骨科英文书籍精读（269）｜开放性股骨干骨折的治疗
我们正在精读国外经典骨科书籍《Apley’s System of Orthopaedics and Fractures》，想要对于骨科英文形成系统认识，为以后无障碍阅读英文文献打下基础，请持续关注。
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Treatment of open fractures
Open femoral fractures should be carefully assessed for (1) skin loss; (2) wound contamination; (3) muscle ischaemia; and (4) injury to vessels and nerves.
The immediate treatment is similar to that of closed fractures; in addition, the patient is started on intravenous antibiotics. The wound will need cleansing: it should be extended to give unhindered access, contaminated areas and dead tissue must be excised and the entire area should be washed thoroughly.
Stabilization of open femoral shaft fractures is best achieved with locked intramedullary nails unless there is heavy contamination or bone loss – in which case external fixation (if necessary with the capacity to deal with bone loss through distraction osteogenesis) is preferable.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
intravenous /ˌɪntrəˈviːnəs/adj. 静脉内的
cleansing /ˈklenzɪŋ/n. 彻底清洁；洗清；清洁霜adj. 清洁的；有去污作用的v. 清洗；净化；免除（某人）的罪过；治愈（cleanse 的现在分词）
unhindered /ʌnˈhɪndərd/adj. 不受妨碍的，不受阻碍的
The wound will need cleansing: it should be extended to give unhindered access, contaminated areas and dead tissue must be excised and the entire area should be washed thoroughly.伤口需要清洗:应该扩大伤口，使其畅通无阻，污染区域和坏死组织必须被切除，整个区域应该彻底清洗。
Stabilization of open femoral shaft fractures is best achieved with locked intramedullary nails unless there is heavy contamination or bone loss – in which case external fixation (if necessary with the capacity to deal with bone loss through distraction osteogenesis) is preferable.除非有严重污染或骨丢失，否则股骨开骨干骨折的稳定最好使用锁定髓内钉，在这种情况下外固定(如有必要，可通过牵张成骨处理骨丢失)更可取。
百度翻译：
开放性骨折的治疗
开放性股骨骨折应仔细评估：（1）皮肤损失；（2）伤口污染；（3）肌肉缺血；（4）血管和神经损伤。
立即治疗与闭合性骨折相似；此外，患者开始使用静脉内抗生素。伤口需要清洗：伤口应该扩大到可以畅通无阻地进入，污染区域和死亡组织必须切除，整个区域应该彻底清洗。
开放性股骨干骨折的稳定最好采用带锁髓内钉，除非有严重的污染或骨丢失-在这种情况下，最好采用外固定（如有必要，可通过牵张成骨处理骨丢失）。