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过去的两年我跟大家一起精读了国外经典骨科书籍《Apley’s System of Orthopaedics and Fractures》
401篇帖子，见证了这一路的学习 关注本公众号，在底部点击“英文”----“书籍”即可查看这些文章。
相信一直跟读的读者都会有所收获。为了督促自己学习，从今天起我将和大家一起精读第二本经典著作《Master Techniques in Orthopaedic Surgery》。这是梅奥诊所的骨科教授伯纳德编著的一本解剖手术入路教材，模式图结合实体解剖图，让大家一看就懂，而且结合临床，对我们骨科手术有很大的指导意义。 获取本书全本内容----->请扫描文末二维码，关注公众号并回复“英文手术入路”。 DORSAL SURGICAL APPROACH 背侧手术入路
FIGURE 1-1 A longitudinal incision centered over the wrist is preferred. Incisional contractures are rarely problematic. 图1-1 首选在在手腕中部的纵向切口。切口挛缩很少有问题。
FIGURE 1-2 An alternative transverse incision in Langer's lines. This incision can extend from the radial styloid to the ulnar styloid, in which case mobilization allows for exposure of the carpometacarpal joints and the distal radial metaphysis. 图1 - 2 兰格氏线的另一个横向切口。这个切口可以从桡骨茎突延伸到尺骨茎突，在这种情况下，移动允许显露腕掌关节和桡骨远端干骺端。
FIGURE 1-3 Full-thickness flaps are developed down to the extensor retinaculum, taking care to identify and preserve the superficial radial nerve, the dorsal sensory branch of the ulnar nerve, and any dorsal veins, and elevating them with the flaps. EDC (extensor digitorum comminus), EDM(extensor digiti minimi), EPL (extensor pollicis longus). 图1 - 3 全层皮瓣向下延伸至伸肌支持带，注意识别和保存桡浅神经、尺神经背侧感觉分支和任何背侧静脉，并将它们与皮瓣一起提升。EDC(指伸肌commin)、EDM(指伸肌minimi)、EPL(拇长伸肌)。
FIGURE 1-4 The posterior interosseous nerve (PIN) may be exposed for neurectomy by dissection 2 cm proximal to the extensor retinaculum. 图1-4 后骨间神经(PIN)可在伸肌支持带近端2厘米处剥离，暴露神经切除。
FIGURE 1-5 A,B: The PIN is identified as it enters the 4th extensor compartment and a 2 cm segment of the nerve, which is purely sensory at this level, is excised to achieve PIN neurectomy. 图1 - 5 A,B:当PIN进入第四伸肌室时，识别PIN，并切除2厘米的神经段(在这个水平上是纯感觉的)，以实现PIN神经切除。
FIGURE 1-6 To gain access to the wrist joint, the retinaculum overlying the 3rd lorsal compartment is incised longitudinally from the deep antebrachial fascia proximally and then distally to the distal margin of the retinaculum. 图1 - 6 为了进入腕关节，从近端深臂筋膜纵向切开覆盖在第三前鼻筋膜室上的支持带，然后从远端到支持带的远端边缘。
FIGURE 1-7A,B: The EPL in the 3rd dorsal compartment is retracted radially, and the 4th extensor compartment is elevated subperiosteally or by dividing the septum between the 3rd and 4th compartments and reflecting the retinaculum as an ulnarly based flap. 图1-7A B: 第三背侧隔室的EPL径向缩回，第四伸肌隔室在骨膜下抬高，或通过在第三和第四隔室之间划分隔隔膜，并反映支持带作为尺侧皮瓣。 ---from 《Master Techniques in Orthopaedic Surgery》 |
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