骨科英文书籍精读（73）｜儿童肩关节脱位
SHOULDER DISLOCATIONS IN CHILDREN
Traumatic dislocation of the shoulder is exceedingly rare in children. Children who give a history of the shoulder ‘slipping out’ almost invariably have either voluntary or involuntary (atraumatic) dislocation or subluxation. With voluntary dislocation, the child can demonstrate the instability at will. With involuntary dislocation, the shoulder slips out unexpectedly during everyday activities. Most of these children have generalized joint laxity and some have glenoid dysplasia or muscle patterning disorders (Chapter 13).
Examination may show that the shoulder subluxates in almost any direction; x-rays may confirm the diagnosis.
Treatment
Atraumatic dislocation should be viewed with great caution. Some of these children have behavioural or muscle patterning problems and this is where treatment should be directed. A prolonged exercise programme may also help. Only if the child is genuinely distressed by the disorder, and provided psychological factors have been excluded, should one consider reconstructive surgery.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
exceedingly /ɪkˈsiːdɪŋli/adv. 非常；极其；极度地；极端
slipping out滑移出
invariably /ɪnˈveriəbli/adv. 总是；不变地；一定地
voluntary or involuntary 自发或非自发
voluntary /ˈvɑːlənteri/n. 志愿者；自愿行动adj. 自愿的；志愿的；自发的；故意的
atraumatic /,eitrɔ:'mætik/adj. 防止损伤的
demonstrate /ˈdemənstreɪt/vt. 证明；展示；论证vi. 示威
at will.随意；任意
unexpectedly/ˌʌnɪkˈspektɪdli/adv. 出乎意料地，意外地
generalized joint laxity广义关节松弛
generalized /ˈdʒenrəlaɪzd/adj. 广义的，普遍的；无显著特点的
dysplasia/dɪs'pleʒə/n. 发育不良；发育异常；异常结构
genuinely/ˈdʒenjuɪnli/adv. 真诚地；诚实地
psychological /ˌsaɪkəˈlɑːdʒɪkl/adj. 心理的；心理学的；精神上的
百度翻译：
儿童肩关节脱位
创伤性肩关节脱位在儿童中极为罕见。有肩关节“滑脱”病史的儿童几乎总是有自愿或非自愿（非创伤性）脱位或半脱位。如果是自愿脱位，孩子可以随意表现出不稳定。在日常活动中，由于非自愿脱位，肩膀会意外地滑脱。这些儿童大多有全身性关节松弛，一些有关节盂发育不良或肌肉模式紊乱（第13章）。
检查可显示肩关节几乎在任何方向半脱位；x光片可证实诊断。
治疗
非外伤性脱位应慎之又慎。其中一些儿童有行为或肌肉模式问题，这是治疗的方向。长时间的锻炼计划也有帮助。只有当孩子真的为这种疾病感到痛苦，并且排除了心理因素，才应该考虑进行重建手术。