骨科英文书籍精读（236）｜股骨颈骨折的治疗(2)
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Internal fixation
Not withstanding the advances in joint replacement, for most patients the principles of treatment are as of old: accurate reduction, secure internal fixation and early activity. Displaced fractures must first be reduced: with the patient under anaesthesia, the fracture is disimpacted by applying traction with the hip held in 45 degrees of flexion and slight abduction; the limb is then slowly brought into extension and finally internally rotated; as traction is released, the fracture re-impacts in the reduced position.
The reduction is assessed by x-ray. The femoral head should be positioned correctly with the stress trabeculae in the femoral head and those in the femoral neck aligned close to their normal position in both anteroposterior and lateral views, as shown in Figure 29.7. In the AP x-ray the trabeculae in the femoral head and a line along the medial border of the femoral shaft should subtend an angle of 155–180 degrees.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
withstanding /wɪðˈstænd,wɪθˈstænd/
vt. 抵挡；禁得起；反抗vi. 反抗
disimpact
impact /ˈɪmpækt/n. 影响；效果；碰撞；冲击力vt. 挤入，压紧；撞击；对…产生影响vi. 影响；撞击；冲突；压紧（on，upon，with）
trabeculae /trəˈbekjələ/n. 骨小梁
subtend /səbˈtend/vt. 对向；朝着
百度翻译：
内固定
尽管关节置换术取得了进展，但对于大多数患者来说，治疗原则仍然是：精确复位、安全内固定和早期活动。移位的骨折必须首先复位：病人在麻醉状态下，通过牵引解除骨折，髋关节保持45度的屈曲和轻微外展；然后四肢缓慢伸直，最后进行内旋；当牵引力释放时，骨折会重新撞击到复位的位置。
用x射线评估其还原程度。股骨头的位置应正确，股骨头中的应力小梁和股骨颈中的应力小梁在前后和侧视图中均接近其正常位置，如图29.7所示。在AP x光片中，股骨头内的小梁和股骨干内侧边缘的一条线应与155–180度的夹角相对应。