骨科英文书籍精读（46）｜骨折晚期并发症之骨性关节炎
OSTEOARTHRITIS
A fracture involving a joint may severely damage the articular cartilage and give rise to post-traumatic osteoarthritis within a period of months. Even if the cartilage heals, irregularity of the joint surface may
cause localized stress and so predispose to secondary osteoarthritis years later. If the step-off in the articular surface involves a large fragment in a joint that is readily accessible to surgery, intra-articular osteotomies and re-positioning of the fragment may help. Often though the problem arises from areas that were previously comminuted and depressed – little can be done once the fracture has united.
Malunion of a metaphyseal fracture may radically alter the mechanics of a nearby joint and this, too, can give rise to secondary osteoarthritis. It is often asserted that malunion in the shaft of a long bone (e.g. the tibia) may act in a similar manner; however, there is little evidence to show that residual angulation of less than 15 degrees can cause proximal or distal osteoarthritis.
---from 《Apley’s System of Orthopaedics and Fractures》P687-688
重点词汇整理：
OSTEOARTHRITIS /ˌɑːstioʊɑːrˈθraɪtɪs/n. [外科] 骨关节炎
irregularity/ɪˌreɡjəˈlærəti/n. 不规则；无规律；不整齐
predispose to secondary osteoarthritis易于引发继发性骨关节炎
predispose /ˌpriːdɪˈspoʊz/vt. 预先处置；使…偏向于
secondary /ˈsekənderi/n. 副手；代理人adj. 第二的；中等的；次要的；中级的
intra-articular osteotomies and re-positioning of the fragment关节内截骨和重新复位骨折碎片
Often though the problem arises from areas that were previously comminuted and depressed 通常情况下，虽然问题是由以前粉碎和凹陷的部位引起的
radically /ˈrædɪkli/adv. 根本上；彻底地；以激进的方式
assert /əˈsɜːrt/vt. 维护，坚持；断言
residual /rɪˈzɪdʒuəl/adj. 剩余的n. 剩余物，残渣；残差
百度翻译：
骨关节炎
关节骨折可能严重损害关节软骨，并在数月内引起创伤后骨关节炎。即使软骨愈合，关节表面的不规则也可能
导致局部压力，因此容易导致继发性骨关节炎多年后。如果关节面上的台阶涉及关节内易于手术的大碎片，关节内截骨和碎片的重新定位可能有帮助。尽管这个问题通常是由以前粉碎和凹陷的区域引起的，但一旦骨折愈合，就没什么办法了。
干骺端骨折的不愈合可能从根本上改变附近关节的力学机制，这也可能导致继发性骨关节炎。常有人断言长骨（如胫骨）骨干的畸形愈合可能以类似的方式起作用；然而，很少有证据表明，小于15度的残余成角可引起近端或远端骨关节炎。