骨科英文书籍精读（252）｜儿童股骨近端骨折的并发症
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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Complications
Avascular necrosis of the femoral head
This is the most common (and most feared) complication; it occurs in about 30 per cent of all cases. Important risk factors are (1) an age of more than 10; (2) a high velocity injury; (3) a type I or II fracture; and (4) displacement. The child complains of pain and loss of movement; x-ray changes usually appear within 3 months of injury. Treatment is problematic. Non-weightbearing, or ‘containment splintage’ in abduction and internal rotation, is sometimes advocated but there is little evidence that this makes any difference. The outcome depends largely on the size of the necrotic area; unfortunately most end up with intrusive pain and marked restriction of movement. Arthrodesis may be advisable, as a late salvage procedure.
Coxa vara
Femoral neck deformity may result from malunion, avascular necrosis or premature physeal closure. If the deformity is mild, remodelling may take care of it. If the neck-shaft angle is less than 110 degrees, subtrochanteric valgus osteotomy will probably be needed.
Diminished growth
Physeal damage may result in retarded femoral growth. Limb length equalization may be needed.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
velocity /vəˈlɑːsəti/n. 【物】速度
problematic /ˌprɑːbləˈmætɪk/adj. 问题的；有疑问的；不确定的
containment/kənˈteɪnmənt/n. 控制，抑制；遏制；封锁（政策）
necrotic/ne'krɔtik/
adj. [病理] 坏死的；骨疽的，坏疽的
intrusive /ɪnˈtruːsɪv/adj. 侵入的；打扰的
premature physeal closure骺板早闭
remodelling may take care of it重构可以解决这个问题。
valgus /vælɡəs/n. 外翻足的人；外翻足adj. 外翻的
retard /rɪˈtɑːrd; ˈriːtɑːrd/n. 延迟；阻止vt. 延迟；阻止；妨碍；使减速vi. 减慢；受到阻滞
equalization/ˌiːkwələˈzeɪʃn/n. 均衡；均等；同等化
百度翻译：
并发症
股骨头缺血性坏死
这是最常见（也是最令人恐惧的）并发症，约占所有病例的30%。重要的危险因素是（1）年龄超过10岁；（2）高速损伤；（3）I型或II型骨折；（4）移位。孩子抱怨疼痛和失去活动能力；x光改变通常在受伤后3个月内出现。治疗是有问题的。非负重，或'遏制夹板'在外展和内旋，有时是提倡的，但很少有证据表明这有任何区别。结果在很大程度上取决于坏死区域的大小；不幸的是，大多数患者最终会出现侵入性疼痛和明显的活动受限。关节融合术可能是一种晚期抢救性手术。
髋内翻
股骨颈畸形可能是由于畸形愈合、股骨头缺血性坏死或过早闭合所致。如果畸形是轻微的，重塑可以照顾它。如果颈干角小于110度，可能需要行转子下外翻截骨术。
肢体生长问题
Physeal损伤可能导致股骨生长迟缓。可能需要肢体长度均衡。