骨科英文书籍精读（329）｜髌骨骨折（2）
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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Clinical features
Following one of the typical injuries, the knee becomes swollen and painful. There may be an abrasion or bruising over the front of the joint. The patella is tender and sometimes a gap can be felt.
Active knee extension should be tested. If the patient can lift the straight leg, the quadriceps mechanism is still intact. If this manoeuvre is too painful, active extension can be tested with the patient lying on his side.
If there is an effusion, aspiration may reveal the presence of blood and fat droplets.
X-ray
The x-ray may show one or more fine fracture lines without displacement, multiple fracture lines with irregular displacement or a transverse fracture with a gap between the fragments (Fig. 30.14). Comparative x-rays of the opposite knee may help to distinguish normal from abnormal appearances in undisplaced fractures.
Patellar fractures are classified as transverse, longitudinal, polar or comminuted (stellate). Any of these may be either undisplaced or displaced. Separation of the fragments is significant if it is sufficient to create a step on the articular surface of the patella or, in the case of a transverse fracture, if the gap is more than 3 mm wide.
A fracture line running obliquely across the superolateral corner of the patella should not be confused with the smooth, regular line of a (normal) bipartite patella. Check the opposite knee; bipartite patella is
often bilateral.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
abrasion or bruising磨损或擦伤
If this manoeuvre is too painful,如果这个动作太痛苦，
manoeuvre /məˈnuːvər/n. 特技动作，熟练动作；（尤指以欺骗为目的）策略，手段；欺诈性操作；军事演习（等于 maneuver）v. （使谨慎或熟练地）移动；操控，使花招；诱使，诱导
the patient lying on his side.病人侧卧着。
If there is an effusion, aspiration may reveal the presence of blood and fat droplets.如果有积液，抽吸后可发现血液和脂肪滴的存在。
effusion/ɪˈfjuːʒn/n. 渗出；泻出；渗漏物
reveal /rɪˈviːl/vt. 显示；透露；揭露；泄露
Patellar fractures are classified as transverse, longitudinal, polar or comminuted (stellate).髌骨骨折分为横向骨折、纵向骨折、上下极骨折和粉碎性骨折(星状骨折)。
superolateral上外侧的
bilateral /ˌbaɪˈlætərəl/adj. 双边的；有两边的
有道翻译（仅供参考，建议自己翻译）：
临床特征
一种典型的损伤发生后，膝盖会变得肿胀和疼痛。关节前部可能有擦伤或瘀伤。髌骨很嫩，有时能感觉到间隙。 应该测试主动膝关节伸展。如果患者能够抬起直腿，则股四头肌机制仍是完整的。如果这个动作太痛苦，可以让病人侧卧，尝试主动伸展。如果有积液，抽吸后可发现血液和脂肪滴的存在。
x射线
x线可显示一条或多条未移位的细骨折线，多条不规则移位的骨折线，或碎片间有间隙的横向骨折(图30.14)。
对侧膝关节的x线比较有助于区分未移位骨折的正常和异常表现。髌骨骨折分为横向骨折、纵向骨折、极骨折和粉碎性骨折(星状骨折)。他们中的任何一个人可能是未被转移的，也可能是被转移的。如果碎片足以在髌骨关节面上形成台阶，或者在横骨折的情况下，如果间隙超过3mm宽，碎片的分离是重要的。斜穿过髌骨上外侧角的骨折线不应与(正常)髌骨二部的光滑、规则的线混淆。检查对膝关节;一式两份的髌骨是经常两国。