骨科英文书籍精读（41）｜骨折晚期并发症之肌腱损伤及神经压迫
TENDON LESIONS
Tendinitis may affect the tibialis posterior tendon following medial malleolar fractures. It should be prevented by accurate reduction, if necessary at surgery. Rupture of the extensor pollicis longus tendon may occur 6–12 weeks after a fracture of the lower radius. Direct suture is seldom possible and the resulting disability is treated by transferring the extensor indicis proprius tendon to the distal stump of the ruptured thumb tendon. Late rupture of the long head of biceps after a fractured neck of humerus usually requires no treatment.
NERVE COMPRESSION
Nerve compression may damage the lateral popliteal nerve if an elderly or emaciated patient lies with the leg in full external rotation. Radial palsy may follow the faulty use of crutches. Both conditions are due to lack of supervision.
Bone or joint deformity may result in local nerve entrapment with typical features such as numbness or paraesthesia, loss of power and muscle wasting in the distribution of the affected nerve. Common sites are: (1) the ulnar nerve, due to a valgus elbow following a malunited lateral condyle or supracondylar fracture; (2) the median nerve, following injuries around the wrist and (3) the posterior tibial nerve, following fractures around the ankle. Treatment is by early decompression of the nerve; in the case of the ulnar nerve this may require anterior transposition.
---from 《Apley’s System of Orthopaedics and Fractures》P721
重点词汇整理：
Tendinitis /,tendi'naitis/n. 腱炎
tibialis posterior tendon 胫后肌腱
tibial /'tibiəl/adj. 胫骨的
medial malleolar fractures内踝骨折 /mə'li:ələ/adj. 踝的
the extensor pollicis longus tendon拇长伸肌腱
pollicis拇指
extensor /ɪkˈstensər,ekˈstensər/n. 伸肌
Rupture /ˈrʌptʃər/n. 破裂；决裂；疝气vt. 使破裂；断绝；发生疝vi. 破裂；发疝气
the extensor indicis proprius tendon指固有伸肌腱
indicis示指的
proprius 固有的
stump /stʌmp/vt. 砍伐；使为难；在…作巡回政治演说n. 树桩；残余部分；假肢
the long head of biceps 二头肌的长头
/ˈbaɪseps/n. 二头肌（尤指肱二头肌和股二头肌）
the lateral popliteal nerve外侧腘神经
emaciated /ɪˈmeɪsieɪtɪd,ɪˈmeɪʃieɪtɪd/adj. 瘦弱的；憔悴的v. 憔悴；消瘦下去（emaciate的过去分词）
in full external rotation. in full external rotation.
palsy/ˈpɔːlzi/n. 麻痹，麻痹状态；中风vt. 麻痹；使瘫痪
crutches /ˈkrʌtʃɪz/n. 拐杖，支撑物；叉状架（crutch复数）
lack of supervision缺乏监管
entrapment /ɪnˈtræpmənt/n. 诱捕；圈套；截留
local nerve entrapment局部神经卡压
typical features 典型特点
numbness or paraesthesia麻木或感觉异常/ˈnʌmnəs/ /,pærɪs'θiʒə/
muscle wasting 肌肉萎缩
valgus elbow /'vælɡəs/n. 外翻足的人；外翻足adj. 外翻的
ulnar nerve尺神经；尺骨神经
lateral condyle or supracondylar fracture外侧髁或髁上骨折
median nerve正中神经
posterior tibial nerve胫后神经
anterior transposition前置术
百度翻译：
肌腱损伤
肌腱炎可能影响内踝骨折后胫骨后肌腱。如有必要，在手术中应通过精确复位来预防。桡骨下段骨折后6-12周可发生拇长伸肌腱断裂。直接缝合是很少可能的，因此造成的残疾是通过转移伸指固有肌腱到拇指肌腱断裂的远端残端。肱骨颈骨折后肱二头肌长头的晚期断裂通常不需要治疗。
神经压迫
如果老年人或消瘦病人的腿完全外旋，神经压迫可能会损伤外侧腘神经。使用拐杖不当可能导致桡骨麻痹。这两种情况都是由于缺乏监督。
骨或关节畸形可导致局部神经卡压，其典型特征是受影响神经分布麻木或感觉异常、失去动力和肌肉萎缩。常见部位有：（1）尺骨神经，因肘外翻所致，伴外侧髁或髁上骨折；（2）正中神经，伴腕关节周围损伤；（3）胫后神经，伴踝关节周围骨折。治疗方法是早期神经减压术；对于尺神经，可能需要前路转位。