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Introductiontobonefracture骨折的概述Abonefractureisamedicalconditioninwhichthereisabreakinthecontinuityofthebone.骨的连续性破坏称为骨折。Abonefracturecanbetheresultofhighforceimpactorstress,ortrivialinjuryasaresultofcertainmedicalconditionsthatweakenthebones，suchasosteoporosis，bonecancer，orosteo-genesisimperfecta,wherethefractureisthenproperlytermedapathologicfracture.骨折可由高冲击力或压力，或者是在骨骼疾病导致骨骼削弱的基础上轻微的损伤造成，比如骨质疏松、骨肿瘤、成骨不全常也被称为病理性骨折。Whatcausesabonefracture?Whenoutsideforcessuchasadirectblowsorfallsareappliedtoboneithasthepotentialtofail.当外部力量比如直接打击或跌倒时施加于骨头导致它有可能承受不了。Fracturesoccurwhenbonecannotwithstandthoseoutsideforces.骨折发生在骨不能承受这些外部力量。Fracture’break，orcrackallmeanthesamething.断裂或裂缝都意味着骨折。Onetermdoesnotimplyamoreorlesssevereinjury.这并不意味着损伤的轻重。Theintegrityofthebonehasbeendamaged，whichcausesthebonestructuretofail,whichresultsinafractureorbrokenbone.骨的完整性已被破坏，这会导致骨结构的破坏，从而导致骨折。Oftenafractureiseasytodetectbecausethereisobviousdeformity.通常骨折易于检测，因为有明显的畸形。However,attimesitisnoteasilydiagnosed.Itisimportantforthephysiciantotakeahistoryoftheinjurytodecidewhatpotentialproblemsmightexist.然而，有时它是不容易诊断。医生采集受伤中的病史是非常重要的，这能够确定潜在可能存在的问题。Moreover，fracturesdon’talwaysoccurinisolation，andtheremaybeassociatedinjuriesthatneedtobeaddressed.此外，骨折并不是常常完全离断，同时骨折常带来一些附带损伤需要解决。Fracturescanoccurbecauseofdirectblows,twistinginjuries,orfalls.直接打击，扭转受伤，或跌倒常导致骨折发生。Thetypeofforcesortraumaappliedtothebonemaydeterminewhattypeofinjurythatoccurs.施加于骨的作用力或损伤的类型，可以确定发生的损伤类型。Somefracturesoccurwithoutanyobvioustraumaduetoosteoporosis，thelossofcalciuminbone(forexampleacompressionfractureofthevertebraeoftheback)oracongenitalbonecystthathasbeenpresentsincebirth,whichcausesaweakareainthebone.有些骨折没有明显的外伤，因为骨质疏松，骨质钙流失（例如背部的脊椎骨压缩性骨折）或因为出生时先天性骨囊肿，它会导致骨中的薄弱区域。Descriptionsoffracturescanbeconfusing.Theyarebasedon：骨折的描述可能令人困惑。他们是基于:Whereinthebonethebreakhasoccurred在骨折发生的地方Howthebonefragmentsarealigned骨折的碎片怎样对齐Whetheranycomplicationsexist是否存在任何并发症Whethertheskinisintact皮肤是否完好Thefirststepindescribingafractureistodecideifitisopenorclosed.首先第一步要确定骨折是开放性的还是闭合性的。Theskinprotectstheinsideofthebody，includingbones,fromtheoutsideworld.皮肤可以保护身体内部，包括防止骨头暴露外界。Iftheskinoverthebreakisdisrupted,thenanopenfractureexists.如果皮肤被破坏，则为开放性骨折。Theskincanbecut,tom,orabraded(scraped)，butiftheskin'sintegrityisdamaged,thepotentialforaninfectionfromtheoutsideworldtogetintotheboneexists.皮肤会被切割或磨（刮），但是如果皮肤完整性受损，潜在的感染从外界获得。Sincethefracturesiteinthebonecommunicateswiththeoutsideworld,theseinjuriesoftenneedtobecleanedoutaggressivelyandmanytimesrequireanesthesiaintheoperatingroomtodothejobeffectively.当骨折端与外界相通，这些损伤需要积极的清创缝合，大部分时候需要麻醉下在手术室完成。Compoundfracturewastheprevioustermusedtodescribeanopenfracture.复合骨折是用来形容开放性骨折的前一个术语。Next,thereneedstobeadescriptionofthefractureline.接下来，需要描述骨折线。Doesthefracturelinegoacrossthebone(transverse),atanangle(oblique)ordoesitspiral?骨折线是否（横向）穿过骨，穿过的角度（斜），穿过是否有螺旋？Isthefractureintwopiecesorisitcomminuted,inmultiplepieces?骨折是分为两块，粉碎状，亦或是多块？Agreenstickfracturedescribesthesituationwhenthebonepartiallybreaks.青枝骨折介绍的情况是骨部分断裂。Thisoftenoc¬cursininfantsandchildrenwherethebonehasn’tcompletelycalcifiedandhasthepotentialtobendinsteadofbreakingcompletelythrough.这通常发生在婴儿和儿童，这些骨质没有完全钙化，弯曲的潜力完成传导而不是完全断裂。Itissimilartotryingtobreakoffayoungbranchorshootfromatree(agreenstick).就像是试着折断新发的树枝或射击绿色的树。Otherfracturetermsincludetorusorbucklefracture,againwhenonlypartofabonebreaks,butthismayoccurinadultsaswell.其他骨折包括圆环或扣断裂，同样是骨头的部分断裂，但这同样发生在成年人。Finally,thefracture’salignmentisdescribedastowhetherthefracturefragmentsaredis¬placedorintheirnormalanatomicposition.最后，骨折的排列是描述骨折碎片是否移位或在正常解剖位置。Ifthebonesfragmentsaren’tintherightplace,theyneedtobereducedor“set”andplacedbackintonormalalignment.如果骨头碎片不在正确的地方，他们需要更少或“设置”步骤来放回正常位置。Whatarethesignsandsymptomsofabonefracture?Whenbonesbreak,theycausepain,swelling,andinflammation.当骨头断裂，它们会引起疼痛、肿胀和发炎Theabilitytomovethejointaboveorbelowaninjurydoesnotguaranteethattheboneisnotbroken.Instead,itmeansthatthemusclesandtendonsthatmovethejointstillwork.受伤的关节的上下方移动的能力不能保证没有骨折。相反，这意味着移动关节的肌肉和肌腱仍然工作。Unlessthereisapreviousunderlyingconditionthatpreventsthepatientfromfeelingpain(suchasaspinalcordinjuryordiabeticneuropathy)allbrokenboneshurt.除非有一个前提条件，防止病人感觉疼痛（如脊髓损伤或糖尿病神经病变）所有骨折都会出现疼痛。Thepainmayormaynotbefeltatthesiteofthebreakbutcanbereferredelsewhere.Forexample,hipinjuries,especiallyinchildren,canhavekneepain.疼痛可能发生在断裂的地方，但也可能发生在其他部位。例如，髋关节受伤，特别是在儿童，可以出现膝关节痛。Otherstructurescanbedamagedwhenabonebreaks.Numbnessandtinglingcanresultifthereisnerveinflammationorinjury.当骨断裂时其他结构可能出现损坏。如果有神经发炎或受伤可以导致麻木和刺痛。Alimbmaybecoolandwithoutpulseifthearteryatthefracturesiteistorn,kinkedorclotsoff,preventingbloodfromcirculating.如果在骨折部位的动脉撕裂、扭曲或断裂，阻断血液循环可能出现肢体变冷，无动脉波动。Whatarecommontypesofbonefractures?常见的骨折类型都有那些类型？Thereareseveraltypesofbonefractures，forexample，stressfractures,compressionfractures,openfractures,skullfractures，ribfractures,wristfractures,hipfractures,legfractures,andhand,toe,orfingerfractures.骨折包括很多类型，比如：应力性骨折，压缩骨折，开放性骨折，颅骨骨折，肋骨骨折，腕部骨折，髋部骨折、腿部骨折、手骨折、足趾骨折、手指骨折等。Howisabonefracturediagnosed?骨折是怎样诊断的