骨科英文书籍精读（266）｜股骨干骨折钢板治疗
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。
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Plate and screw fixation
Plating is a comparatively easy way of obtaining accurate reduction and firm fixation. The method was popular at one time but went out of favour because of a high complication rate. This occurred when plates were applied through a wide open exposure of the fracture site and perfect anatomical reduction of all bone pieces. Such extensive surgery damaged the healing potential and led to tardy union and implant failure. However, plates have encountered resurgence: today, they are inserted through short incisions and placed in a submuscular plane, rather than deep to periosteum; an indirect (closed) reduction of the fracture is done; fewer screws are used, and usually placed at the ends of the plate, leading to a less rigid hold on the fracture. This technique of minimally invasive plate osteosynthesis (MIPO) has led to better union rates. However, postoperative weightbearing will need to be modified as the implant is not as strong as an intramedullary nail.The main indications for plates are (1) fractures at either end of the femoral shaft, especially those with extensions into the supracondylar or pertrochanteric areas, (2) a shaft fracture in a growing child, and (3)a fracture with a vascular injury which requires repair (Figure 29.24).
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
The method was popular at one time but went out of favour because of a high complication rate.
这种方法曾经很流行，但由于并发症发生率高而失宠。
went out of favour ：失宠
tardy /ˈtɑːrdi/n. 迟到adj. 缓慢的，迟缓的；迟到的
encounter /ɪnˈkaʊntər/v. 遭遇；邂逅；遇到n. 遭遇；偶然碰见
resurgence /rɪˈsɜːrdʒəns/n. 复活；再现；再起
they are inserted through short incisions and placed in a submuscular plane, rather than deep to periosteum.它们通过短切口插入并放置在肌肉下平面，而不是深入骨膜。
minimally invasive plate osteosynthesis (MIPO)微创钢板固定术(MIPO)
synthesis /ˈsɪnθəsɪs/n. 综合，[化学] 合成；综合体
supracondylar 髁上的
pertrochanteric经大转子的
百度翻译：
钢板螺钉固定
电镀是获得精确复位和牢固固定的相对简单的方法。这种方法一度很流行，但因并发症发生率高而不受欢迎。当钢板通过骨折部位的大面积暴露和所有骨块的完美解剖复位应用时，就会发生这种情况。如此广泛的手术损伤了愈合潜力，导致愈合迟缓和植入失败。然而，接骨板遇到了复苏：今天，他们是通过短切口插入并放置在肌肉下平面，而不是骨膜深部；间接（闭合）复位骨折；使用较少的螺钉，通常放置在钢板的末端，导致对骨折的固定不太牢固。这种微创钢板接骨技术（MIPO）已导致更好的愈合率。然而，术后负重需要改进，因为植入物不如髓内固定牢固钉子。钉子钢板的主要适应证是：（1）股骨干两端的骨折，特别是延伸到髁上或转子周围的骨折，（2）生长期儿童的骨干骨折，（3）骨折伴血管损伤，需要修复（图29.24）。