希腊文翻译10

　　距骨体骨折多为高处跌下，暴力直接冲击所致。距骨体可在横的平面发生骨折，也可形成纵的劈裂骨折。骨折可呈线状，星状或粉碎性。距骨体骨折往往波及踝关节及距下关节，虽然移位很轻，但可导致上述关节的阶梯状畸形，最终产生创伤性关节炎，因此距骨体骨折预后比距骨颈骨折更差。

　　距骨骨折较少见，多由直接暴力压伤或由高处堕落间接挤压所伤。以局部肿胀、疼痛、皮下瘀斑、不能站立行走等为主要表现的距骨部骨折。X线片可诊断。此病的常见并发症为：

　　1、缺血性骨坏死：距骨骨折，由于血供破坏较多，易引起不愈合或缺血性骨坏死；

　　2、慢性疼痛：由于关节面的破坏不能完全修复，造成行走及运动时疼痛；

　　3、创伤性关节炎：反复的磨损，致使关节面发生磨损，久之造成创伤性关节炎。

　　距骨骨折是由于外伤性因素引起，故注意生产生活安全，避免创伤是预防本病的关键。同时注意应积极进行治疗且彻底清创，防止感染和创伤性关节炎。

　　1、Ερωτήσεις για την κατάσταση του τραυματισμού, συμπεριλαμβανομένων των αιτιών, της χρονολογίας, του τόπου, της στάσης του σώματος κατά τη στιγμή του τραυματισμού και ποιο μέρος έπεσε πρώτα, αν υπάρχει τραύμα ή αιμορραγία, πρέπει να ερωτηθεί για την πορεία της επεξεργασίας του τραύματος, αν έχει χρησιμοποιηθεί δάκτυλος και πόσο χρόνο έχει τεθεί.

　　2、Ολοκληρωτικός έλεγχος υγείας, με προσοχή στην παρουσία σοκ, τραυματισμών μαλακών ιστών, αιμορραγίας, έλεγχο του μεγέθους, μορφής, βάθους και μολυσματικής κατάστασης των创ασμάτων. Υπάρχουν εξωτερικές εκθέσεις οστούν, νεύρων, αρθρικών αγγείων, εγκεφάλου, εσωτερικών οργάνων και άλλων τραυματισμών. Για σοβαρούς τραυματισμούς πρέπει να γίνει γρήγορα.

　　3、Η ακτινογραφία Χ-ρενίου, εκτός από τις ακτινογραφίες ακτίνας και πλευρικής θέσης, πρέπει να ληφθούν και ειδικές θέσεις σύμφωνα με την κατάσταση της τραυματισμού, όπως η θέση ανοίγματος (τραυματισμός του ανώτερου τραχήλου), η δυναμική πλευρική θέση (τράχηλος), η θέση άξονα (κυβώνας, οστεόφυτεο κ.λπ.) και η θέση τάσεως (κυβική οστεοφυτεο) κ.λπ. Για σύνθετους τραυματισμούς του οστικού πυθαμοστομίου ή για υποψία σπασμωδικού τραυματισμού του σπονδύλου, πρέπει να ληφθούν και ημερές ή CT ελέγχοι.

　　In order to make the fractured bone heal as soon as possible after the astragalus fracture, it is first necessary to ensure the necessary nutrients for the growth of the broken bone in the diet. The requirements for diet are different at different stages after the fracture. What should be paid attention to in the diet after the fracture surgery?

　　early stage(1-2week)

　　The ecchymosis and swelling at the site of injury, the meridians and collaterals are not unobstructed, and the Qi and blood are blocked. The treatment during this period focuses on promoting blood circulation and removing blood stasis, and dissipating Qi. Traditional Chinese medicine believes that "if the blood stasis does not disappear, the bone cannot grow" and "if the blood stasis disappears, new bone will grow." It can be seen that removing swelling and blood stasis is the primary factor for fracture healing. Most of the early stage of fracture is the period of immobilization, and at this time, it should be avoided to eat greasy bone soup and a large amount of meat that is difficult to digest, and it is not advisable to intake an excessive amount of calcium. The diet should be easy to digest and absorb, and tonifying should be postponed to the middle and late stages of fracture to have a nourishing effect. The principle of diet during this stage should be light, such as vegetables, eggs, soy products, fruits, fish soup, lean meat, etc. It is forbidden to eat sour and spicy, dry and hot, and greasy foods, especially not to apply rich and nourishing foods such as bone soup, fat chicken, and stewed water fish too early, otherwise the blood stasis will accumulate and be difficult to dissipate, which will inevitably delay the course of the disease, slow down the growth of the callus, and affect the recovery of joint function in the future. At this stage, dietary therapy can use Panax notoginseng.10grams, Angelica sinensis10grams, pigeon1pieces, all stewed until soft, soup and meat together, daily1times, continuous7-10days. In the early stage of fracture, due to less movement and worry, the Qi is stagnant, and there is a lack of power to push and move, leading to constipation. Bedridden patients are more prone to constipation. It is forbidden to eat yams, taros, glutinous rice, and other easily bloated or indigestible foods. It is advisable to eat more vegetables rich in fiber and eat some bananas, honey, and other foods that promote defecation. If necessary, take laxatives such as Maren pills.6grams to9grams, daily1times or2times. Bedridden patients are prone to urinary tract infections and urinary tract stones, and it is advisable to drink more water to promote urination.

　　middle stage(2-4week)

　　Most of the ecchymosis is absorbed, and the treatment during this period focuses on harmonizing the camp and relieving pain, removing blood stasis and promoting the formation of new tissues, and continuing the bone and tendons. At this time, the callus begins to grow, and after a period of lying in bed, the body is in a high metabolic state, with a significant loss of potassium, calcium, and other minerals. The diet should gradually shift from light to high-nutrient supplementation, actively consuming vitamins, calcium, potassium, zinc, and other trace elements to meet the needs of callus growth. The initial diet can be supplemented with bone soup, Panax notoginseng chicken stew, animal liver, etc., to provide more vitamin A, D, calcium, and protein. Dietary therapy can use Angelica sinensis.10grams, Lycium barbarum15grams, bone broken supplement15grams, Dipsacus asper10grams, fresh pork rib or beef rib250 grams, stewed1hours above, soup and meat together, continuous use2week.

　　late stage(5above)

　　Injury5After the first week, the ecchymosis at the fracture site is basically absorbed, and the callus formation has begun, which is the late stage of fracture. Treatment should focus on supplementation, through tonifying the liver and kidney, and promoting the formation of a more solid callus, as well as relaxing the tendons and meridians to allow the adjacent joints of the fracture site to move freely and flexibly, restoring the previous function. Diet restrictions can be lifted, and the diet can be supplemented with old hen soup, pork bone soup, lamb bone soup, deer tendons soup, stewed water fish, etc. Those who can drink can choose Du Zhong bone broken supplement wine, chicken blood vine wine, tiger bone papaya wine, etc. Dietary therapy can use Lycium barbarum.10grams, Fraxinus spp.15grams, Dipsacus asper10grams, Coix seed50 grams. Boil Fraxinus spp. and Dipsacus asper first to remove the residue, then add the rest2flavor cooked congee for eating. Every day1times,7day is1treatment course. Every1treatment course interval3-5days, can be used3-4疗程

　　For displaced fractures in this disease, open reduction is often required, and firm internal fixation with screws is used. It is generally believed that even if the fracture is reduced, it is not easy to achieve a good painless range of motion, so for comminuted fractures or when there are progressive signs of ischemic necrosis, tibiocalcaneal and talocalcaneal joint fixation surgery can be performed. Common surgical methods include the following:

　　1、Internal Fixation

　　The fundamental method for preventing talus fracture avascular necrosis is early surgery and strong, reliable internal fixation. If the fracture ends of the talus can be tightly compressed, the necrosis rate can be reduced10％approximately. For larger fracture fragments, the use of mini-screws for internal fixation achieves good therapeutic effects.

　　2、Fenestration

　　For smaller bone cartilage fragments that cannot be fixed, they need to be thoroughly removed. Using a small Kirschner wire to perform a fenestration on the injury site can promote the formation of fibrocartilage, which can allow the talus body to withstand greater pressure. The posterior medial injury of the talus can be completed by transverse retrograde drilling through the talus.

　　3、Arthrodesis

　　For severe comminuted talus fractures, it is not possible to use any reduction or fixation methods. Some scholars advocate for a one-stage ankle arthrodesis. Arthrodesis can be chosen in the form of talocalcaneal joint arthrodesis, tibiocalcaneal joint arthrodesis, Blair arthrodesis, talonavicular joint arthrodesis, etc. When severe talocalcaneal arthritis occurs, it is necessary to treat it with talocalcaneal joint arthrodesis or triple joint arthrodesis to prevent severe talocalcaneal arthritis after bone necrosis leading to loss of function. For talus head fractures, if internal fixation is unstable or fixation results in non-union of the bone, talonavicular joint arthrodesis can be considered.