Great doctor starts with adding points
Chapter 55
After Wu Xie finished Xiang Gong's lateral dislocation and reset, he put a plaster cast on him before letting him leave.
After doing all this, he went to give Zhuo Zhiyang an order for antibiotics. Zhuo Zhiyang's wound had been exposed for a period of time, and the antibiotics that should be used for prophylaxis still had to be used.
Jin Yinshan, Jin Ping's son, rushed into the doctor's office at this moment, and brought a bag of bananas to Wu Xie, with a sincere tone: "Xiao Xie, I'm really sorry about what happened before, your cousin and I are very rough."
"You must not take it to heart." Jinping and Wu Xie are far away from each other, and they cannot be considered relatives.
Today, he can be regarded as having increased his knowledge.
Zhu Fagen didn't believe that Wu Xie could cure the dislocation, but Lu Junyin believed that in the end Lu Junyin's brother-in-law Xiang Gong walked out of the hospital happily.
This matter is not simple. I heard from my father that Lu Junyin, the director, suffered a lot when he was dislocated, and he can still trust Wu Xie. Wu Xie really has something to say...
Hurry up to apologize, and hope that Wu Xie can give his father a good look, regardless of previous suspicions.
Wu Xie was still full of guard against Jinyinshan, and refused: "Cousin, we are now under strict control. Those who have a medical relationship are not allowed to take things. It will be very troublesome if you find them. You can take them back."
"Biao Gonggong's situation, I have to think about it carefully. I will live in it first, and I will think about it before I take medicine. You also know that the current situation of Biao Gonggong is a bit complicated. The conditions and level of Qianjiang Central Hospital are better than ours. Much taller..."
Wu Xie was talking and explaining, but Jinyinshan sounds like a different feeling, but he also admitted: "I'm sorry, little crab, I caused you trouble, don't worry, it will be the same if you take medicine tomorrow or the day after tomorrow. .”
"I'll go to your house to play in two days."
"It's been a long time since I saw sister Yao and brother-in-law." Jin Yinshan took the fruit away angrily, and didn't deliberately keep it to embarrass Wu Xie.
The relationship between Jinyinshan and Xiangmei is closer. Although Xiangmei is the fifth row and has a younger brother, but the seniority here is the youngest among the sisters.
When Jin Yinshan went out, he happened to meet Lu Junyin who came in. Lu Junyin was tall and burly, and although he wore glasses, his fighting power was definitely not weak.
Jin Yinshan greeted with slightly evasive eyes: "Hi Director Lu."
Lu Junyin replied with a warning: "Jinyinshan, your father's situation is complicated now, and our hospital may not be able to take it. If there is no way, you can transfer yourself to another hospital and think of other ways."
Before I met you, you went out to make troubles by yourself, but now this mess is out of our hospital's control.
Although Jin Yinshan was unhappy in his heart, he could only follow by and make amends and go out with a smile.
Seeing Lu Junyin coming in, Wu Xie stood up and called out to the director. After all, Jinyinshan hadn't gone far, it wasn't in private, and it was hard to call uncle.
While adjusting the frames of his glasses, Lu Junyin said, "You're welcome, you sit down, little crab."
Having said that, Lu Junyin rubbed his nose again: "Xiao Xie, I'm asking you something, don't take it to heart, it's not that I don't trust you, it's just a casual question."
"Absolutely nothing else!" Lu Junyin tried to comfort him first.
Wu Xie vaguely guessed: "Director Lu, do you want to ask about Zhu Fagen and Uncle Xiang Gong?"
But Lu Junyin smiled: "Why am I asking about Zhu Fagen? I'm just curious. The elbow dislocation is lateral. Although the injury mechanism is simple, it is also violent. So it will lead to serious soft tissue damage."
"I don't know, how did you evaluate that Xiang Gong's dislocation can be reset by hand?"
"It's not that I don't believe you, but I really want to learn, because, once before, like Chang Quansheng below, I took the side prostration as the back prostration..." Lu Junyin was a little embarrassed when he said this.
Professionals know that although elbow dislocation is not as complicated and classified as shoulder dislocation, in terms of severity and complications, elbow dislocation is more likely to be complicated by soft tissue injury.
Therefore, dislocation of this joint is more difficult.
Wu Xie did not choose to leave Zhu Fagen for a simple anterior dislocation of the shoulder joint. Instead, he performed a lateral dislocation of the elbow joint under pressure. Lu Junyin felt very surprised.
Wu Xie smiled, he really knows about this thing.
Because Wu Xie discovered that his skill level may be related to the operation technique, and he has a relatively solid knowledge reserve before he wants to operate.
He sorted out the knowledge structure in advance, so he replied skillfully:
"Director Lu, the mechanism of elbow dislocation is generally that the humerus slides out of the lateral, medial, and posterior parts of the elbow joint, which are called lateral dislocation and posterior dislocation respectively, and then it is dislocated dislocation."
"This can be diagnosed from the plain film. This is a lateral dislocation. It is a type of lateral dislocation."
"The severity of lateral elbow dislocation is generally assessed by the Mayo Clinic scale, one is light five, two is ten, and three is more than ten."
"It means that the injury is mild, moderate, or severe, and the critical point is that the articular surface of the elbow joint is displaced by 50% or 100%."
"According to statistical experience, for first-degree and second-degree lateral elbow dislocations, the common treatment methods are manual reduction and functional exercises."
"Then when we went back to the plain film, we found that the displacement of the articular surface was almost 20%, which proved that manual reduction is feasible."
"Then to assess soft tissue damage, I did five ways, the LPS test to detect damage to the lateral ligaments of the elbow joint. The Varus Stress test to detect damage to the medial ligaments of the elbow joint. Then the Valgus Stress test to double check the lateral ligaments, you know, this is the lateral damage."
"I tested the stability of the joint capsule by testing the tender point. If the joint capsule exists, there will be severe painful contraction when pressed..."
"Also, we also know that there are existing angles of the elbow joint, 10-15 degrees of external rotation and 5-10 degrees of retroversion. When the elbow joint is dislocated laterally, these angles will change, causing the elbow The stability of the joint is affected, but the dislocation of Uncle Xiang Gong's elbow actually doesn't change much in these angles..."
"After presuming that there is no soft tissue injury with a high probability, I thought about it and tried to reset again. The methods of reset can be selected from the traditional heart-seeking technique and the revolving door technique, as well as the Milch technique and Kocher technique in modern medicine. Manipulation and Stimson Maneuver!"
"Our hospital's conditions are limited, and Uncle Xiang Gong has undergone several resets before, and the cost of trial and error must be reduced as much as possible, so I finally chose the Milch manipulative reset that has a higher success rate but is not the most commonly used."
"This method does not require anesthesia, and is the easiest to operate and perform, but there is a certain degree of soft tissue and nerve damage."
"However, as long as no strong violence is applied, this kind of injury can still be avoided by taking the initiative. If the manipulative reset exceeds five times, surgery is necessary."
"So in order to avoid this as much as possible, I can only take some risks. I have explained all these to Uncle Xianggong."
"Of course, Director Lu, this kind of physical examination and X-ray examination to infer soft tissue damage are only preliminary presumptions. Now there are examinations such as MRI that can be seen at a glance, so I think it is better to do it. It is a bit expensive, but the price It's not unacceptable, just be at ease..."
Wu Xie not only explained clearly why he needed treatment, but also explained why he asked Xiang Gong to go to the county for an examination.
However, Wu Xie thought she had explained clearly, but Lu Junyin was confused on the spot.
When Wu Xie talked about the SSS inspection, he was stupid. If he could understand this, he would have started to reset it.
You may understand that your trust is right.
"Sure enough, professional enough, as long as the professional knowledge is sufficient and the knowledge reserve is complete, qualifications are not a problem. Xiao Wu, my absolute trust in you is correct!" Lu Junyin let out a long sigh of relief and laughed.
This trust comes from the professional examination written by Wu Xie to Xiang Lunwu...
As a practitioner of modern medicine, Lu Junyin does not believe in the theory that theories are useless. Most of the people who say this are people with insufficient theoretical reserves.
"Who is it? What are you talking about? What happened to Zhu Fagenlang?"
"Are you in the ICU?" While Wu Xie and Lu Junyin were talking, they suddenly heard such a voice from the department, and the person who spoke was Zhuo Qingshan.
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