骨科英文书籍精读（216）｜骶骨和尾骨损伤
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。
INJURIES TO THE SACRUM AND COCCYX
A blow from behind, or a fall onto the ‘tail’ may fracture the sacrum or coccyx, or sprain the joint between them. Women seem to be affected more commonly than men.
Bruising is considerable and tenderness is elicited when the sacrum or coccyx is palpated from behind or per rectum. Sensation may be lost over the distribution of sacral nerves.
X-rays may show: (1) a transverse fracture of the sacrum, in rare cases with the lower fragment pushed forwards; (2) a fractured coccyx, sometimes with the lower fragment angulated forwards; or (3) a normal appearance if the injury was merely a sprained sacrococcygeal joint.
Treatment
If the fracture is displaced, reduction is worth attempting. The lower fragment may be pushed backwards by a finger in the rectum. The reduction is stable, which is fortunate. The patient is allowed to resume normal activity, but is advised to use a rubber ring cushion when sitting. Occasionally, sacral fractures are associated with urinary problems, necessitating sacral laminectomy.
Persistent pain, especially on sitting, is common after coccygeal injuries. If the pain is not relieved by the use of a cushion or by the injection of local anaesthetic into the tender area, excision of the coccyx may be considered.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
SACRUM /ˈseɪkrəm,ˈsækrəm/n. [解剖] 骶骨；[解剖] 荐骨
COCCYX /ˈkɑːksɪks/n. 尾骨；尾椎
the distribution of sacral nerves骶神经的分布
sacral /ˈseɪkrəl/adj. 骶骨的；圣礼的；祭典的
merely /ˈmɪrli/adv. 仅仅，只不过；只是
resume /rɪˈzuːm/vt. （中断后）重新开始，继续；重新回到，恢复（席位，地位或职位）；（停顿或被打断后）继续说；重选，重穿，重新占用vi. 重新开始，继续；再次出现n. （文章、讲话等的）梗概，摘要；个人简历，履历
necessitating /nəˈsesɪteɪtɪŋ/v. 使成为必要，需要；迫使（necessitate 的现在分词）
laminectomy. /ˌlæmɪˈnektəmi/n. [外科] 椎板切除术
coccygeal /kɔk'sidʒiəl/adj. （与）尾骨，尾椎（有关）的
tender area压痛点
excision of the coccyx尾骨切除
百度翻译：
骶骨和尾骨受伤
从后面击打或摔在“尾巴”上，可能会使骶骨或尾骨骨折，或扭伤它们之间的关节。女性似乎比男性更容易受到感染。
当从后方或直肠触碰骶骨或尾骨时，瘀伤是相当严重的，并引起压痛。骶神经的分布可能会失去知觉。
X光片可显示：（1）骶骨横断性骨折，少数情况下下节段向前推进；（2）尾骨骨折，有时下节段向前成角度；或（3）如果损伤只是骶尾关节扭伤，外观正常。
治疗
如果骨折移位，值得复位。直肠中的一根手指可能会将下部的碎片向后推。减少是稳定的，这是幸运的。允许患者恢复正常活动，但建议患者坐着时使用橡胶圈垫。偶尔，骶骨骨折会伴有泌尿系统问题，因此需要进行骶骨椎板切除术。
持续性疼痛，尤其是坐着，是尾骨受伤后常见的。如果使用垫子或在压痛区注射局部厌氧菌不能减轻疼痛，可考虑切除尾骨。