骨科英文书籍精读（334）｜髌骨脱位（4）
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。
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。
OPERATIVE TREATMENT
The area is approached through a medial incision. If the patellofemoral ligament is avulsed from the femur, it is reattached with suitable anchors. Mid-substance tears of the ligaments are sutured directly. At the same time, if the lateral retinaculum is tight it is released.
Osteochondral fragments are removed – unless they are single, large and amenable to reattachment. Postoperatively a padded cylinder cast is applied with the knee in extension; this can be renewed when the swelling has subsided. A hinged brace is substituted, which provides control for weightbearing and allows knee movement. Quadriceps exercises are encouraged.
A hinged brace
Complications
Recurrent dislocation Patients treated non-operatively for a first-time dislocation have a 15–20 percent chance of suffering further dislocations. This depends also on whether there are other predisposing abnormalities, and prevention consists of dealing with all these conditions (the subjects of recurrent dislocation, subluxation, chronic patellar instability and patellar mal-tracking are dealt with in Chapter 20).
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
Mid-substance tears of the ligaments are sutured directly韧带的中间撕裂直接缝合
amenable /əˈmiːnəbl,əˈmenəbl/adj. 有责任的：顺从的，服从的；有义务的；经得起检验的
be amenable to teattachment 可以复位
substitute/ˈsʌbstɪtuːt/n. 代用品；代替者vi. 替代vt. 代替
predispose /ˌpriːdɪˈspoʊz/vt. 预先处置；使…偏向于
subluxation, /,sʌblʌk'seiʃən/n. [外科] 半脱位；不全脱位
有道翻译（仅供参考，建议自己翻译）：
手术治疗
该区域通过内侧切口进入。如果髌股韧带从股骨上撕下，用合适的锚重新固定。韧带中段撕裂直接缝合。同时，如果外侧支持带很紧，它就会被释放。
骨软骨碎片被移除-除非它们是单一的，大的并且易于再附着。术后应用带衬垫的圆柱体铸型，膝盖伸直；当肿胀消退时，可以更新铸型。一个铰链支撑被取代，它提供了负重控制，并允许膝盖运动。鼓励股四头肌锻炼。
并发症
对于首次脱位而非手术治疗的复发性脱位患者，有15-20%的机会发生进一步的脱位。这还取决于是否存在其他易感异常，预防包括处理所有这些情况（复发性脱位、半脱位、慢性髌骨不稳定和髌骨跟踪不良的主题在第20章中讨论）。