Great doctor starts with adding points

Hearing what Wu Liangshan said, He Ling, who was still sitting in the consulting room, couldn't sit still anymore. He stood up, and the voice of explanation came first: "I mean there should be no fracture, but it doesn't mean there is definitely no fracture."

"You can't understand the words so deadly?"

Although he didn't know how Wu Xie made the judgment, he believed in Wu Xie's professionalism.

Even though Zhao Ping's elbow film did not show any obvious signs of fracture.

"But you said there was no fracture?" Wu Liangshan's tone flickered.

"This must have a fracture, you have to go to the county."

"Whether there is a fracture or not, I didn't say it."

"Even if you say it, you can't treat a fracture as if you don't have a fracture?" Wu Xie hurriedly explained.

This point must be made clear, fractures are definitely not spoken out, and patients with fractures cannot be said to have no fractures without fractures.

"Really?" Wu Liangshan was skeptical, but he was more likely to be convinced. He Ling was so old anyway, and had much more experience than Wu Xie.

Before Wu Xie came, He Ling's rhetoric was not like this.

Generally speaking, older doctors have older qualifications and are more authoritative, and young doctors dare not distrust older doctors.

Now, with He Ling and Wu Xie, it's the other way around. Coupled with Dong Lianghe's strong recommendation before, Wu Liangshan's inner line of defense has been slightly loosened.

Besides, if Wu Xie was only doing it for money, it would be easier to do it with Dong Lianghe, there is no need to hold on to Zhao Ping who just came to the hospital.

"Boss Wu, in fact, this fracture is relatively hidden. If you want to miss the team, it's pretty easy to judge. Just do a CT that is more detailed than X-ray observation. In his current situation, before going to the county for surgery, he must Use CT to assess fracture severity and surgical options."

"It will be clear at a glance whether there is a fracture or not."

"If there is no fracture, if I say there is a fracture, it won't really become fractured just because I said fracture, will it?" Wu Xie explained.

Facts speak louder than words, and CT is not an expensive examination that ordinary people cannot afford.

Besides, Wu Liangshan is not a professional. Even if you use a lot of medical professional knowledge to deliberate on him, he will not understand. Instead, it is better to show him the fracture directly on the CT level, which is more intuitive and clear.

"Doctor Wu, what you said is also reasonable, so let's make one. If there is a fracture, it will be troublesome." Wu Liangshan now has a headache when he hears the word fracture.

The previous Dong Lianghe's fracture really made him sleepless for a long time. Recently, Dong Lianghe said that his own wound was improving, and Wu Liangshan felt a little better.

It's just that Wu Liangshan still glanced at He Ling, which was meaningful, as if he felt that He Ling was a little unreliable.

He Ling immediately went to help with the CT checklist, and then perhaps because he was a bit rash in what he said before, he personally led Zhao Ping to the CT room.

There is only one CT room in the township hospital, and there is no rotation, and it can be taken at any time, not to mention queuing.

Therefore, He Ling took Zhao Ping to finish taking the photo immediately, and before he left the CT clinic, Wu Xie and Wu Liangshan were able to read Zhao Ping's CT results.

In the results, it was found that under the olecranon olecranon, which is a part of the ulna and elbow joint, there is really a long fracture line, and the bone is cracked, which is clear at a glance on the CT level.

The reason why it cannot be shown on the X-ray is because the bone has not been separated, resulting in the fracture line on the X-ray level being indistinguishable and invisible to the naked eye.

Then it can also be seen on the CT level that the joint dislocation belongs to the rear dislocation of the elbow joint, and the degree of dislocation is quite serious.

"There is really a fracture, Dr. Wu, you are really amazing."

"It's like having a perspective eye." The complete skeleton should be smooth and flat, but Wu Liangshan can see the cracked bone on the CT, so he tilted his head in surprise.

"Boss Wu, this is not my god. With such a degree of posterior elbow dislocation, statistically, almost 95% of them will be accompanied by fractures. This is statistical experience."

"It's the conclusion drawn by the orthopedic medical seniors." Wu Xie didn't dare to take the credit, so he explained it like this.

"This fracture involves the articular surface and cannot be reduced. It must be treated with surgery."

When the bones near the elbow are fractured, the fractures involving the articular surface are absolute indications for surgery, and the corresponding contraindications are manipulative reduction.

Understand this, then the principle of diagnosis and treatment will not go wrong.

"Then you have to know Dr. Wu?" Wu Liangshan said four words in such a eccentric manner, and then fell silent.

The Shazhen Health Center is not big, and He Ling has brought Zhao Ping back at this moment.

After entering the consultation room, he asked Wu Xie: "Doctor Wu, how is the result?"

"The fracture above the ulna near the elbow joint is classified as type AO 3 according to the classification." Wu Xie talked to He Ling relatively professionally.

As soon as He Ling heard this, his chubby belly shrank, and he said with a slightly nervous expression: "In this case, we can only temporarily fix it with a plaster cast or a small splint. You can go to the county for surgery or proceed depending on the situation." Take it one step at a time."

Wu Xie's words told He Ling a lot.

This is a fracture of the articular surface. Lu Junyin can't do this kind of fracture surgery, so don't take it to the department.

But this hidden meaning can only be understood by people in this court like He Ling.

While talking, He Ling began to quickly write the medical records, and then asked: "Do you want to put on plaster for temporary treatment? If not, it's the same to go directly to the county to deal with it together."

"Wait a minute, the CT room only needs ten minutes of overtime, and you can print out the CT and flat films."

The X-ray printing time in a large hospital is two hours, and the CT is 24 hours, which means that the patient is too large, but in the Shazhen Health Center, almost no one does CT, so you can work overtime alone, and you will be able to quickly The result is that there is no report.

Taking the film away can also reduce the time for patients to go to the county hospital for examination.

"Then let's not deal with it for now. It's useless to put a plaster cast on it."

"Zhao Ping, please call home first, go to the hospital in the county first, and perform surgery if necessary, and I will report work-related injury and sick leave for you..." Wu Liangshan made the decision for Zhao Ping himself.

Zhao Ping sighed, and could only admit that he was unlucky.

I just feel that this boss is too stupid. If I knew this, I might as well go directly to the county. It is really wronged to come to this Sha Town for a circle.

After this, Wu Liangshan and Zhao Ping left. Before leaving, Wu Liangshan thanked Wu Xie again for Dong Lianghe's affairs.

He Ling also wiped the fine sweat from his forehead, and the embarrassment gradually eased: "Xiao Wu, whether it's diagnosis or treatment, this joint dislocation is still troublesome. It's thanks to you that you came today, otherwise it will be very difficult to end."

"Thank you for your hard work."

He Ling thought to himself, if he talks to him and signs, or tries to reset the technique by himself, it will be really fun.

It seems that if you want to do manual reduction of joint dislocation in clinical practice, you must have a systematic knowledge structure.