate forwards over the fibula during dorsiflexion and eversion. Treatment is operative and is based on the observation that the attachment of the retinaculum to the periosteum on the front of the fibula has come adrift, creating a pouch into which the tendons displace. Using non-absorbable sutures through drill holes in the bone, the normal anatomy is recreated (Das De and Balasubramaniam, 1985). An alternative approach is to modify the morphology of the distal fibula, posteriorly translating a shelf of bone to constrain the tendons mechanically in a deepened posterior channel. Whichever method of stabilization is used, it is important to also assess the state of the tendons themselves, as an associated longitudinal split tear is commonly found, and this will lead to continuing pain and dysfunction around the lateral border of the ankle if it is not repaired.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
PERONEAL TENDONS腓骨肌腱
Tell-tale signs on x-ray are an oblique fracture of the lateral malleolus (the so-called 'rim fracture’)x线显示的迹象是外踝斜骨折(所谓的“边缘骨折”)。
flake /fleɪk/n. 小薄片，碎片；
a small flake of bone进入翻
retinaculum/ˌretəˈnækjələm/n. 支持带；韧带
unmistakable /ˌʌnmɪˈsteɪkəbl/adj. 明显的；不会弄错的
adrift /əˈdrɪft/adj. 漂流的，随波逐流的；松动的
drift/drɪft/n. 漂流，漂移；趋势；漂流物vi. 漂流，漂移；漂泊
pouch /paʊtʃ/n. 小袋；育儿袋；烟草袋vi. 成袋状
morphology /mɔːrˈfɑːlədʒi/n. 形态学，形态论；[语] 词法，[语] 词态学
posteriorly translating a shelf of bone to constrain the tendons mechanically in a deepened posterior channel. 在加深的后通道中机械地转换骨架来约束肌腱。
有道翻译（仅供参考，建议自己翻译）：
腓骨肌腱脱位
腓骨肌腱的急性脱位可能导致或被误认为是侧韧带拉伤。x光片显示外踝斜行骨折（所谓的“边缘骨折”）或外踝外侧的一小块骨头（支持带撕脱）。膝下石膏治疗6周将有助于一部分病例；其余的人会抱怨残留的症状。
复发性半脱位或脱位是不可忽视的；患者可以证明在屈伸和外翻时腓骨肌腱在腓骨上方向前移位。治疗是可操作的，其基础是观察到支持带附着在腓骨前部的骨膜上已经脱落，形成一个肌腱移位的囊袋。通过在骨头上钻孔使用不可吸收缝线，重建了正常的解剖结构（Das De和Balasubramaniam，1985）。另一种方法是改变腓骨远端的形态，向后平移一块骨板，将肌腱机械地约束在一个深的后通道中。无论使用哪种稳定方法，评估肌腱本身的状态也很重要，因为通常会发现相关的纵向撕裂，如果不修复，这将导致踝关节外侧边界周围持续疼痛和功能障碍。