骨科英文书籍精读(191)|骨盆骨折APC分型
Young and Burgess分型(1) (APC) (前方应力骨折)
ANTEROPOSTERIOR COMPRESSION (APC) INJURIES
The ‘open book’ pattern appears as either diastasis of the pubic symphysis or fracture(s) of the pubic rami; as the pelvis is sprung open, the posterior (sacroiliac) elements also are strained. This general pattern is subclassified according to the severity of the injury:
In APC-I injuries there may be only slight (less than 2 cm) diastasis of the symphysis; however, although invisible on x-ray, there will almost certainly be some strain of the anterior sacroiliac ligaments. The pelvic ring is stable.
In APC-II injuries diastasis is more marked and the anterior sacroiliac ligaments (often also the sacrotuberous and sacrospinous ligaments) are torn. CT may show slight separation of the sacroiliac joint on one side. Nevertheless, the pelvic ring is still stable.
In APC-III injuries the anterior and posterior sacroiliac ligaments are torn. CT shows a shift or separation of the sacroiliac joint; the one hemi-pelvis is effectively disconnected from the other anteriorly and from the sacrum posteriorly. The ring is unstable.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理:
diastasis of the pubic symphysis耻骨联合分离
diastasis /dai'æstəsis/n.;脱位;分离;心休息期
subclassify /sʌb'klæsifai/vt. 将…归入;被细分类的
the one hemi-pelvis is effectively disconnected from the other anteriorly and from the sacrum posteriorly. 一侧半骨盆在前方和骶骨后方有效地分离。
百度翻译:
前骨压缩(APC)损伤
“开卷”模式表现为耻骨联合的散发或耻骨支骨折;骨盆张开时,骶髂后部的成分也会受到拉伸。根据损伤的严重程度,将此通用模式分为以下类别:
APC-I损伤中,联合的舒张可能只有轻微(小于2 cm);然而,尽管x线上看不见,但几乎肯定会出现骶髂前韧带的一些应变。骨盆环稳定。
APC-II损伤中,舒张酶更为明显,骶髂前韧带(通常也包括骶凸和骶棘韧带)被撕裂。CT可显示一侧骶髂关节轻微分离。然而,骨盆环仍然稳定。
在APC-III损伤中,骶髂前韧带和后韧带撕裂。CT显示骶髂关节移位或分离;一个半骨盆有效地与另一个前、后骶断开。戒指不稳定。