我們正在精讀國外經典骨科書籍《Apley’s System of Orthopaedics and Fractures》，想要對於骨科英文形成系統認識，為以後無障礙閱讀英文文獻打下基礎，請持續關注。
獲取本書全本內容>請掃描文末二維碼，關注公眾號並回復「骨折肌肉學」。
『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》
重點詞彙整理：
splay /spleɪ/n. 展開；斜面adj. 傾斜的；八字形的vt. 張開；展開
concentrate on regaining movement集中精力恢復運動
concentrate /ˈkɑːnsntreɪt/n. 濃縮，精選；濃縮液vi. 集中；濃縮；全神貫注；vt. 集中；濃縮
anatomically reduced,解剖復位
commence/kəˈmens/
v. 開始；著手
百度翻譯：
中指骨PILON骨折
這些都是很常見的傷害，而且非常麻煩。近節指骨的頭部撞擊到中間指骨的底部，導致後者張開成幾塊。對於這些損傷，最好使用彈簧加載的外固定器進行動態牽張治療，該外固定器繞近節指骨的頭部旋轉，並破壞遠端骨折片。結果會出人意料的好。
髁突骨折
pha關節的基底關節面或遠端關節面可以骨折，通常是由成角力造成的。如果碎片沒有移位，最好忽略骨折，將手指綁在相鄰部位，集中注意力恢復活動。一周後應拍x光片，以確保沒有移位。
如果骨折移位，則有永久性角畸形和關節活動喪失的風險。骨折應解剖復位，閉合或開放手術，並用小克氏針或微型螺釘固定。接下來的幾天裡，手指都要用夾板固定。
獲取本書全本內容>掃描以下二維碼，關注公眾號並回復「骨折肌肉學」。