骨科英文书籍精读（241）｜股骨颈骨折的治疗(4)
中国十大名师之一赖世雄老师说过，学习英语没有捷径，少就是多，快就是慢。不要以量取胜，把一个音标、一个单词、一段对话、一篇文章彻底搞透，慢慢积累，你会发现，你并不比每天走马观花的输入大量英文学的差。
Avascular necrosis
Ischaemic necrosis of the femoral head occurs in about 30 per cent of patients with displaced fractures and 10 per cent of those with undisplaced fractures. There is no way of diagnosing this at the time of fracture. A few weeks later, an isotope bone scan may show diminished vascularity. X-ray changes may not become apparent for months or even years. Whether the fracture unites or not, collapse of the femoral head will cause pain and progressive loss of function (Figure 29.10). In patients over 45 years, treatment is by total joint replacement.
In younger patients, the choice of treatment is controversial. Core decompression has no place in the management of traumatic osteonecrosis. Realignment or rotational osteotomy is suitable for those with a relatively small necrotic segment. Arthrodesis is often mentioned in armchair discussions, but in practice it is seldom carried out. Provided the risks are carefully explained, including the likelihood of at least one revision procedure, joint replacement may be justifiable even in this group.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
isotope bone scan同位素骨骼扫描
/ˈaɪsətoʊp/n. 同位素
vascularity/,væskju'læriti/n. 多血管；血管质
diminish /dɪˈmɪnɪʃ/vt. 使减少；使变小vi. 减少，缩小；变小
controversial /ˌkɑːntrəˈvɜːrʃl/adj. 有争议的；有争论的
Core decompression has no place in the management of traumatic osteonecrosis.髓芯减压术在外伤性骨坏死的治疗中没有一席之地。
decompression /ˌdiːkəmˈpreʃn/n. [特医] 解压；降压
armchair /ˈɑːrmtʃer/n. 扶手椅，单人沙发adj. 不切实际的
Arthrodesis is often mentioned in armchair discussions, but in practice it is seldom carried out.关节融合术常被提及，但在实践中很少进行。
百度翻译：
缺血性坏死
股骨头缺血性坏死发生在30%的不移位骨折患者和10%的未放置骨折患者中。在骨折的时候没有办法诊断。几周后，同位素骨扫描可能显示血管减少。X光改变可能在数月甚至数年内都不明显。无论骨折是否愈合，股骨头塌陷都会导致疼痛和进行性功能丧失（图29.10）。对于45岁以上的患者，治疗方法是全关节置换。
对于年轻患者，治疗的选择是有争议的。核心减压在创伤性骨坏死的治疗中没有一席之地。再植骨或旋转截骨术适用于坏死节段相对较小的患者。关节融合术常被提及，但在实践中很少进行。只要仔细解释风险，包括至少一次翻修手术的可能性，即使在这类患者中，关节置换也可能是合理的。