骨科英文书籍精读（360）｜足踝损伤
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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injuries of the ankle and foot
INTRODUCTION
The foot and ankle act to both support and propel the body and are well adapted for these roles. During running and jumping, loads well in excess of 10 times body weight are transmitted through the ankle and foot. If this loading is excessive, or excessively repeated, it can lead to foot and ankle injuries.
The ankle is a close-fitting hinge-like joint of which the two parts interlock like a mortise (the box formed by the distal ends of the tibia and fibula) and tenon (the upward projecting talus). The mortise bones are held together as a syndesmosis by the distal (inferior) tibiofibular and interosseous ligaments, and the talus is prevented from slipping out of the mortise by the medial and lateral collateral ligaments and joint capsule. The peroneal tendons provide additional stability.
The ankle moves only in one plane (flexion/ extension), but with a complex axis of rotation, actually rolling forward as the talus goes into plantar flexion; sideways movement is prevented by the malleolar buttresses and the collateral ligaments, but the bony constraint lessens as the ankle flexes. If the talus is forced to tilt or rotate, something must give: the ligaments, the malleoli or both. Movements of the talus into internal or external rotation come about from a rotatory force upon the foot, or more commonly inversion/supination of the foot, which, through the orientation of the subtalar joint, causes external rotation of the talus. Whenever a fracture of the malleolus is seen, it is important to ask about the associated ligament injury.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
mortise /ˈmɔːrtɪs/n. 榫眼v. 榫接，使牢固相接；给……开榫眼
talus /ˈteɪləs/n. 距骨；踝；斜面
syndesmosis/ˌsɪndesˈmoʊsɪs/n. [解剖] 韧带联合
distal (inferior) tibiofibular and interosseous ligaments远端(下)胫腓联合韧带和骨间韧带
peroneal 美 /,perə'ni:əl/adj. 腓骨的；腓侧的
plantar flexion跖屈
plantar /ˈplæntər/adj. [解剖] 跖的；[解剖] 脚底的
malleolar /mə'li:ələ/adj. 踝的
the bony constraint lessens as the ankle flexes. 随着踝关节的屈曲，骨约束减轻。
internal or external rotation 内旋或外旋
subtalar joint距下关节
有道翻译（仅供参考，建议自己翻译）：
脚踝和脚受伤
导言
脚和踝关节起着支撑和推动身体的作用，很好地适应了这些角色。跑步和跳跃时，超过体重10倍的负荷通过脚踝和脚传递。如果这种负荷过大或重复过多，会导致脚和脚踝受伤。
踝关节是一个紧密贴合的铰链状关节，其两部分像榫眼（胫骨和腓骨远端形成的盒子）和榫（向上突出的距骨）一样互锁。榫状骨通过远端（下）胫腓韧带和骨间韧带连接在一起，内侧和外侧副韧带和关节帽防止距骨滑出榫状骨。腓骨肌腱提供额外的稳定性。
踝关节仅在一个平面上运动（屈曲/伸展），但具有复杂的旋转轴，当距骨进入足底屈曲时实际向前滚动；踝关节和副韧带阻止了侧向运动，但随着踝关节的弯曲，骨性紧张减少。如果距骨被迫倾斜或旋转，一定要有什么东西：韧带，踝关节或两者兼而有之。距骨内旋或外旋的运动是由脚上的旋转力引起的，或者更常见的是脚的内翻/旋后，通过距骨下关节的方向，引起距骨的外旋。当看到踝关节骨折时，询问相关韧带损伤是很重要的。