骨科英文书籍精读（129）｜腕关节舟骨骨折（1）
FRACTURED SCAPHOID
Scaphoid fractures account for almost 75 per cent of all carpal fractures although they are rare in the elderly and in children. With unstable fractures there may also be disruption of the scapho-lunate ligaments and dorsal rotation of the lunate.
Mechanism of injury and pathological anatomy
The scaphoid lies obliquely across the two rows of carpal bones, and is also in the line of loading between the thumb and forearm. The combination of forced carpal movement and compression, as in a fall on the dorsiflexed hand, exerts severe stress on the bone and it is liable to fracture. Most scaphoid fractures are stable; with unstable fractures the fragments may become displaced. The distal fragment, unrestrained by the scapho-lunate ligament, flexes and the proximal fragment tilts dorsally with the lunate (a DISI deformity); the hump-backed deformity of the scaphoid is permanent.
The blood supply of the scaphoid diminishes proximally. This accounts for the fact that 1 per cent of distal third fractures, 20 per cent of middle third fractures and 40 per cent of proximal fractures result in non-union or avascular necrosis of the proximal fragment.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
disruption /dɪsˈrʌpʃn/n. 扰乱，打乱，中断
exert /ɪɡˈzɜːrt/vt. 运用，发挥；施以影响
humpbacked /'hʌmpbækt/adj. 驼背的
permanent. /ˈpɜːrmənənt/
adj. 永久的，永恒的；不变的n. 烫发（等于permanent wave）
diminish /dɪˈmɪnɪʃ/vt. 使减少；使变小vi. 减少，缩小；变小
distal third fractures,远端三分之一
middle third fractures,中三分之一
proximal third fractures,近端三分之一
avascular necrosis 缺血性坏死
百度翻译：
更常见的病变处理如下。
舟骨骨折
舟状骨骨折几乎占所有腕关节骨折的75%，尽管它们在老年人和儿童中很少见。对于不稳定骨折，肩胛月骨韧带断裂和月骨背侧旋转也可能出现。
损伤机制与病理解剖
舟状骨斜躺在两排腕骨上，也在拇指和前臂之间的负荷线上。腕关节的强迫运动和压迫的结合，如摔倒在背伸的手上，会对骨骼产生严重的应力，容易骨折。大多数舟状骨骨折是稳定的；不稳定骨折的碎片可能会移位。远端骨块不受舟骨-月骨韧带的约束，弯曲，近端骨块与月骨背侧倾斜（DISI畸形）；舟骨驼背畸形是永久性的。
舟状骨的血供减少。这说明了1%的不完全三分之一骨折、20%的中三分之一骨折和40%的近端骨折导致近端骨折不愈合或缺血性坏死。