骨科英文书籍精读（79）｜儿童肱骨近端骨折
FRACTURES OF THE PROXIMAL
HUMERUS IN CHILDREN
At birth, the shoulder is sometimes dislocated or the proximal humerus fractured. Diagnosis is difficult and a clavicular fracture or brachial plexus injury should also be considered.
In infancy, the physis can separate (Salter–Harris I); reduction does not have to be perfect and a good outcome is usual.
In older children, metaphyseal fractures or Type II physeal fractures occur. Considerable displacement and angulation can be accepted; because of the marked growth and remodelling potential of the proximal humerus, malunion is readily compensated for during the remaining growth period.
Pathological fractures are not unusual, as the proximal humerus is a common site of bone cysts and tumours in children. Fracture through a simple cyst usually unites and the cyst often heals spontaneously; all that is needed is to rest the arm in a sling for 4–6 weeks. Other lesions require treatment in their own right (See Chapter 9).
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
infancy /ˈɪnfənsi/n. 初期；婴儿期；幼年
physis骨骺 /'faisis/n. 自然界生长原则；后缀生长
metaphyseal 干骺端的
Considerable displacement and angulation can be accepte; because of the marked growth and remodelling potential of the proximal humerus, malunion is readily compensated for during the remaining growth period.可接受相当大的位移和角度；由于肱骨近端明显的生长和重塑潜力，畸形愈合在剩余的生长期间很容易得到补偿。
rest the arm in a sling for 4–6 weeks用吊带使手臂休息4-6周
百度翻译：
儿童肱骨近端骨折
出生时，肩膀有时会脱位或肱骨近端骨折。诊断很困难，还应考虑锁骨骨折或臂丛神经损伤。
在婴儿期，物理可以分开（Salter-Harris I）；复位不一定是完美的，而且通常会有一个好的结果。
在年龄较大的儿童中，会发生干骺端骨折或II型干骺端骨折。可以接受相当大的位移和角度；由于肱骨近端的显着生长和重塑潜力，畸形愈合在剩余的生长期间很容易得到补偿。
病理性骨折并不罕见，因为肱骨近端是儿童骨囊肿和肿瘤的常见部位。通过简单的囊肿骨折通常会愈合，囊肿通常会自发愈合；所需要的只是将手臂放在吊带上4-6周。其他病变需要单独治疗（见第9章）。