骨科英文书籍精读（161）｜拇指掌指骨关节尺侧副韧带损伤(2)
Treatment
Partial tears can be treated by a short period (2–4 weeks) of immobilization in a splint followed by increasing movement. Pinch should be avoided for 6–8 weeks.
Complete tears need operative repair. Care should be taken during the exposure not to injure the superficial radial nerve branches. The Stener lesion is found at the proximal edge of the adductor aponeurosis. The aponeurosis is incised and retracted to expose the ligaments and capsule and the torn structures are then carefully repaired. Postoperatively, the joint is immobilized in a thumb splint for 6 weeks, but can be moved early in the flexion–extension plane as the ligament is isometric (i.e. the same length in flexion and extension). The thumb interphalangeal joint should be left free from the outset to avoid the adductor aponeurosis becoming adherent (which would limit flexion). A neglected tear leads to weakness of pinch. In early cases without articular damage, stability may be restored by using a free tendon graft. If this fails, or if the joint is painful, MP joint arthrodesis is reliable and leaves minimal functional deficit.
In children, the injury may be accompanied by a Salter–Harris Type III fracture through the physis. This should be reduced and fixed with smooth Kwires which should not cross the growth plate.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
Pinch /pɪntʃ/n. 捏，拧
the superficial radial nerve branches桡浅神经支
superficial /ˌsuːpərˈfɪʃl/adj. 表面的；肤浅的 ；表面文章的；外表的；（人）浅薄的
adductor /ə'dʌktə/n. [解剖] 内收肌；内转肌
aponeurosis /æpənʊˈroʊsɪs/n. [解剖] 腱膜
incise /ɪnˈsaɪz/vt. 切；切割；雕刻
in the flexion–extension plane 在屈伸面
plane /pleɪn/n. 飞机；平面；程度，水平adj. 平的；平面的
isometric /ˌaɪsəˈmetrɪk/n. 等容线adj. [数] 等距的；等角的；等轴的；等体积的
functional deficit.功能缺失
physis /'faisis/n. 自然界生长原则；后缀生长
the growth plate.生长板。
百度翻译：
治疗
部分撕裂可以通过短时间（2-4周）固定在夹板上，然后增加运动来治疗。6-8周内应避免夹伤。
完全撕裂需要手术修补。暴露时应注意不要损伤桡神经末梢支。狭窄的病变位于内收肌腱膜的近端边缘。腱膜被切开和收缩，露出韧带和包膜，然后小心地修复撕裂的结构。在术后6周内，拇指的伸直和伸直是一样的。拇指指间关节从一开始就应该保持自由，以避免内收肌腱膜粘连（这会限制屈曲）。不经意的眼泪会使人手足无措。在没有关节损伤的早期病例中，可以通过使用游离肌腱移植来恢复稳定性。如果失败，或者关节疼痛，MP关节融合术是可以缓解的，并留下最小的功能缺陷。
对于儿童来说，损伤可能伴有Salter-HarrisⅢ型骨折。应减少并用光滑的K 线固定，不应穿过生长板。