principles of fractures （二）
TYPES OF FRACTURE
Fractures are variable in appearance but for practical reasons they are divided into a few well-defined groups.
COMPLETE FRACTURES
The bone is split into two or more fragments. The fracture pattern on x-ray can help predict behaviour after reduction: in a transverse fracture the fragments usually remain in place after reduction; if it is oblique or spiral, they tend to shorten and re-displace even if the bone is splinted. In an impacted fracture the fragments are jammed tightly together and the fracture line is indistinct. A comminuted fracture is one in which there are more than two fragments; because there is poor interlocking of the fracture surfaces, these are often unstable.
INCOMPLETE FRACTURES
Here the bone is incompletely divided and the periosteum remains in continuity. In a greenstick fracture the bone is buckled or bent (like snapping a green twig); this is seen in children, whose bones are more
springy than those of adults. Children can also sustain injuries where the bone is plastically deformed (misshapen) without there being any crack visible on the x-ray. In contrast, compression fractures occur when cancellous bone is crumpled. This happens in adults and typically where this type of bone structure is present, e.g. in the vertebral bodies, calcaneum and tibial plateau.
CLASSIFICATION OF FRACTURES
Sorting fractures into those with similar features brings advantages: it allows any information about a fracture to be applied to others in the group (whether this concerns treatment or prognosis) and it facilitates
a common dialogue between surgeons and others involved in the care of such injuries.
Traditional classifications, which often bear the originator’s name, are hampered by being applicable to that type of injury only; even then the term is often inaccurately applied, famously in the case of Pott’s fracture, which is often applied to any fracture around the ankle though that is not what Sir Percival Pott implied when he described the injury in 1765.
A universal, anatomically based system facilitates communication and the sharing of data from a variety of countries and populations, thus contributing to advances in research and treatment. An alphanumeric
classification developed by Müller and colleagues has now been adapted and revised (Muller et al., 1990; Marsh et al., 2007; Slongo and Audige 2007). Whilst it has yet to be fully validated for reliability and reproducibility, it fulfils the objective of being comprehensive. In this system, the first digit specifies the bone (1 = humerus, 2 = radius/ulna, 3 = femur, 4 = tibia/fibula) and the second the segment (1 = proximal, 2 = diaphyseal, 3 = distal, 4 = malleolar). A letter specifies the fracture pattern (for the diaphysis: A = simple, B = wedge, C = complex; for the metaphysis: A = extra-articular, B = partial articular,
C = complete articular). Two further numbers specify the detailed morphology of the fracture (Fig. 23.3).
---from 《Apley’s System of Orthopaedics and Fractures》P687-688
重点词汇整理：
practical reasons 实际原因
well-defined 界限清楚的；定义明确的
COMPLETE FRACTURES 完全骨折
split /splɪt/n. 劈开；裂缝
predict /prɪˈdɪkt/v. 预言，预知，预卜；做预报；断言
reduction /rɪˈdʌkʃn/n. 减少；下降；缩小；还原反应（骨折复位）
transverse fracture横行骨折
oblique or spiral 斜或螺旋
re-displace 再移位
splinted /splɪnt/n. 夹板；薄木条；薄金属片vt. 用夹板固定
impacted fracture 嵌插骨折
jammed /dʒæmd/adj. 堵塞的；拥挤的；轧住了的
indistinct /ˌɪndɪˈstɪŋkt/adj. 模糊的，不清楚的；朦胧的；难以清楚辨认的
comminuted fracture粉碎性骨折 /'kɑmə,njʊt/adj. 粉碎的
interlocking v. （使）紧密连接；连结（interlock 的现在分词）n. 紧密连接；紧紧相扣
INCOMPLETE FRACTURES 不完全骨折
periosteum /,pɛrɪ'ɑstɪəm/ n. [解剖] 骨膜；管膜
continuity /ˌkɑːntɪˈnuːəti/ n. 连续性；一连串；分镜头剧本
greenstick fracture 青枝骨折
buckled or bent 扣或弯曲（都是弯曲的意思）
snapping a green twig 折断一根绿色的小树枝 /twɪɡ/n. 小枝，嫩枝，
springy /ˈsprɪŋi/adj. 有弹力的
plastically deformed (misshapen) 可塑性变形(畸形)
compression fractures 压缩骨折
crumpled /ˈkrʌmpld/v. 弄皱，起皱
vertebral bodies, calcaneum and tibial plateau. 椎体、跟骨和胫骨平台。
plateau英 /ˈplætəʊ/ 美 /plæˈtoʊ/n. 高原；稳定水平
CLASSIFICATION OF FRACTURES 骨折分类
facilitates v. 促进；帮助；使…容易
a common dialogue between 一个共同的对话
originator /əˈrɪdʒɪneɪtər/n. 创始人；发明者；提出者
hampered /ˈhæmpərd/v. 阻碍（hamper的过去分词）；限制
applicable to 适用于，适用的
inaccurately applied 不准确应用
universal, anatomically 普遍的,在解剖学上
alphanumeric /ˌælfənuːˈmerɪk/adj. [计] 字母数字的
adapted and revised 调整和修改
Whilst /wailst/conj. 当……的时候；与……同时；然而；虽然，尽管；直到……为止（等于 while）adv. 在……时候（等于 while）
fully validated for reliability 充分验证可靠性
reproducibility /riprə,dju:sə'biliti/n. [自] 再现性
comprehensive /ˌkɑːmprɪˈhensɪv/n. 综合学校；专业综合测验
humeru肱骨
radius/ulna; 桡骨、尺骨
femur 股骨
tibia/fibula 胫骨、腓骨
proximal 近端
diaphyseal 骨干的
malleolar /mə'li:ələ/adj. 踝的
specifies vt. 指定；详细说明；列举（specify的第三人称单数）
wedge n. 楔子；楔形物；不和v. 楔入；挤进；楔住
metaphysis 干骺端
partial lar,部分守护神
detailed morphology 详细的形态详细的形态
/mɔːrˈfɑːlədʒi/n. 形态学，形态论；[语] 词法，[语] 词态学
百度翻译：
骨折类型
骨折在外观上是可变的，但出于实际原因，它们被分为几个定义明确的组。
完全性骨折
骨头被分成两块或更多的碎片。x线片上的骨折模式有助于预测骨折复位后的行为：在横向骨折中，骨折块通常在复位后保持原位；如果骨折是斜的或螺旋形的，即使用夹板固定，骨折块也会变短并重新移位。在受冲击的骨折中，碎片被紧紧地挤在一起，骨折线模糊。粉碎性骨折是指有两个以上碎片的骨折；由于骨折面互锁不良，这些碎片往往不稳定。
不完全骨折
这里的骨头不完全分开，骨膜保持连续。在绿蜱的骨折中，骨头是弯曲或弯曲的（就像折断一根绿色的树枝）；这在儿童中可见，他们的骨头更多
比成年人有弹性。儿童也可以在骨骼发生塑性变形（畸形）时承受损伤，而在x光片上看不到任何裂缝。相反，松质骨皱缩时发生压缩性骨折。这种情况发生在成年人身上，典型的是这种类型的骨结构，例如椎体、跟骨和胫骨平台。
骨折分类
将骨折分为具有相似特征的骨折会带来好处：它允许将任何有关骨折的信息应用于该组中的其他人（无论是与治疗还是预后有关），并且它有助于
外科医生和其他参与此类损伤治疗的人之间的共同对话。
传统的分类法，通常以创始者的名字命名，但由于只适用于这种类型的损伤而受到阻碍；即使这样，这个术语也常常被错误地应用，著名的例子是Pott骨折，它经常应用于脚踝周围的任何骨折，尽管这不是Percival Pott爵士描述时所暗示的1765年的伤害。
一个普遍的、以解剖为基础的系统有助于各种国家和人口之间的交流和数据共享，从而促进研究和治疗的进展。字母数字Müller及其同事开发的分类现在已经被修改和修订（Muller等人，1990年；Marsh等人，2007年；Slongo和Audige，2007年）。虽然还没有完全验证其可靠性和再现性，但它实现了全面性的目标。在这个系统中，第一个数字指定骨骼（1=肱骨，2=桡骨/尺骨，3=股骨，4=胫骨/腓骨），第二个数字指定节段（1=近端，2=骨干，3=远端，4=踝）。字母表示骨折类型（对于骨干：A=简单，B=楔形，C=复杂；对于干骺端：A=关节外，B=部分关节，
C=完全关节）。另外两个数字规定了骨折的详细形态（图23.3）。