骨科英文书籍精读（157）｜特殊类型指骨骨折
‘PILON’ FRACTURES OF THE MIDDLE PHALANX
These are quite common injuries and can be very troublesome. The head of the proximal phalanx impacts into the base of the middle phalanx, causing the latter to splay open in several pieces. These injuries are best treated with dynamic distraction using a spring-loaded external fixator which rotates around the head of the proximal phalanx and disimpacts the distal fragment. The results can be surprisingly good.
CONDYLAR FRACTURE
The basal joint surface or distal joint surface of the phalanges can be fractured, usually by an angulation force. If the fragment is not displaced, it is best to disregard the fracture, strap the finger to its neighbour and concentrate on regaining movement. An x-ray should be taken after a week to ensure there is no displacement.
If the fracture is displaced, there is a risk of permanent angular deformity and loss of movement at the joint. The fracture should be anatomically reduced, either closed or by open operation and fixed with small K-wires or mini-screws. The finger is splinted for a few days and then supervised movements are commenced.
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
splay /spleɪ/n. 展开；斜面adj. 倾斜的；八字形的vt. 张开；展开
concentrate on regaining movement集中精力恢复运动
concentrate /ˈkɑːnsntreɪt/n. 浓缩，精选；浓缩液vi. 集中；浓缩；全神贯注；vt. 集中；浓缩
anatomically reduced,解剖复位
commence/kəˈmens/
v. 开始；着手
百度翻译：
中指骨PILON骨折
这些都是很常见的伤害，而且非常麻烦。近节指骨的头部撞击到中间指骨的底部，导致后者张开成几块。对于这些损伤，最好使用弹簧加载的外固定器进行动态牵张治疗，该外固定器绕近节指骨的头部旋转，并破坏远端骨折片。结果会出人意料的好。
髁突骨折
pha关节的基底关节面或远端关节面可以骨折，通常是由成角力造成的。如果碎片没有移位，最好忽略骨折，将手指绑在相邻部位，集中注意力恢复活动。一周后应拍x光片，以确保没有移位。
如果骨折移位，则有永久性角畸形和关节活动丧失的风险。骨折应解剖复位，闭合或开放手术，并用小克氏针或微型螺钉固定。接下来的几天里，手指都要用夹板固定。