骨科英文书籍精读（221）｜髋关节后脱位治疗（2）
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。
Reduction is usually stable in type I injuries, but the hip has been severely injured and needs to be rested. The simplest way is to apply traction and maintain it for a few days. Movement and exercises are begun as soon as pain allows; continuous passive movement machines are helpful. The terminal ranges of hip movements are avoided to allow healing of the capsule and ligaments. As soon as active limb control is achieved, and this may take about 2 weeks, the patient is allowed to walk with crutches but without taking weight on the affected side.The rationale for not bearing weight is to prevent collapse of femoral head due to an unsuspected avascular change.
The period of hip ‘protection’ varies according to the risk of avascular necrosis: if the reduction was performed promptly (within 6 hours), then no more than 6 weeks should suffice, but if there was a longer delay then an extended period of 12 weeks may be wiser.Progression of weightbearing should be graduated and the hip joint monitored by x-ray (Tornetta and Mostafavi 1997).
If the post-reduction x-rays or CT scans show the presence of intra-articular bone fragments or larger femoral head pieces that are incompletely reduced, an open procedure should be planned. The approach is dictated by the location of the fragment on CT scan; however, the operation is not an emergency and can be done once the patient’s condition has stabilized. The joint needs to be thoroughly washed out at the conclusion of the procedure to remove bone ‘grit’.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
without taking weight on the affected side.避免患侧负重。
rationale /ˌræʃəˈnæl/n. 基本原理；根本原因
The rationale for not bearing weight is to prevent collapse of femoral head due to an unsuspected avascular change. 不负重的基本原理是防止股骨头因未被怀疑的无血管变化而塌陷。
suffice /səˈfaɪs/vt. 使满足；足够…用；合格vi. 足够；有能力
Progression of weightbearing 负重分级
the patient’s condition has stabilized.：病人的病情已经稳定下来。
The joint needs to be thoroughly washed out at the conclusion of the procedure to remove bone ‘grit’.在手术结束时，关节需要彻底清洗以去除骨头中的“沙砾”。
conclusion /kənˈkluːʒn/n. 结论；结局；推论
百度翻译：
在I型损伤中复位通常是稳定的，但髋部已经严重受伤，需要休息。最简单的方法是施加牵引力并维持几天。只要疼痛允许，就开始运动和锻炼；持续的被动运动机器是有帮助的。避免髋关节活动的末端范围，以使帽状沟和韧带愈合。一旦实现了肢体的主动控制，这可能需要2周左右的时间，患者就可以拄着拐杖行走，但患侧不必负重。不负重的基本原理是为了防止由于意外的无血管变化而导致的股骨头塌陷。
髋关节“保护”的时间根据缺血性坏死的风险而变化：如果及时（在6小时内）复位，则不超过6周就足够了，但如果延迟时间较长，则可延长12周更明智的进步负重量应分级，髋关节由x射线（Tornetta和Mostafavi，1997年）。
如果复位后的x射线或CT扫描显示关节内骨碎片或较大的股骨头碎片未完全复位，则应计划开放手术。入路取决于CT扫描上碎片的位置；但是，手术不是紧急情况，一旦病人病情稳定，就可以进行手术。手术结束后，关节需要彻底清洗，以去除骨“砂砾”。