骨科英文书籍精读（42）｜骨折晚期并发症之肌肉挛缩
臀肌挛缩症
功能锻炼
• 术后48小时，走一字步：挺胸抬头双肩水 平，双下肢交叉直线行走。3次/天，30分钟 /次。 • 术后3～4天，在走一字步的基础上逐步增 加紧臀外展并膝下蹲练习：双脚并拢，双 手平举，足跟不能离地，腰背部挺直。3次/ 天，重复运动200次。
功能锻炼
• 术后第7天，在纠正异常 步态的基础上，进行腿部 锻炼(翘二郎腿，踢毽子)， 翘腿时端坐于靠背椅上， 背部紧贴靠背，一腿过膝， 交叉架于另一腿上，左右 腿交叉，进行左右摆臀主 动伸展运动。3次/天，30 度和强度，必须循序渐进， 逐渐加大，既要防止运动幅度过大，造成 软组织损伤，影响伤口愈合，又要防止怕 痛苦，训练方法不正确，造成软组织粘连 影响疗效。总之坚持科学，有效长期的康 复训练，才能彻底改变患者不良的姿势和 步态，使患者康复。
健康教育
• 任何注射用药物都有刺激性，但由于药物分子结 构及分子团大小不同，对人体组织的刺激程度也 各异。 • 对儿童应尽量避免臀肌注射，尤其避免用苯甲醇 做溶媒的药物注射。 • 确实需要肌肉注射的，疗程以5天为宜。对注射部 位用热毛巾外敷，每日2次，每次10分钟。 • 对一些较多地接受肌肉注射的患儿，在每一注射 疗程结束后，应给予适当的理疗，改善局部组织 的血液循环，加速肌肉功能的恢复，同时进行髋 关节的内收、内旋及屈曲运动锻炼。
术后护理
• 潜在并发症护理： 术后用绷带或其他约束 带绷拢双膝使双下肢成内收位, 并用软枕垫 高双下肢, 使髋关节、膝关节呈屈曲位, 既 利于臀肌的松弛也可减轻疼痛。术后仰卧 4h 后更换体位。双侧臀肌挛缩症患者仰卧 与俯卧交替, 预防骶尾部压疮的发生。指导 在床上练习起坐，防止切断的挛缩束接触， 粘连。
护理问题
• 局部血肿：与术中止血 不彻底、术后引流欠佳 有关 。 • 护理目标：避免血肿发 生或发生后及时处理。 • 护理措施：保持引流的 通畅，做好管路护理。
骨科英文书籍精读（90）｜桡骨头骨折
骨科英文书籍精读（90）｜桡骨头骨折FRACTURED HEAD OF RADIUSRadial head fractures are common in adults but are hardly ever seen in children (probably because the proximal radius is mainly cartilaginous) whereas radial neck fractures occur in children more frequently.Mechanism of injuryA fall on the outstretched hand with the elbow extended and the forearm pronated causes impaction of the radial head against the capitulum. The radial head may be split or broken. In addition, the articular cartilage of the capitulum may be bruised or chipped; this cannot be seen on x-ray but is an important complication. The radial head is also sometimes fractured during elbow dislocation.Clinical featuresThis fracture is sometimes missed, but tenderness on pressure over the radial head and pain on pronation and supination should suggest the diagnosis.X-rayThree types of fracture are identified and classified by Mason as:Type I An undisplaced vertical split in the radial headType II A displaced single fragment of the headType III The head broken into several fragments (comminuted).An additional Type IV has been proposed, for those fractures with an associated elbow dislocation.Special radial head views, rather than simple PA and lateralviews are needed to fully assess the fracture. The wrist also should be x-rayed to exclude a concomitant injury of the distal radioulnar joint, which would signify damage to the interosseous membrane (acute longitudinal radioulnar dissociation).TreatmentAn undisplaced split (Type I)Worthwhile pain relief can be achieved by aspirating the haematoma and injecting local anaesthetic. The arm is held in a collar and cuff for 3 weeks; active flexion, extension and rotation are encouraged. The prognosis for this injury is very good, although there is often some loss of elbow extension.A single large fragment (Type II)If the fragment is displaced, it should be reduced and held with one or two small headless screws.A comminuted fracture (Type III)This is a challenging injury. Always assess for an associated soft tissue injury:Rupture of the medial collateral ligament;Rupture of the interosseous membrane (Essex Lopresti lesion);Combined fractures of the radial head and coronoid process plus dislocation of the elbow – the ‘terrible triad’.If any of these is present, excision of the radial head is contra-indicated; this may lead to intractible instability of the elbow or forearm. The head must be meticulously reconstructed with small headless screws or replaced with a metal spacer. A medial collateral rupture, if unstable after replacing or fixing the radial head, should be repaired.Radial head excision usually gives a good long-term result if there are no contraindications; however, wrist pain from ulnarhead impaction, valgus instability of the elbow and trochleo-olecranon arthritis can develop.ComplicationsJoint stiffness is common and may involve both the elbow and the radioulnar joints. Even with minimally displaced fractures the elbow can take several months to recover, and stiffness may occur whether the radial head has been excised or not.Myositis ossificans is an occasional complication. Recurrent instability of the elbow can occur if the medial collateral ligament was also injured and the radial head excised.---from 《Apley’s System of Orthopaedics and Fractures》重点词汇整理：outstretched /ˌaʊtˈstretʃt/adj. 伸开的；扩张的v. 伸出；扩大；伸展得超出…的范围（outstretch的过去分词形式）pronate /'pronet/vt. 旋前；将手掌向下或向后转动vi. 俯身；伏身capitulum /kə'pɪtʃʊləm/n.桡骨小头[组织][生物] 小头，骨端；[植] 头状花序supination /,sju:pi'neiʃən/n. 旋后；反掌姿势concomitant /kənˈkɑːmɪtənt/n. 伴随物adj. 相伴的；共存的；附随的the distal radioulnar joint桡尺远侧关节 /,reidiəu'ʌlnə/adj. 桡尺骨的the interosseous membrane骨间膜membrane /ˈmembreɪn/n. 膜；薄膜；羊皮纸longitudinal /ˌlɑːndʒəˈtuːdnl/adj. 长度的，纵向的；经线的dissociation /dɪˌsoʊsiˈeɪʃn,dɪˌsoʊʃiˈeɪʃn/n. 分解，分离；分裂aspirate/'æspərət/n. 送气音；抽出物adj. 送气音的vt. 送气发音；吸入haematoma /,hi:mə'təumə, ,hem-/n. [病理] 血肿local anaesthetic局部麻醉/ˌænəsˈθetɪk/n. 麻醉剂；麻药adj. 麻醉的prognosis /prɑːɡˈnoʊsɪs/n. [医] 预后；预知Rupture of the medial collateral ligament; 内侧副韧带断裂;collateral /kəˈlætərəl/adj. 附属的；旁系的；并行的n. 抵押品，担保品；旁系亲属coronoid process[解剖] 冠突；[解剖] 喙突 /'kɔrənɔid/adj. 冠状的；喙状的contraindications /ˌkɑːntrəˌɪndɪˈkeɪʃn/n. [医] 禁忌症；禁忌征候valgus/'vælɡəs/n. 外翻足的人；外翻足adj. 外翻的trochleo-olecranon arthritis 滑车鹰嘴关节炎Myositis/,maiəu'saitis/n. [外科]骨化性肌炎；肌炎，肌肉发炎百度翻译：桡骨头骨折桡骨头骨折在成人中很常见，但在儿童中很少见（可能是因为桡骨近端主要是软骨），而桡骨颈骨折在儿童中更常见。
骨科学 英语
骨科学 英语Ankle: Achilles Tendonitis 跟腱炎Ankle: Ruptured Achilles Tendon 跟腱破裂Ankle: Sprain 踝部扭伤Ankle Fracture 踝部骨折Ankylosing Spondylitis 关节黏连脊椎炎Aseptic Necrosis 无菌的骨疽Back Pain: Approach to Management 怎样处理背痛问题Back Pain: Prevention 预防背痛Baker's Cyst 贝勾氏囊Bones 骨骼的功能Bone Tumors 骨肿瘤Bunions 姆趾黏液囊肿大Carpal tunnel syndrome 腕管综合症Colles Fracture 桡骨下端骨折Compression Fracture of the Vertebrae 脊椎压迫性骨折Dislocation 脱臼Dupuytren Contracture 掌挛缩病Elbow: Golfer's Elbow 高尔夫球肘Elbow: Tennis Elbow 网球肘Fibromyalgia 纤维组织肌痛Flat Foot 扁平足Foot: Hammer Toe 锤状趾Foot: Plantar Fasciitis 足底筋膜炎Foot: Ulcers 脚溃疡Fracture 骨折Fracture: Bones in the Foot 脚部骨折Fracture: Clavicle 锁骨骨折Fracture Types 骨折的种类Frozen Shoulder 凝肩Ganglion 腱鞘囊肿Hand Fracture 手骨折Hand: Tenosynoritis 手部腱鞘滑膜炎Heel Spurs 脚跟骨刺和发炎Herniated Disk 椎间盆后凸。
外科学 第五篇 骨外科(翻译版)
第五篇骨外科#1Orthopaedics General introduction to fracture1.★DEFINITION OF FRACTUREA fracture is a break in the continuity of a bone即骨的完整性和连续性中断。
2.Causes of fracturesA.Direct forceB.Indirect forceC.Muscular contraction force肌肉收缩力D.Cyclic force循环力–fatigue fracture疲劳~★积累性劳损：长期、反复、轻微的直接或间接伤力可集中在骨骼的某一点上发生骨折，骨折无移位，但愈合慢。
好发部位：第2、3跖骨和腓骨中下1/3处。
E.Bone diseases：Localized diseases—tubercular osteomyelitis结核性骨髓炎,osteosarcoma骨肉瘤,localized metastatic carcinoma,etc.Generalized diseases—osteoporosis骨质疏松,multiple myeloma多发性骨髓瘤,diffuse metaststic carcinoma3.★Classification of fractures(一)根据骨折处皮肤、粘膜的完整性分类1．闭合性骨折：骨折处皮肤或粘膜完整，骨折端不与外界相通。
2．开放性骨折：骨折处皮肤或粘膜破裂，骨折端与外界相通。
(二)根据骨折的程度和形态分类⑴不完全骨折：骨的完整性或连续性部分中断，按其形态分为：①裂缝骨折：多见于肩胛骨、颅骨。
②★青枝骨折：见于儿童。
⑵完全骨折：骨的完整性或连续性完全中断。
按其骨折线方向和形态可分为：横形骨折、斜形骨折、螺旋形骨折、粉碎性骨折、嵌插性骨折、压缩性骨折、凹陷性骨折和骨骺分离。
(三)根据骨折端稳定程度分类①稳定性骨折：复位后经适当外固定不易发生再移位者，如青枝骨折、裂缝骨折、嵌插性骨折、横形骨折。
骨科英文书籍精读（93）｜肘关节脱位（2）
Medial epicondyledegrees; after 3 weeks movements are begun under supervision.Head of radiusThe combination of ligament disruption and a type II or III radial head fracture is an unstable injury; stability is restored only by healing or repair of the ligaments and restoration of the radial pillar – either by fracture fixation or (in the case of a comminuted fracture) by prosthetic replacement of the radial head. The medial collateral ligament may also be repaired to protect the radial head fixation or implant from undue valgus stress.Olecranon processIn the rare forward dislocation of the elbow, the olecranon process may fracture; a large piece of the olecranon is left behind as a separatefragment. Open reduction with internal fixation is the best treatment.Side-swipe injuriesThese severe fracture-dislocations are often associated with damage to the large vessels of the arm. The priorities are repair of any vascular injury, skeletal stabilization and soft tissue coverage. This is demanding surgery, necessitating a high level of expertise, and is best undertaken in a unit specialising in upper limb injuries.Persistent instabilityIn cases where the elbow remains unstable after the bone and joint anatomy has been restored, a hinged external fixator can be applied inorder to maintain mobility while the tissues heal.---from 《Apley’s System of Orthopaedics and Fractures》重点词汇整理：trochlear groove.滑车沟。
骨科英文书籍精读（371）｜踝部骨折（2）
骨科英文书籍精读（371）｜踝部骨折（2）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。
中国十大名师之一赖世雄老师说过，学习英语没有捷径，少就是多，快就是慢。
不要以量取胜，把一个音标、一个单词、一段对话、一篇文章彻底搞透，慢慢积累，你会发现，你并不比每天走马观花的输入大量英文学的差。
Clinical featuresAnkle fractures are seen in skiers, footballers and climbers; an older group includes women with postmenopausal osteoporosis.A history of a severe twisting injury, followed by intense pain and inability to stand on the leg suggests something more serious than a simple sprain. The ankle is swollen and deformity may be obvious. The site of tenderness is important; if both the medial and lateral sides are tender, a double injury (bony or ligamentous) must be suspected.X-rayAt least three views are needed: anteroposterior, lateral and a 30-degree oblique 'mortise’ view. The level of the fibular fracture is often best seen in the lateral view; diastasis may not be appreciated without the mortise view. Further x-rays may be needed to exclude a proximal fibular fracture.From a careful study of the x-rays it should be possible to reconstruct the mechanism of injury. The four most common patterns are shown in Figure 31.5.TreatmentSwelling is usually rapid and severe, particularly in the higher energy injuries. If the injury is not dealt with within a few hours, definitive treatment may have to be deferred for several days while the leg is elevated so that the swelling can subside; this can be hastened by using a foot pump (which also reduces the risk of deep-vein thrombosis).Fractures are visible on x-ray; ligaments are not.Always look for clues to the invisible ligament injury –widening of the tibiofibular space, asymmetry of the talotibial space, widening of the medial joint space, or tilting of the talus –before deciding on a course of action.Like other intra-articular injuries, ankle fractures must be accurately reduced and held if later mechanical dysfunction is to be prevented. Persistent displacement of the talus, or a step in the articular surface, leads to increased stress and predisposes tosecondary osteoarthritis.In assessing the accuracy of reduction, four objectives must be met: (1) the fibula must be restored to its full length; (2) the talus must sit squarely in the mortise, with the talar and tibial articular surfaces parallel; (3) the medial joint space must be restored to its normal width, i.e. the same width as the tibio-talar space (about 4 mm); (4) oblique x-rays must show that there is no tibiofibular diastasis.Ankle fractures are often unstable. Whatever the method of reduction and fixation, the position must be checked by x-ray during the period of healing.---from 《Apley’s System of Orthopaedics and Fractures》postmenopausal osteoporosis绝经后骨质疏松症suspect /səˈspekt/v. 怀疑；猜想n. 嫌疑犯adj. 靠不住的；可疑的diastasis may not be appreciated without the mortise view. 如果没有踝穴视图，可能无法鉴别分离。
volkmann挛缩名词解释
volkmann挛缩名词解释
Volkmann挛缩是一种医学术语，用于描述肌肉在过度收缩时出现的症状。
这种情况通常发生在肌肉受到长时间持续性压迫或血液供应不足的情况下。
当肌肉受到压迫或血液供应不足时，通常会出现肌肉疼痛、僵硬和功能障碍的症状。
这可能是由于肌肉纤维内的代谢产物积累、缺氧、营养不良或神经损伤引起的。
其中，Volkmann挛缩是一种严重的肌肉病理状态，可以导致肌肉的坏死和功能损伤。
Volkmann挛缩主要发生在四肢肌肉，尤其是在手和腕部。
常见的引起Volkmann挛缩的原因包括骨折、关节脱位、肌肉损伤和动脉闭塞等。
当这些情况发生时，肌肉会过度收缩，导致血管收缩，进一步加重肌肉组织的损伤。
早期识别和干预是防止Volkmann挛缩并减少其严重程度的关键。
如果患者出现严重的疼痛、肿胀和功能障碍，应及时就医进行全面评估。
治疗方法通常包括解除压力、恢复正常血液供应、物理治疗以及必要时手术干预。
总之，Volkmann挛缩是一种由肌肉过度收缩引起的病理状态，常见于肌肉受到压迫或血液供应不足的情况下。
及早识别和干预是预防和治疗Volkmann挛缩的关键。
如果出现相关症状，应及时就医以获取专业的医疗建议和治疗。
Volkmann挛缩
• 拇内收肌筋膜间室综合征的检查方法： 牵引拇指使其处于外展位，藉此紧张拇 内收肌，根据有无症状做出判断。大鱼 际肌很少发生筋膜间室综合征。
• 筋膜间室测压，尤其是第一骨间背侧肌、 大鱼际肌及小鱼际肌筋膜间室的压力测 定对诊断有意义。 筋膜间室内压力增高 使筋膜间室综合征的诊断得到证实。 • Whitesides，Mubarak和Matsen等用不同 的方法测定筋膜间室内压力。
• 疼痛是最常见的症状，但在昏迷病人不 能发现。被动牵拉手指加重疼痛，前臂 因肿胀而出现紧张和触痛，指尖灵敏度 降低或消失。 • 两点辨别试验可用来帮助判断神经缺血 情况， Gelbernan等曾报道九例压力超 过30mmHg的筋膜间室综合征，这九位 清醒病人中有四例病人正中神经的两点 辨别距离超过1cm。
前臂及手部筋膜室间隔综合征 及缺血性肌肉挛缩的治疗
苏州大学附属第一医院 骨科 杨同其
一、历史回顾 • 1881年 , Volkmann在他的经典著作中首 先报道了麻痹性挛缩，他发现在动脉供 血不足或肌肉缺血后几个小时之内即可 发生此症。他认为绷带包扎过紧是产生 供血不足的原因，这种认为外在压力是 麻痹性挛缩主要原因的观点在英文文献 中持续了相当 一段时间。
• 切口从肱二 头肌肌膜内 侧开始，斜 行跨过肘横 纹，向远侧 直达手掌， 以便打开腕 管，注意切 口与腕横纹 勿成直角。
• 分开变性的肌纤维束，清除血肿。怀疑 有肱动脉损伤时，显露并探查有无活动 性出血。如果血流不畅，打开血管外膜， 观察膜下有无血凝块、痉挛或内膜撕裂。 必要时切除血管外膜并行血管吻合或动 脉移植。
• 继续向远端解剖，注意保护正中神经。 松解旋前圆肌的起点，用手术刀或锋利 的骨膜起子在骨膜下松解指深屈肌的起 点。然后松解旋前圆肌的远侧起点、掌 长肌和桡侧腕屈肌的起点。之后，游离 指浅屈肌的起点，暴露肘关节囊。松解 尺侧腕屈肌的远侧起点，勿损伤尺神经。 显露骨间膜，反复屈伸手 指，以帮助确 定起点的哪些部位需做进一步分离。
挛缩的康复电子教材
挛缩的康复电子教材【学习目标】1．掌握：挛缩的基本概念、主要功能障碍、康复评定、康复治疗。
2．熟悉：挛缩的分类、病因。
3．了解：挛缩的手术治疗。
一、概述（一）基本概念关节周围的软组织、肌肉、韧带和关节囊等失去原有弹性，引起关节的主动和被动活动范围受限。
其临床表现为：肌张力高，关节畸形，关节活动度差。
常见于骨骼、关节和肌肉系统损伤及疾病后，各种类型的神经瘫痪、烧伤、长期坐轮椅或卧床以及老年患者。
其发病机理为：限制关节活动导致肌纤维间结缔组织、胶原纤维增生；关节囊纤维化，疏松结缔组织变为致密结缔组织，使关节周围软组织短缩，活动范围减少；关节变得僵硬，甚至强直畸形，严重者关节可能完全不能活动。
其临床疗效不十分理想，常常后遗关节活动功能降低或消失，不仅影响疾病的康复，还可造成患者日常生活的严重障碍，影响患者的生活质量。
（二）挛缩对机体的主要影响挛缩对机体的主要危害为影响机体的运动功能和完成日常生活活动的能力降低。
包括以下几个方面：①关节活动范围受限：关节处于限制性体位状态，达不到正常关节活动范围，使关节的活动能力下降，功能减退；②肌力下降：肌肉出现废用性萎缩和肌力下降，肌肉能量代谢障碍；③日常生活活动能力降低：因运动功能下降，导致完成日常生活自理、处理家务、户外活动的能力减退，使患者的社会参与程度降低。
（三）病因与分类1．病因关节挛缩的形成不仅与肢体瘫痪及限制活动有关，也与痉挛及重力的影响使四肢处于不适当的强制肢位有关。
（1）关节病损：骨、关节、软组织创伤或手术后，早期为减轻损伤局部的出血、水肿、疼痛和炎症反应，减少进一步损伤或再发损伤，常要求以石膏或夹板固定病变部位，关节被迫长期维持于一个位置。
特别是不适当的外固定或超时间的外固定，导致关节周围的软组织因受不到牵拉而自动缩短、失去弹性，疏松结缔组织会出现增生性变化，胶原成分增多，密度增大而变成较致密结缔组织，逐渐丧失活动性，造成挛缩。
常见疾病有骨折、关节病变及损伤、滑膜及腱鞘疾病、骨性关节病等。
骨科临床护理专题—骨折或创伤后后晚期并发症
– 皮肤改变：发生DVT 后，皮肤温度逐渐由 暖变冷 ，出现青紫、 花斑
骨折或创伤后晚期并发症—四、深静脉栓塞 （4）警惕DVT的症状与体征
— Homans征: 平卧时将足用力背屈，小腿肌肉疼痛 出现Homans征(+)。
— 浅静脉曲张 深静脉阻塞可引起浅静脉压升高，
发病1、2周后可见浅静脉曲张
① 高龄（>60y）、女性、 肥胖者
② 下肢制动者 ③ 卧床休息者 ④ 手术时间超过1h者 ⑤ 心功能不全和有下肢深
静脉血栓形成史 ⑥ 大剂量使用止血药及输
注血液制品者 ⑦ 严重的外伤史 ⑧ 糖尿病和恶性肿瘤 ⑨ 化疗 ⑩ 遗传因素
骨折或创伤后晚期并发症—四、深静脉栓塞
1、DVT易感因素分组——Hulls评估系统
骨折或创伤后晚期并发症—四、深静脉栓塞
下肢酸胀不适，乏力， 久站或活动后加重；下 肢浅静脉曲张；皮肤色 素沉着、增厚粗糙、瘙 痒；经久不愈或反复发 作的溃疡
（2）血栓形成后遗症
骨折或创伤后晚期并发症—四、深静脉栓塞
血栓——沉默的杀手
美国每年有600,000DVT病人， 50,000到200,000死于PTE
DVT 3年后血栓后综合症的发生率为 35%-69%，5年后的发生率为49%-100%
预防胜于治疗 及时评估，尽早发现
骨折或创伤后晚期并发症—四、深静脉栓塞
高危因素
高危人群
创伤、长骨骨折、 大面积烧伤、 下肢挤压伤、 膝关节手术、 髋关节手术、 肥胖、怀孕、 心肌梗死或心力衰竭、 有脑卒中病史 吸烟、久坐久卧
股四头肌收缩运动
踝泵运动
骨折或创伤后晚期并发症—四、深静脉栓塞
（预6防）D预VT防护D理V措T施护理措施
骨科专业英语[解说]
![骨科专业英语[解说]](https://img.taocdn.com/s3/m/719d71c329ea81c758f5f61fb7360b4c2e3f2a61.png)
骨科ORTHOPEDICS1、概论INTRODUCTION*fracture n.骨折pathological fracture 病理骨折fatigue fracture 疲劳骨折*open fracture 开放骨折close fracture 闭合骨折*comminuted fracture粉碎性骨折compressed fracture 压缩骨折shock n.休克*deformity n.畸形tenderness n.压痛swelling n.肿胀ecchymosis n.瘀斑obstacle n.功能障碍*bonefascial compartment syndrome 骨筋膜室综合征infection n.感染spinal cord injury 脊髓损伤surrounding nerve 周围神经*fat embolism 脂肪栓塞bedsore n.褥疮arthroclisis n.关节僵硬ischemic necrosis 缺血性坏死ischemic contraction 缺血性挛缩*traumatic arthritis 创伤性关节炎hematoma n.血肿*callus n.骨痂heal n.愈合*synovitis n.滑膜炎*ligament n.韧带*tendon n.肌腱* pyogenic osteomyelitis 化脓性骨髓炎*reduction n.复位*bone traction 骨牵引*osteoporosis n.骨质疏松2、上肢骨折FRACTURE OF UPPER EXTREMITIES clavicle n.锁骨*humerus n.肱骨*rotation n.旋转supracondyle n.髁上blister n.水疱pulsate n.搏动thrombus n.血栓*cancellous n.松质骨*epiphysis n.骨骺*injury n.损伤*joint n.关节stability n.稳定ulna n.尺骨radius n.桡骨metacarpal bone 掌骨bone graft 植骨hemostasis 止血*periosteum n.骨膜tension n.张力adhesion n.粘连*skin grafting 植皮*arthrodesis n.关节融合extrusion n.挤压gangrene n.坏疽pallor n.苍白、灰白*amputation n.截肢plaster n.石膏paralys is n.瘫痪bandage n.绷带2、手外伤HAND TRAUMAavulsion n.撕脱*dislocation n.脱位stiff adj.僵硬3、下肢骨折与关节损伤FRACTURE OF LOWER EXTREMITIES AND ARTICULAR INJURYfemur n.股骨adduction n.内收separate v.分离cartilage n.软骨*synovialis n.滑膜*spinal column 脊柱5、脊柱及骨盆骨折FRACTURE OF VERTEBRAL COLUMN AND PELVIScolumn n.椎体cervical column 颈椎*lumber vertebra 腰椎sacrum n.骶椎sense n.感觉movement n.运动reflect v.反射*pelvis n.骨盆6、关节脱位ARTICULAR DISLOCATION congenital dislocation 先天性脱位pathological dislocation 病理性脱位*osteoarthritis n.骨关节炎*total hip replacement 全髋置换术7、运动系统慢性损伤CHRONIC STRAIN OF MOVEMENT SYSTEMstrain n.劳损*cystis n.滑囊*stenosed tenosynovitis 狭窄性腱鞘炎*ganglion n.腱鞘囊肿degenerative adj.退行性变multiply v.增生abnormal sense 感觉异常8、腰腿痛和颈肩痛LUMBAGO AND SHOULDER PAINSstenosed column 椎管狭窄9、骨与关节化脓感染OSTEOARTICULAR PURULENT LNFECTIONchannel n.窦道drill hole 钻孔*drainage n.引流10、骨与关节结核OSTEOARTICULAR TUBERCULOSISbone tuberculosis 骨结核spinal cord compression 脊髓压迫11、骨肿瘤BONE TUMORbone tumor 骨肿瘤*osteochondroma n.骨软骨瘤*osteosarcoma n.骨肉瘤chemotherapy n.化疗*synoviosarcoma n.滑膜肉瘤医学英语分科常用词汇人体解剖学HUMAN ANATOMY之运动系统LOCOMOTOR SYSTEM1、中轴骨AXIAL BONES*bone n.骨*vertebrae n.椎骨*cervical vertebrae 颈椎*thoracic vertebrae 胸椎lumbar vertebrae 腰椎*sacrum n.骶骨coccyx 尾骨atlas n.寰椎axis n.枢椎*sternum n.胸骨sternal angle 胸骨角sternal manubrium 胸骨柄xiphoid process 剑突*rib n.肋*thoracic cage 胸廓2、颅SKULL*skull n.颅*frontal bone 额骨*parietal bone 顶骨*occipital bone 枕骨*temporal bone 颞骨*sphenoid bone 蝶骨*ethmoid bone 筛骨*mandible n.下颌骨hyoid bone 舌骨vomer n.犁骨*maxilla n.上颌骨palatine bone 腭骨nasal bone 鼻骨lacrimal bone 泪骨inferior nasal concha 下鼻甲zygomatic bone 颧骨*coronal suture冠状缝*sagital suture 矢状缝*lambdoid suture 人字缝orbit n.眶cranial fontanelle 颅囟2、附肢骨TARSAL BONES AND EXTREMITAL BONES*clavicle n.锁骨*scapula n.肩胛骨*humerus n.肱骨*radius n.桡骨*ulna n.尺骨carpal bone 腕骨metacarpal bone 掌骨phalanges n.指骨，趾骨*hip bone 髋骨*ilium n.髂骨*ischium n.坐骨*pubis n.耻骨*femur n.股骨patella n.髌骨*tibia n.胫骨*fibula n.腓骨tarsal bone 跗骨metatarsal bone 跖骨4、关节学ARTHROLOGY*articulation n.关节*ligament n.韧带*flexion n.屈*extension n.伸*adduction n.收*medial rotation 旋内*lateral rotation 旋外pronation n旋前.supination n.旋后circumduction n.环转*vertebral column脊柱*thoracic cage 胸廓*intervertebral disc 椎间盘*temporal-mandibular joint 颞下颌关节*shoulder joint 肩关节*elbow joint 肘关节*radiocarpal joint 桡腕关节*pelvis n.骨盆*hip joint 髋关节*knee joint 膝关节*ankle joint 踝关节5、肌肉系统MUSCULATURE(1)肌学系统INTRODUCTION OF MUSCULATURE *muscle n.肌肉muscle belly 肌腹tendon n.肌腱aponeurosis n.腱膜*fascia n.筋膜*tendinous sheath 腱鞘（2）躯干肌TRUNK MUSCLEStrapezius n.斜方肌latissimus dorsi 背阔肌erector spinae 竖脊肌*sternocleidomastoid adj.胸锁乳突的*scalenus n.斜角肌pectoralis major 胸大肌intercostales n.肋间肌*diaphragm n.膈（肌）*inguinal canal 腹股沟管*sheath of rectus abdominis 腹直肌鞘（3）头肌HEAD MUSCLESorbicularis oculi 眼轮匝肌masseter n.咬肌*temporalis n.颞肌*deltoid n.三角肌*biceps brachii 肱二头肌*triceps brachii 肱三头肌*axillary fossa 腋窝（4）附肢肌MUSCLES ATTACHED TO EXTREMITTES*gluteus maximus 臀大肌piriformis n.梨状肌*sartorius n.缝匠肌*quadriceps femoris 股四头肌triceps surae 小腿三头肌*femoral triangle 股三角popliteal fossa 腘窝医学英语分科常用词汇诊断学——骨关节系统OSTEOARTICULAR SYSTEM*Codman’striangle 骨膜三角，科德曼三角H-shaped vertebra,butterfly vertebra 蝴蝶椎Rugger-Jersay vertebra 夹心椎体Scheuermann’s disease 绍尔曼病Schmorl’s nodule 施莫尔结节Shenton’s line 沈通氏线apophysis n. 骺状突*arthrography n.关节造影basilar impression,basilarinvagination 颅底凹陷block vertebra 融合椎bone island 骨岛bursography n.泪囊造影compacta n.骨密度cortical porosity 皮质骨疏松症craniolacunia,luckenschadel n.颅骨陷窝*empty sella 空蝶鞍endosteal proliferation 骨内膜增生*epiphysis n.骨骺Intratrabecular resorption 骨小梁内吸收ivory vertebra 象牙椎marrow-packing disease 骨髓充填疾病massive osteolysis 大片骨溶解melopheostosis n.蜡油骨症ossification n.骨化osteopathia striata 纹骨症*osteopenia n.骨质减少osteopetrosis n.石骨症osteopoikilosis n.斑骨症pars interarticularis 椎弓峡部periosteal reaction 骨膜反应physis n.骨生长端*pseudofracture, Looser zone n.假骨折spina ventosa 骨气鼓spongiosa 骨疏松woven bone 编织骨*zone of provisional calcification 临时钙化带。
骨科英文书籍精读（113）｜孟氏骨折（1）
骨科英文书籍精读（113）｜孟氏骨折（1）MONTEGGIA FRACTURE DISLOCATION OF THE ULNAThe injury described by Monteggia in the early nineteenthth century (without benefit of x-rays!) was a fracture of the shaft of the ulna associated with dislocation of the proximal radio-ulnar joint; the radiocapitellar joint is inevitably dislocated or subluxated as well. More recently the definition has been extended to embrace almost any fracture of the ulna associated with dislocation of the radio-capitellar joint, including trans-olecranon fractures in which the proximal radioulnar joint remains intact. If the ulnar shaft fracture is angulated with the apex anterior (the commonest type) then the radial head is displaced anteriorly; if the fracture apex is posterior, the radial dislocation is posterior; and if the fracture apex is lateral then the radial head will be laterally displaced. In children, the ulnar injury may be an incomplete fracture (greenstick or plastic deformation of the shaft).Mechanism of injuryUsually the cause is a fall on the hand; if at the moment of impact the body is twisting, its momentum may forcibly pronate the forearm. The radial head usually dislocates forwards and the upper third of the ulna fractures and bows forwards. Sometimes the causal force is hyperextension.Clinical featuresThe ulnar deformity is usually obvious but the dislocated head of radius is masked by swelling. A useful clue is pain and tenderness on the lateral side of the elbow. The wrist and hand should be examined for signs of injury to the radial nerve.X-rayWith isolated fractures of the ulna, it is essential to obtain a true anteroposterior and true lateral view of the elbow. In the usual case, the head of the radius (which normally points directly to the capitulum) is dislocated forwards, and there is a fracture of the upper third of the ulna with forward bowing. Backward or lateral bowing of the ulna (which is much less common) is likely to be associated with, respectively, posterior or lateral displacement of the radial head. Trans-olecranon fractures, also, are often associated with radial head dislocation.Bado主要根据桡骨头脱位与尺骨骨折方向进行分型。
Volkmann挛缩
2
北京积水潭医院手外科 栗鹏程
病理生理学
3
北京积水潭医院手外科 栗鹏程
组织压较动脉舒张压低10~30mmHg时，小 动脉闭合，导致组织缺血。正常人组织压升 高到40~60mmHg时，有可能使微循环停止。
功能障碍 神经 30min 永久性功能丧失 12~24hr
肌肉
2~4hr
4~12hr
肌肉缺血4小时以上，会产生肌红蛋白尿，在 循环恢复后3小时达到最高峰。 完全缺血12小时以上足以产生挛缩。
经过变性组织切除、神经肌腱松解后仍残存充足 的肌肉组织时，可选用肌腱移位或游离肌肉移植。 最佳时机是神经松解பைடு நூலகம்获得最大程度的恢复，挛 缩已经通过活动、支具、切除等办法解除时。 最常用的是肱桡肌代屈拇长肌，桡侧伸腕长肌代 屈指深肌。爪形手可以通过EDQ和EIP，或ECU 移位治疗。 轻度的病例行肌腱移位效果较好。
北京积水潭医院手外科 栗鹏程
16
分型
Zancolli(1975)将Volkmann 缺血挛缩分为4 型。
1型：手内在肌正常型 2型：手内在肌麻痹型 3型：手内在肌挛缩型 4型：混合型
17
北京积水潭医院手外科 栗鹏程
Steven认为这些分型使严重程度迥异的分到了同一 型，不能将术前和术后功能相对比。他在肌腱手术 后评价运动功能的Buck-Gramcko分型的基础上进行 分型。同时兼顾感觉的评价（做Semmes Weinstein test)。
北京积水潭医院手外科 栗鹏程
6
骨筋膜室综合征的预防
原因有很多，最常见的是骨折。其中，儿 童肱骨髁上骨折是最常见的原因。
骨科英文书籍精读（35）｜骨折晚期并发症之延迟愈合
骨科英文书籍精读（35）｜骨折晚期并发症之延迟愈合LATE COMPLICATIONSDELAYED UNIONThe timetable on page 692 is no more than a rough guide to the period in which a fracture may be expected to unite and consolidate. It must never be relied upon in deciding when treatment may be discontinued. If the time is unduly prolonged, the term ‘delayed union’ is used.CausesFactors causing delayed union can be summarized as:biological, biomechanical or patient-related.BIOLOGICALInadequate blood supply A badly displaced fracture of a long bone will cause tearing of both the periosteum and interruption of the intramedullary blood supply. The fracture edges will become necrotic and dependent on the formation of an ensheathing callus mass to bridge the break. If the zone of necrosis is extensive, as might occur in highly comminuted fractures, union may be hampered.Severe soft tissue damage Severe damage to the soft tissues affects fracture healing by: (1) reducing the effectiveness of muscle splintage; (2) damaging the local blood supply and (3) diminishing or eliminatingthe osteogenic input from mesenchymal stem cells within muscle.Periosteal stripping Over-enthusiastic stripping of periosteum during internal fixation is an avoidable cause of delayed union.BIOMECHANICALImperfect splintage Excessive traction (creating a fracture gap) or excessive movement at the fracture site will delay ossification in the callus. In the forearm and leg a single-bone fracture may be held apart by an intact fellow bone.Over-rigid fixation Contrary to popular belief, rigid fixation delays rather than promotes fracture union. It is only because the fixation device holds the fragments so securely that the fracture seems to be ‘uniting’. Union by primary bone healing is slow, but provided stability is maintained throughout, it does eventually occur.Infection Both biology and stability are hampered by active infection: not only is there bone lysis, necrosis and pus formation, but implants which are used to hold the fracture tend to loosen.PATIENT RELATEDIn a less than ideal world, there are patients who are:· Immense· Immoderate· Immovable· Impossible.These factors must be accommodated in an appropriate fashion.Clinical featuresFracture tenderness persists and, if the bone is subjected to stress, pain may be acute.On x-ray, the fracture line remains visible and there is very little or incomplete callus formation or periosteal reaction. However, the bone ends are not sclerosed or atrophic. The appearances suggest that, although the fracture has not united, it eventually will.TreatmentCONSERVATIVEThe two important principles are: (1) to eliminate any possible cause of delayed union and (2) to promote healing by providing the most appropriate environment. Immobilization (whether by cast or by internal fixation) should be sufficient to prevent shear at the fracture site, but fracture loading is an important stimulus to union and can be enhanced by: (1) encouraging muscular exercise and (2) by weightbearing in the cast or brace. The watchword is patience; however, there comes a point with every fracture where the illeffects of prolonged immobilization outweigh the advantages of non-operative treatment, or where the risk of implant breakage begins to loom.OPERATIVEEach case should be treated on its merits; however, if union is delayed for more than 6 months and there is no sign of callus formation, internal fixation and bone grafting are indicated. The operation should be planned in such a way as to cause the least possible damage to the soft tissues.---from 《Apley’s System of Orthopaedics and Fractures》P716重点词汇整理：unduly /ˌʌnˈduːli/adv. 过度地；不适当地；不正当地biological, biomechanical or patient-related.生物学、生物力学或与病人相关periosteum /,pɛrɪ'ɑstɪəm/n. [解剖] 骨膜；管膜mesenchymal stem cells 间充质干细胞Periosteal stripping 骨膜剥离enthusiastic /ɪnˌθuːziˈæstɪk/adj. 热情的；热心的；狂热的ossification/ˌɑːsɪfɪˈkeɪʃn/n. 骨化；成骨；（思想的）僵化Contrary to popular belief, rigid fixation delays rather than promotes fracture union.与普遍的看法相反，刚性固定延迟而不是促进骨折愈合。
骨科英文书籍精读（12）｜骨折复位
骨科英文书籍精读（12）｜骨折复位REDUCTIONAlthough general treatment and resuscitation must always take precedence, there should not be undue delay in attending to the fracture; swelling of the soft parts during the first 12 hours makes reduction increasingly difficult. However, there are some situations in which reduction is unnecessary: (1) when there is little or no displacement; (2) when displacement does not matter initially (e.g. in fractures of the clavicle) and (3) when reduction is unlikely to succeed(e.g. with compression fractures of the vertebrae).Reduction should aim for adequate apposition and normal alignment of the bone fragments. The greater the contact surface area between fragments the more likely healing is to occur. A gap between the fragment ends is a common cause of delayed union or nonunion. On the other hand, so long as there is contact and the fragments are properly aligned, some overlap at the fracture surfaces is permissible. The exception is a fracture involving an articular surface; this should bereduced as near to perfection as possible because any irregularity will cause abnormal load distribution between the surfaces and predispose to degenerative changes in the articular cartilage. There are two methods of reduction: closed and open.---from 《Apley’s System of Orthopaedics and Fractures》P695重点词汇整理：resuscitation /rɪˌsʌsɪˈteɪʃn/n. 复苏；复兴；复活clavicle /ˈklævɪkl/n. [解剖] 锁骨Reduction should aim for adequate apposition and normal alignment of the bone fragments. 复位的目的应是使骨碎片充分贴合和正常对齐。
骨科英文书籍精读（28）｜开放性骨折的后遗症
骨科英文书籍精读（28）｜开放性骨折的后遗症If split-thickness skin grafts are used inappropriately, particularly where flap cover is more suited, there can be areas of contracture or friable skin that breaks down intermittently. Reparative or reconstructive surgery by a plastic surgeon is desirable.BoneInfection involves the bone and any implants that may have been used. Early infection may present as wound inflammation without discharge. Identifying the causal organism without tissue samples is difficult but, at best guess, it is likely to be S. aureus (including methicillin-resistant varieties) or Pseudomonas. Suppression by appropriate antibiotics, as long as the fixation remains stable, may allow the fracture to proceed to union, but further surgery is likely later, when the antibiotics are stopped.Late presentation may be with a sinus and x-ray evidence of sequestra. The implants and all avascular pieces of bone should be removed; robust soft tissue cover (ideally a flap) is needed. An external fixator can be used to bridge the fracture. If the resulting defect is too large for bone grafting at a later stage, the patient should be referred to a centre with the necessary experience and facilities for limb reconstruction.JointsWhen an infected fracture communicates with a joint, the principles of treatment are the same as with bone infection, namely debridement and drainage, drugs and splintage. Onresolution of the infection, attention can be given to stabilizing the fracture so that joint movement can recommence. Permanent stiffness is a real threat; where fracture stabilization cannot be achieved to allow movement, the joint should be splinted in the optimum position for ankylosis, lest this should occur.---from 《Apley’s System of Orthopaedics and Fractures》P710重点词汇整理：SEQUEL /ˈsiːkwəl/n. 续集；结局；继续；后果split-thickness skin grafts刃厚皮片移植inappropriately,/ˌɪnəˈproʊpriətli/adv. 不适当地contracture 美 /kən'træktʃɚ/n. [医] 挛缩；异位骨化friable /ˈfraɪəbl/adj. 易碎的；脆弱的intermittently /ˌɪntərˈmɪtəntli/adv. 间歇地Reparative /'rɛpərətɪv/adj. 修缮的；赔偿的；弥补的Reparative or reconstructive surgery修复或重建手术Early infection may present as wound inflammation without discharge。
骨科英文书籍精读（270）｜?股骨干骨折合并血管损伤
骨科英文书籍精读（270）｜股骨干骨折合并血管损伤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。
中国十大名师之一赖世雄老师说过，学习英语没有捷径，少就是多，快就是慢。
不要以量取胜，把一个音标、一个单词、一段对话、一篇文章彻底搞透，慢慢积累，你会发现，你并不比每天走马观花的输入大量英文学的差。
FRACTURES ASSOCIATED WITH VASCULAR INJURYWarning signs of an associated vascular injury are (1) excessive bleeding or haematoma formation; and (2) paraesthesia, pallor or pulselessness in the leg and foot. Do not accept ‘arterial spasm’ as a cause of absent pulses; the fracture level on x-ray will indicate the region of arterial damage and arteriography may only delay surgery to re-establish perfusion. Most femoral fractures with vascular injuries will have had warm ischaemia times greater than 2–3 hours by the time the patient arrives in the operating theatre; when this exceeds 4–6 hours, salvage may not be possible and the risk of amputation rises. This means that diagnosis must be prompt and re-establishing perfusion a priority; fracture stabilization is secondary.A recommended sequence for treatment, particularly if the warm ischaemia time is approaching the salvage threshold, is (a) to create a shunt from the femoral vessels in the groin to beyond the point of injury using plastic catheters; (b) to stabilize the fracture (usually by plating or external fixation) and then (c) to carry out definitive vascular repair. This sequence establishes blood flow quickly and permits fracture fixation and vascular重点词汇整理：Most femoral fractures with vascular injuries will have had warm ischaemia times greater than 2–3 hours by the time the patient arrives in the operating theatre.大多数血管损伤的股骨骨折在患者到达手术室时，会有2-3小时以上的热缺血。
骨科英文书籍精读（223）｜髋关节后脱位早期并发症
骨科英文书籍精读（223）｜髋关节后脱位早期并发症中国十大名师之一赖世雄老师说过，学习英语没有捷径，少就是多，快就是慢。
不要以量取胜，把一个音标、一个单词、一段对话、一篇文章彻底搞透，慢慢积累，你会发现，你并不比每天走马观花的输入大量英文学的差。
ComplicationsEARLYSciatic nerve injuryThe sciatic nerve is damaged in 10–20 per cent of cases but it usually recovers. Nerve function must be tested and documented before reduction is attempted. If, after reducing the dislocation, a sciatic nerve lesion is diagnosed, the nerve should be explored to ensure it is not trapped by the reduction manoeuvre. Recovery often takes months and in the meantime the limb must be protected from injury and the ankle splinted to overcome the foot drop.Vascular injuryOccasionally the superior gluteal artery is torn and bleeding may be profuse. If this is suspected, an arteriogram should be performed. Thetorn vessel may need to be ligated.Associated fractured femoral shaftWhen this occurs at the same time as the hip dislocation, the dislocation is often missed. It should be a rule that with every femoral shaft fracture, the buttock and trochanter are palpated, and the hip clearly seen on x-ray. Even if this precaution has been omitted, a dislocation should be suspected if the proximal fragment of a transverse shaft fracture is seen tobe adducted. Closed reduction of the dislocation will be much more difficult. A prompt open reduction of the hip followed by internal fixation of the shaft fracture should be undertaken.---from 《Apley’s System of Orthopaedics and Fractures》重点词汇整理：manoeuvre /məˈnuːvər/n. 特技动作，熟练动作；（尤指以欺骗为目的）策略，手段；欺诈性操作；军事演习（等于aneuver）v. （使谨慎或熟练地）移动；操控，使花招；诱使，诱导the superior gluteal artery臀上动脉gluteal /ɡluːˈtiəl/n. 臀肌adj. 臀肌的，和臀肌有关的profuse /prəˈfjuːs/adj. 丰富的；很多的；慷慨的；浪费的ligate /ˈlaɪɡeɪt/v. 结扎，绑扎（动脉或血管等）buttock /ˈbʌtək/n. 半边臀部；船尾vt. 用腰摔trochanter /tro'kæntər/n. [解剖] 转子；粗隆；昆虫的转节this precaution has been omitted, 这种预防措施被省略了，precaution /prɪˈkɔːʃn/n. 预防，警惕；预防措施vt. 警惕；预先警告omit /əˈmɪt/vt. 省略；遗漏；删除；疏忽百度翻译：早期并发症坐骨神经损伤坐骨神经在10%-20%的情况下受损，但通常会恢复。
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骨科英文书籍精读（42）｜骨折晚期并发症之肌肉挛缩
MUSCLE CONTRACTURE
Following arterial injury or compartment syndrome, the patient may develop ischaemic contractures of the affected muscles (Volkmann’s ischaemic contracture). Nerves injured by ischaemia sometimes recover, at least partially; thus the patient presents with deformity and stiffness, but numbness is inconstant. The sites most commonly affected are the forearm and hand, leg and foot.
In a severe case affecting the forearm, there will be wasting of the forearm and hand, and clawing of the fingers. If the wrist is passively flexed, the patient can extend the fingers, showing that the deformity is largely due to contracture of the forearm muscles. Detachment of the flexors at their origin and along the interosseous membrane in the forearm may improve the deformity, but function is no better if sensation and active movement are not restored. A pedicle nerve graft, using the proximal segments of the median and ulnar nerves may restore protective sensation in the hand, and tendon transfers (wrist extensors to finger and thumb flexors) will allow active grasp. In less severe cases, median nerve sensibility may be quite good and, with appropriate tendon releases and transfers, the patient regains a considerable degree of function.
Ischaemia of the hand may follow forearm injuries, or swelling of the fingers associated with a tight forearm bandage or plaster. The intrinsic hand muscles fibrose and shorten, pulling the fingers into flexion at the metacarpophalangeal joints, but the interphalangeal joints remain straight. The thumb is
adducted across the palm (Bunnell’s ‘intrinsic-plus’ position).
Ischaemia of the calf muscles may follow injuries or operations involving the popliteal artery or its divisions. This is more common than is usually supposed. The symptoms, signs and subsequent contracture are similar to those following ischaemia of the forearm. One of the causes of late claw-toe deformity is an undiagnosed compartment syndrome.
---from 《Apley’s System of Orthopaedics and Fractures》P721
重点词汇整理：
muscle contracture肌肉挛缩
inconstant /ɪnˈkɑːnstənt/adj. 变化无常的；易变的；多变的
clawing of the fingers 爪形手
passively flexed被动弯曲，
interosseous membrane 前臂骨间膜
/,intər'ɔsiəs/adj. 骨间的；小腿骨间的；前臂骨间的
/ˈmembreɪn/n. 膜；薄膜
active movement主动活动
restored/ri'stɔ:d/v. 修复（restore的过去式）；恢复健康adj. 精力充沛的；精力恢复的
pedicle nerve graft,椎弓根神经移植
grasp /ɡræsp/v. 抓牢，握紧；试图抓住；理解，领悟；毫不犹豫地抓住（机会）n. 抓，握；理解，领会；力所能及，把握；权力，控制
regain/rɪˈɡeɪn/n. 收复；取回vt. 恢复；重新获得；收回vi. 上涨intrinsic hand muscles手内在肌
fibrose形成纤维性组织
metacarpophalangeal joints掌指关节
interphalangeal joints指间关节
adduct /'ædʌkt/n. [化学] 加合物vt. 使内收
calf muscles腓肠肌群；小腿后肌
/kæf/n. [解剖] 腓肠，小腿；小牛；小牛皮
popliteal artery 腘动脉
/pɔp'litiəl, ,pɔpli'ti-/adj. 腘的，腿弯部的
This is more common than is usually supposed. The symptoms, signs and subsequent contracture are similar to those following ischaemia of the forearm.这种情况比人们通常想象的更为常见。
症状、体征和随后的挛缩类似于那些随之而来的前臂缺血。
百度翻译：
肌肉挛缩
动脉损伤或室间隔综合征后，患者可能出现受影响肌肉的缺血挛缩（沃尔克曼缺血挛缩）。
因缺血而受伤的神经有时会恢复，至少部分恢复；因此病人会出现畸形和僵硬，但麻木是不稳定的。
最常受影响的部位是前臂和手、腿和脚。
在严重影响前臂的情况下，前臂和手会消瘦，手指会被抓。
如果手腕被动弯曲，患者可以伸出手指，说明畸形主要是由于前臂肌肉挛缩所致。
屈肌在其起点和前臂骨间膜的分离可以改善畸形，但如果感觉和主动运动不恢复，功能就不好。
利用正中神经和尺神经近端节段的带蒂神经移植可以恢复手部的保护性感觉，肌腱转移（手腕伸肌到手指和拇指屈肌）将允许主动抓握。
在不太严重的情况下，正中神经的敏感性可能相当好，适当的肌腱松解和转移，患者可以恢复相当程度的功能。
手部缺血可能是前臂损伤，或手指肿胀与前臂绷带或石膏绷带紧密相关。
手的固有肌肉纤维化并变短，手指在掌指关节处弯曲，但指间关节保持笔直。
拇指在手掌上内收（邦内尔的“内在加”位置）。
小腿肌肉的缺血可能发生在损伤或涉及腘动脉或其分支的手术之后。
这比通常想象的要普遍。
症状、体征和随后的挛缩与前臂缺血后
的症状相似。
晚期爪趾畸形的原因之一是未确诊的筋膜室综合征。