骨科英文书籍精读（172）｜手外伤（11）
Postoperative management
IMMEDIATE AFTERCARE
Following an operation, the hand is kept elevated in a roller towel or high sling. If the latter is used, the sling must be removed several times a day to exercise the elbow and shoulder. Too much elbow flexion can stop venous return and make swelling worse. Antibiotics are continued as necessary.
REHABILITATION
Movements of the hand must be commenced within a few days at most. Splintage should allow as many joints as possible to be exercised, consistent with protecting the repair. Most extensor tendon injuries are splinted for about 4 weeks. Dynamic splintage can be used, particularly for injuries at the level of the extensor retinaculum and the metacarpo-phalangeal joint.
Various protocols are followed for flexor tendon injuries, including passive, active or elastic-band assisted flexion. Early movement promotes tendon healing and excursion. In all cases the risk of rupture
is balanced against the need for early mobilization. Close supervision and attention to detail are essential.
Once the tissues have healed, the hand is increasingly used for more and more arduous and complex tasks, especially those that resemble the patient’s normal job, until he or she is fit to start work; if necessary, his or her work is modified temporarily. If secondary surgery is required, tendon or nerve repair is postponed until the skin is healthy, there is no oedema and the joints have regained a normal range of passive movement.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
aftercare /ˈæftərker/n. （病人出院后）护理，（犯人出狱后）安置；售后服务
Antibiotics are continued as necessary.必要时继续使用抗生素。
rehabilitation /ˌriːəˌbɪlɪˈteɪʃn/n. 复原
habilitation /,hæbilə'teiʃən/n. 教授论文；资格；小儿康复
consistent /kənˈsɪstənt/adj. 始终如一的，一致的；坚持的
retinaculum /ˌretəˈnækjələm/n. 支持带；韧带；
extensor retinaculum 伸肌支持带
elastic-band /ɪˌlæstɪk ˈbænd/橡皮筋
excursion. /ɪkˈskɜːrʒn/n. 偏移；远足；短程旅行；
In all cases the risk of rupture is balanced against the need for early mobilization.在所有情况下，破裂的风险与早期动员的需要是平衡的。
Close supervision and attention to detail are essential.密切的监督和对细节的关注至关重要。
arduous /ˈɑːrdʒuəs/adj. 努力的；费力的；险峻的
resemble /rɪˈzembl/vt. 类似，像
postpone /poʊˈspoʊn/vt. 使……延期；把……放在次要地位；把……放在后面vi. 延缓，延迟；延缓发作
oedema/ɪˈdiːmə/n. [病理] 水肿
百度翻译：
术后处理
立即善后
手术后，手用毛巾或高吊带抬高。如果使用后者，吊带必须每天拆下几次，以锻炼肘部和肩部。过度屈肘会阻止静脉回流，使肿胀加重。必要时继续使用抗生素。
康复
手的动作最多只能在几天内开始。夹板固定应允许尽可能多的关节活动，与保护修复一致。大多数伸肌腱损伤用夹板固定大约4周。动态夹板可用于治疗伸肌支持带和掌指骨关节的损伤。
屈肌肌腱损伤有多种治疗方案，包括被动、主动或弹性带辅助屈曲。早期运动促进肌腱愈合和远足。在任何情况下都有破裂的危险与早期动员的需要相平衡。密切监督和关注细节是必不可少的。
一旦组织愈合，手就越来越多地用于越来越艰巨和复杂的任务，尤其是那些与患者正常工作相似的任务，直到他或她适合开始工作；如有必要，他或她的工作会临时改变。如果需要二次手术，肌腱或神经修复将推迟到皮肤健康，没有水肿，关节恢复了正常的被动活动范围。