骨科英文书籍精读（213）｜髋臼骨折的手术治疗
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
Operative treatment is indicated for all unstable hips and fractures resulting in significant distortion of the ball and socket congruence. The hip may be dislocated centrally, anteriorly or posteriorly. Patients with isolated posterior wall fractures and dislocation may require immediate open reduction and stabilization. In other cases operation is usually deferred for 4 or 5 days.
Matta and Merritt (1988) have made the important point that open reduction is an operation on the pelvis and not merely the acetabular socket. Adequate exposure is essential, if possible through a single approach which is selected according to the type of fracture.
The posterior Kocher–Langenbach exposure allows good access to the posterior wall and column but may have to be combined with a trochanteric osteotomy to gain adequate sight in transverse fractures. The anterior ilioinguinal approach is suited for anterior wall and column fractures. Both exposures are usually needed in T-type and both-column fractures – this is a considerable undertaking, encouraging some surgeons to adopt the singular triradiate or extended iliofemoral approaches instead. The fracture (or fractures) is fixed with lag screws or special buttressing plates which can be shaped in the operating theatre. It is useful to monitor somatosensory evoked potentials during the operation, in order to avoid damaging the sciatic nerve (separate electrodes are required for medial and lateral popliteal branches).
Prophylactic antibiotics are used, and postoperatively hip movements are started as soon as possible. Some prophylaxis against heterotopic ossification is often used, usually indomethacin. The patient is allowed up, partial weightbearing with crutches, after 7 days. Exercises are continued for 3–6 months; it may take a year or longer for full function to return.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
distortion/dɪˈstɔːrʃn/n. 变形；[物] 失真；扭曲；曲解
defer /dɪˈfɜːr/vt. 使推迟；使延期vi. 推迟；延期；服从
trochantericadj. 转子的
ilioinguinal髂腹股沟的
special buttressing plates特殊的支撑板
operating theatre.手术室
somatosensory /ˌsoʊmətəˈsensəri/adj. 躯体感觉的
evoke/ɪˈvoʊk/vt. 引起，唤起；博得
Prophylactic antibiotics预防性应用抗生素
Prophylactic/ˌproʊfəˈlæktɪk/n. 预防性药物（或器具、措施）；预防法；避孕用具adj. 预防性的，预防疾病的
heterotopic ossification异位性骨化
indomethacin吲哚美辛, 消炎痛
百度翻译：
手术治疗
手术治疗是指所有不稳定的髋部和骨折，导致球窝一致性明显扭曲。髋关节可能在中央、前后脱臼。孤立性后壁骨折和脱位的患者可能需要立即切开复位和固定。在其他情况下，手术通常推迟4到5天。
Matta和Merritt（1988）提出了一个重要的观点，即切开复位是一种骨盆手术，而不仅仅是髋臼窝。充分的暴露是必要的，如果可能的话，通过根据骨折类型选择的单一方法。
后Kocher-Langenbach暴露可以很好地进入后壁和后柱，但可能必须结合转子截骨术来获得足够的横向骨折视野。髂腹股沟前入路适用于前壁和柱状骨折。T型和双柱状骨折通常需要两种暴露方式——这是一项相当大的任务，鼓励一些周边地区采用单一的三辐射或扩展髂股肌方法。可在手术室用特殊的支撑螺钉固定骨折或骨折。术中监测体感诱发电位有助于避免损伤坐骨神经（腘内侧支和外侧支需要单独的电极）。
使用预防性抗生素，并尽快开始术后髋关节活动。一些预防异位骨化的方法经常被使用，通常是消炎痛。7天后，病人可以用拐杖部分负重。练习持续3-6个月；可能需要一年或更长时间才能恢复完整功能。