Great doctor starts with adding points
Chapter 53 Lu Junyin's Trust (for collection, for further reading)
Although elbow dislocation is not as complicated as shoulder dislocation, and there are many types, it also has inherent difficulties in elbow dislocation itself.
Posterior dislocation is common. This kind of dislocation is due to the wide and thick inner and outer condyle of the humerus at the lower end of the elbow joint. Condylar avulsion fracture.
Anterior dislocation is often combined with olecranon fracture. And this kind of injury is more serious in the soft tissue of the elbow, especially in blood vessels and nerves.
The lateral dislocation of the elbow joint is caused by violence. When the elbow is subjected to conductive violence, the elbow joint is in a varus or valgus position, causing the collateral ligament and joint capsule of the elbow joint to tear. Under the action of strong varus and valgus, the medial and lateral humeral condyle avulsion fractures are caused by the violent contraction of the forearm extensor or flexor muscles, especially the medial epicondyle of the humerus is more prone to fracture.
It is even more complicated, and the dislocation of the elbow joint that is best diagnosed and treated often occurs in infants and young children with subluxation of the radial head. This is definitely not the case for Xiang Gong at his age.
Difficult.
This Chang Quansheng was able to rule out fractures without plain films, which also required effort, and it must not be as simple and easy as he said verbally.
I had time to spare, but in the end I couldn't handle it well——
"Brother Lun Wu, did that Doctor Chang tell you about Xiang Gong's diagnosis?" Wu Xie continued to inquire, so as to sort out and prepare for the knowledge structure in advance.
If you are not strong enough, you must be more cautious and cautious.
Xiang Lunwu squinted his eyes and raised his fat face: "What he said earlier was a radial dislocation, it must be a mistake..."
Wu Xie was taken aback when he heard this.
I cursed in my heart.
paralysis!
What the hell is this, why are there still people looking for dislocation of the radial head here in adults?
This is not a charlatan, is it?
Radial head subluxation, also known as pulled elbow in modern medicine, is one of the common elbow injuries in infants and young children. The age of onset is 1 to 4 years old, and the incidence rate is the highest at 2 to 3 years old.
If the upper radioulnar joint is dislocated, if this Chang Quansheng dares to do manual reduction directly, then there is really a 'something'?
Strictly speaking, a dislocation of the superior radioulnar joint is not considered a dislocation of the elbow.
Of course, peers should not comment on each other's right or wrong. Now that it has become like this, we still have to think of a solution, and it is not what Wu Xie wants.
Hope the final situation can be simpler.
As soon as Wu Xie was about to reply, he saw Lu Junyin calling Wu Xie, meaning to ask Wu Xie to go up first, he told Xiang Gong, and Xiang Gong went directly to the office to look for it later.
Xiang Lunwu also heard Wu Xie's call, so he stood up and said, "I'll go back to Ao first, and I'm here to show Xiang Gong Yaoyao the way."
"Okay, Brother Lunwu, be careful, don't fall down." Wu Xie said so, and then walked upstairs, Xiang Lunwu University is an adult fat man, so he won't find his way home.
But when Wu Xie walked upstairs, he hadn't reached the door of the office yet.
I saw that at the top of the stairs, there was an acquaintance poking his head. He was the owner of several shops in the town. He is also the owner who plans to open a Chinese medicine clinic this time.
Surnamed Hu, called Hu Zhou, about forty years old, slightly fat, looks amiable, big bald, slightly short and fat fingers, ticked, and said softly: "Doctor Wu?"
"Boss Hu?" Wu Xie looked at it for a while, and he was not very familiar with the other party, and he was not related to him, so he squinted his eyes and asked suspiciously.
"Doctor Wu, Xiang Gong, send him to the county hospital. I thank you for your kindness, so you won't be troubled!" Boss Hu said in such a soft voice, winking at Wu Xie.
The meaning is obvious!
In doing so, Wu Xie didn't have to work hard, and he could still please him, and he could also have an argument with Xiang Gong.
Wu Xie's expression turned slightly chilly when he heard the words: "Boss Hu, our director is in the department. I must check the situation first."
"It's not good to just send it away?"
Wu Xie would definitely not agree with this statement. If the strength is not enough, where should Xiang Gong go, but if the ability is sufficient and the diagnosis is clear, Wu Xie will not want him to run around.
Boss Hu's smiling face froze slightly, and he said, "Doctor Wu, anyway, this is just a matter of a few words from you. If Dr. Wu can help me with this, I will definitely thank you."
"We are all from the same village, and I watched you grow up too, right..."
He planned to open a Chinese medicine clinic because he was jealous after seeing Xiong Yao's reputation and good business!
After finally inviting a capable Chinese medicine doctor over, I naturally want to follow Xiong Yao.
Unexpectedly, it turned out to be a bad start from the beginning!
Wu Xie said, "Boss Hu, I'll take a look later. If I can't handle it well, I'll definitely go to the county."
Seeing Wu Xie's response, Boss Hu's face darkened, and he muttered: "You just made a J8!"
"I won't give you favors. If something goes wrong, you can do it if you like. You will eventually follow Lu Junyin's old way. Western medicine still wants to reset..." Cursing in a low voice, he walked downstairs.
Of course he didn't dare to show up and play black under the lights with Xiang Gong and others.
...
Wu Xie was not particularly angry when he heard Hu Zhou's words, he just thought it was funny.
After entering the office, after waiting for a few minutes, Lu Junyin and Xiang Gong arrived at the office at the same time.
Wu Xie stood up and asked, "Uncle Xiang Gong, what's the number of your photo?"
When Xiang Gong took the photos, he didn't register, but he could have an inspection number to check, which means he didn't spend any money.
This can be regarded as a convenience to Lu Junyin.
Xiang Gong said: "Doctor Zhou said that you can just search 9987 directly."
Lu Junyin walked in at this moment and explained to his brother-in-law: "Your clothes may have to be cut. This is a uniform. It doesn't matter if you cut it?"
"We'll have to do a careful physical examination later."
Wu Xie also took a glance, Xiang Gong's elbow joints were so swollen that the uniform could no longer be taken off!
And if you want to do a physical examination, you must cut it.
Lu Junyin knows this, and he is definitely not an amateur in the manipulation of dislocated joints.
In this way, when diagnosing Xiang Gong, you need to be more cautious.
"This can be cut, it's okay." Xiang Gong nodded, saying that it doesn't matter, the traffic police team will not be held accountable for saying that the uniform is tattered after being injured on duty.
"Brother-in-law, you said that I was dislocated, did that Doctor Chang make a mistake?" Xiang Gong asked so clearly.
Lu Junyin can’t express his position directly: “The diagnosis of Chinese medicine and Western medicine is slightly different. We can’t say he’s wrong, and he didn’t write any medical records. You can only say that his practice location doesn’t match. After all, the current Chinese medicine clinic has not opened up… ..."
"There is no record, but it is inappropriate. Others think we are deliberately finding fault." Lu Junyin analyzed it from an objective perspective.
Then decisively cut Xiang Gong's clothes...
Wu Xie just glanced at the film at this moment, and said in a deep voice: "Director Lu, it's a lateral dislocation!"
It's the tricky kind of dislocation.
Lu Junyin's expression darkened when he heard the words: "Xiaoxie, come here and have a physical examination, evaluate whether it is good or not, and reset immediately, if not, go directly to the county hospital."
Lu Junyin gave Wu Xie the bottom line again.
On the one hand is my brother-in-law, and on the other is the young man who is valued by my department. He can't cheat anyone, he can't be biased, and he leaves a retreat for both sides.
"The joints are uniformly swollen, so there should be no local bleeding. If there is no hematoma with local hemorrhage, the possibility of blood vessels and fractures is quite small." Wu Xie said while inspecting the joint!
"There is no filling protrusion in the joint cavity..." This means that the possibility of bleeding inside is unlikely, otherwise, the joint space will look particularly round.
This is judgment bleed!
Wu Xie then made another vertical percussion pain, which ruled out a fracture.
Although no obvious fractures are seen on plain radiographs, the probability of lateral dislocation of the elbow joint with fractures is very high, and the fracture line may not be visible with a simple positive oblique position of the elbow joint.
"No pain?" Wu Xie repeated professionally, afraid that Xiang Gong's pain would last for a long time, and then he would become dull and unable to respond immediately.
Xiang Gong shook his head again.
"Fracture means no fracture for the time being, and dislocation is certain. The joint deformity of this elbow joint is very serious. Director Lu, I need to watch the film again." Wu Xie explained to Lu Junyin like this.
Lu Junyin knew that his existence was hindering Wu Xie's performance.
"You all decide for yourself! I'm not here to interfere with your decisions."
"Xiao Wu, reset it if you feel confident. Then Xiang Gong, if you can trust me, let Wu Xie reset it for you. No matter what, I will bear the final responsibility!"
"You can't trouble Xiao Wu in our department. I don't believe he won't bring you here!"
Lu Junyin walked out with such a firm statement, his tone still not biased.
Xiang Gong watched his brother-in-law leave the office with a confused expression, frowning slightly.
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