骨科英文书籍精读（202）｜骨盆骨折的治疗（3）
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。
APC-III and VS injuries
These are the most dangerous injuries and the most difficult to treat. It may be possible to reduce some or all of the vertical displacement by skeletal traction combined with an external fixator; even so, the patient needs to remain in bed for at least 10 weeks. This prolonged recumbency is not without risk. As these injuries represent loss of both anterior and posterior support, both areas will need to be stabilized. Two techniques are used: (a) anterior external fixation and posterior stabilization using screws across the sacroiliac joint, or (b) plating anteriorly and iliosacral screw fixation posteriorly. Posterior operations are hazardous (the dangers include massive haemorrhage, neurological damage and infection) and should be attempted only by surgeons with considerable experience in this field.
Persisting with skeletal traction and external fixation is probably safer, though the malposition is likely to leave a legacy of posterior pain. It should be emphasized that more than 60 per cent of pelvic fractures need no fixation.
Open pelvic fractures
Open fractures are best managed by external fixation. A diversion colostomy may be necessary.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
recumbency /ri'kʌmbənsi/n. 斜靠着；躺着；休息 半卧位
hazardous /ˈhæzərdəs/adj. 有危险的；冒险的；碰运气的
considerable experience 丰富的经验
malposition /ˌmælpəˈzɪʃən/n. 位置不正；胎位不正
legacy /ˈleɡəsi/n. 遗产；遗赠财物；遗留问题；后遗症
A diversion colostomy转移结肠造口术
百度翻译：
APC-III和VS损伤
这些是最危险和最难治疗的损伤。通过骨骼牵引结合外固定器可以减少部分或全部垂直位移；即使如此，患者仍需要卧床至少10周。这种长时间的卧位并非没有风险。由于这些损伤意味着失去前后支撑，这两个区域都需要稳定。采用两种技术：（a）前外固定和骶髂关节螺钉后路固定，或（b）后路钢板和髂骶螺钉固定。后路手术是危险的（危险包括大出血、神经损伤和感染），只有在这方面有丰富经验的外科医生才能尝试。
坚持骨骼牵引和外固定可能更安全，尽管错位可能会留下后遗症。需要强调的是，超过60%的骨盆骨折不需要固定
开放性骨盆骨折
开放性骨折最好采用外固定。可能需要改道结肠造口术。