骨科英文书籍精读（396）｜跗骨-跖骨损伤的治疗
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。
获取本书全本内容----->请扫描文末二维码，关注公众号并回复“骨折肌肉学”。
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。
Treatment
The method of treatment depends on the severity of the injury. Undisplaced sprains require cast immobilization for 4–6 weeks. Subluxation or dislocation calls for accurate reduction. This can often be achieved by traction and manipulation under anaesthesia; the position is then held with percutaneous K-wires or screws and cast immobilization. The cast is changed after a few days when swelling has subsided; the new cast is retained, non-weightbearing, for 6–8 weeks. The Kwires are then removed and rehabilitation exercises begun.
If closed reduction fails, open reduction is essential. The key to success is the second TMT joint. Through a longitudinal incision, the base of the second metatarsal is exposed and the joint manipulated into position. Reduction of the remaining parts of the tarso-metatarsal articulation will not be too difficult. The bones are fixed with percutaneous K-wires or screws and the foot is immobilized as described earlier.
Complications
Compartment syndrome
A tensely swollen foot may hide a serious compartment syndrome that could result in ischaemic contractures. If this is suspected, intracompartmental pressures should be measured (see Chapter 23). Treatment should be prompt and effective: through a medial longitudinal incision, or two well-spaced dorsal incisions, all the compartments can be decompressed; the wound is left open until swelling subsides and the skin can be closed without tension.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
rehabilitation exercises 康复锻炼
/ˌriːəˌbɪlɪˈteɪʃn/n. 康复，复原；（权利、名誉的）恢复；修复，
ischaemic contractures缺血性挛缩
intracompartmental pressure间隔室内压力
DeepL翻译（仅供参考，建议自己翻译）：
治疗方法
治疗方法取决于受伤的严重程度。未移位的扭伤需要石膏固定4-6周。半脱位或脱位需要准确的复位。这通常可以通过麻醉下的牵引和操作来实现；然后用经皮K线或螺钉和石膏固定来固定位置。几天后，当肿胀消退时，要更换石膏；新的石膏要保留，不负重，6-8周。然后拆除K线，开始康复训练。
如果闭合复位失败，则必须进行开放复位。成功的关键是第二个TMT关节。通过一个纵向切口，第二跖骨的基部被暴露出来，并对关节进行操作定位。缩小跗骨-跖骨关节的其余部分不会太困难。用经皮K线或螺钉固定骨头，并按前面所述固定脚。
并发症
腔隙综合征
紧张肿胀的足部可能隐藏着严重的室间隔综合征，可能导致缺血性挛缩。如果怀疑有这种情况，应测量腔内压力（见第23章）。治疗应及时有效：通过内侧纵向切口，或两个间隔良好的背侧切口，可对所有的隔间进行减压；伤口保持开放，直到肿胀消退，皮肤可以无张力闭合。