骨科英文书籍精读（219）｜髋关节后脱位（2）
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X-ray
In the anteroposterior film the femoral head is seen out of its socket and above the acetabulum. A segment of acetabular rim or femoral head may have been broken off and displaced; oblique films are useful in demonstrating the size of the fragment. If any fracture is seen, other bony fragments (which may need removal) must be suspected. A CT scan is the best way of demonstrating an acetabular fracture (or any bony fragment) but detailed imaging at this stage should be undertaken only if it does not delay reduction of the dislocation unduly.
Thompson and Epstein (1951) suggested a classification which is helpful in planning treatment. Types I and II are relatively simple dislocations; these are associated with either minor chip fractures (small fragments of the acetabular wall or fovea centralis) or a single large fragment from the posterior acetabular wall. In Type III the posterior wall is comminuted. type IV has an associated fracture of the acetabular floor, and Type V an associated fracture of the femoral head, which can be further subdivided according to Pipkin’s (1957) classification. (Figure 29.2)
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
suspected /səˈspektɪd/v. 怀疑；疑有，察觉；猜想（suspect 的过去分词和过去式）adj. 有嫌疑的，疑似……的
unduly/ˌʌnˈduːli/adv. 过度地；不适当地；不正当地
relatively/ˈrelətɪvli/adv. 相当地；相对地，比较地
fovea centralis中央凹
百度翻译：
X射线
在前位片中，股骨头位于髋臼上方。髋臼边缘或股骨头的一段可能被折断并移位；斜位片可用于显示碎片的大小。如果发现任何骨折，必须怀疑其他骨碎片（可能需要取出）。CT扫描是显示髋臼骨折（或任何骨碎片）的最佳方法，但只有在不过度延迟脱位复位的情况下，才应在此阶段进行详细成像。
Thompson和Epstein（1951）提出了一种有助于计划治疗的分类方法。I型和II型是相对简单的脱位；这些脱位伴有轻微的骨片骨折（髋臼壁或中央凹的小碎片）或髋臼后壁的单个大碎片。Ⅲ型患者后壁粉碎。Ⅳ型为髋臼底合并骨折，Ⅴ型为合并股骨头骨折，可根据Pipkin（1957）分类进一步细分。（图29.2）