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Zeng Yi, Li Changhong and Cai Dongfan were not majored in joint surgery. When they were working, they only had undergraduate degrees, and they studied clinical medicine (five-year program) as a co-ordinator. Their postgraduate status was also obtained after working.

However, although I am not specialized in joint surgery, I have been immersed in clinical practice for so many years, and I still have a basic understanding of joint dislocation.

There are four main signs of joint dislocation -

Deformity, pain, limited movement, and imaging examination showed dislocation.

The four major signs go hand in hand and rarely exist independently.

Evaluating the signs of successful joint dislocation reduction is also closely related to these four signs.

Pain is relieved and activities resumed.

But now the patient has received a brachial plexus block. If the patient can still feel pain relief and resume activities, it means that Zeng Yi, the director of the anesthesiology department, is not skilled enough.

So there are only two evaluations left that can be used.

The affected limb is deformed, and the deformity visible to the naked eye disappears.

However, the disappearance of the deformity visible to the naked eye is not as accurate as the palpable joint surface returning to its normal structure.

All three people only saw the disappearance of the deformity, and their minds were spinning for who knows how many times.

Zeng Yi and Li Changhong immediately turned to look at Cai Dongfan.

This dislocation? Is it done like this?

So at the beginning, Cai Dongfan sent someone who could solve the problem to us, but we drove him away, and then caused so many troubles later?

Cai Dongfan hurriedly explained in a low voice: "Director Zeng, Director Li, I knew that Zhou Cheng knew how to perform surgical reduction, so I immediately called people to the Department of Orthopedics!"

"Of course it's too late to say this now, let's resolve the matter first."

After saying that, he first leaned towards the operating table and waited for Zhou Cheng to perform a standard physical examination on the patient. This was also the second time to determine the evaluation criteria for successful reduction of joint dislocation before another fluoroscopy of the C arm.

Zhou Cheng did not let everyone wait for a long time. Instead, after carefully checking the radioulnar joints, metacarpal joints and other previously dislocated planes, he looked at Luo Yun cautiously, took two steps back, and got out of the way.

Location.

He opened his mouth and said, "Teacher Luo, I think you are lucky enough to live up to your destiny."

"Please check again to be on the safe side."

Zhou Cheng's tone was sincere, not because he was deliberately showing off in front of Luo Yun and others, but because he felt that the physical examination results would be more convincing when told from Luo Yun's mouth.

Because it can be seen that Zeng Yi, Li Changhong and others trust Luo Yun more. Now that Luo Yun is around, there is no need to cause any more misunderstandings. Luo Yun will have another physical examination, which will not take much time.

And now everyone in the operating room can't afford to waste their time. As long as the patient's dislocation is corrected, it won't be a problem if the patient is delayed for half an hour!

Luo Yun nodded, and then began the physical examination: "The lower radioulnar joint surface is flat and has basically recovered."

"The dislocated articular surface of the palm and wrist has basically recovered."

Luo Yun’s physical examination was not limited to this, but showed his extremely profound skills and professionalism as a joint surgeon: “Checking the stability of the radial styloid process, ulnar head, snuff fossa and distal radioulnar joint can.

"

"Active range of motion cannot be matched. Passive range of motion: fully extended position is 0°, palmar flexion is 0°~60°, dorsal extension is 0°~50°, radial deviation is 0°~30°, and ulnar deviation is 0°~40°.

.”

"The patient's unaffected upper limb is undergoing intravenous infusion and cannot be compared. However, the passive range of motion is within the normal range." Luo Yun explained to the patient after completing the physical examination very professionally.

Zeng Yi and Li Changhong breathed a long sigh of relief when they saw Luo Yun demonstrating the range of motion for them and explaining one by one.

After the reset, it is already very good to be able to have such a good passive range of motion. I can at least look forward to it.

When Ke Zengyi was about to say something else, Luo Yun's hands continued to move and he began to dictate at the same time:

"The Finkelstein test cannot be performed due to anesthesia."

When Zeng Yi heard this, his expression under the mask froze. What was Luo Yun talking about? What is Finkelstein?

Cai Dongfan and Li Changhong also opened their mouths slightly.

Luo Yun chose to continue:

"Kirk Watson's sign (negative)."

“Lane-Kirk Watson Sign(-)”

Luo Yun once again spit out two extremely professional terms, and then seemed to see the blank embarrassment in the eyes of Zeng Yi and others, while Zhou Cheng looked a little calm, as if he really understood.

Luo Yun instantly felt confident.

Experts will know as soon as they take action. Joint surgery has its own very specialized knowledge system and system.

Zhou Cheng's expression showed that he understood the location and purpose of his examination. He had indeed done detailed homework, not some random tricks.

After finding out Zhou Cheng's background, Luo Yun felt that there was no need to continue to embarrass Zeng Yi, Cai Dongfan and others, so he directly added explanations for the next physical examination:

"Radial carpal and mid-carpal drawer test (-), no laxity in the mid-carpal joint."

"Mid-wrist shift test (-), there is no ulnar deviation of the affected limb."

"Fulcrum shift test (+), the skull is strong, and the interlunate plane structure is restored."

"Reagan test has no relaxation and crepitus (-): there are no abnormalities in the plane structure of the lunate, triquetrum, and pisiform bones."

"Chris-Bain test (-), the stability of the lunate, triquetral, and pisiform bones is restored."

"Piano Key Test (-): No dorsal subluxation."

"Radial ruler drawer test (-)"

"Depression test (-), no DRUJ (dorsal radioulnar joint subluxation)."

After doing this, Luo Yun fiddled with it for a while, but seemed to shake their heads before turning around and saying: "Director Zeng, Director Li. There are some other special signs. The patient currently feels no pain and cannot cooperate with the examination. I think

It’s time to proceed to the next step of perspective.”

"Does the directors feel it necessary to add anything else?"

Luo Yun had his reasons for doing this. It was not just to show off his knowledge, but to improve Cai Dongfan. He is really a very professional joint surgeon. Our Department of Orthopedics can start to close some joints.

Specialist patients in surgery.

Secondly, although Zhou Cheng is just a junior resident, he has performed manual reduction of joint dislocation. In fact, you are not sure whether Zhou Cheng's manual reduction is good or not.

I'm sure, I'm not saying I'm sure, but I'm really sure, because I'm a professional.

The above are the results of joint stability and stimulation-response tests that I can do after systematic physical examination. These examination results support my current argument.

As early as when Luo Yun started talking about a lot of difficult-to-understand specialist medical examinations, Zeng Yi and Li Changhong became nervous because they couldn't understand!

They are not newbies anymore, but as Luo Yun said, they are really too professional.

Just like if joint surgery is a palace, then Cai Dongfan and the others only walked around the palace at most, and Luo Yun has lived in it, so when it comes to understanding it, it is naturally not as good as living in it.

People are so familiar.

As soon as Luo Yun said these words, Zeng Yi immediately calmed down for a while, shook his head and said: "I don't think there is any need to add anything. Your physical examination is detailed enough. Let's do a C-arm fluoroscopy."

Rao Zeng Yi's cultivation was pretty good. When Li Changhong tried to pass the buck to him before, he didn't curse in his heart.

But at this moment, I also cursed in my heart, Luo Yun, let me add to your grandma and ancestors, you definitely did it on purpose...

"Changhong, Dongfan, what do you think?" After more than half of the matter was resolved, Zeng Yi felt relieved. Naturally, he felt that the sword handed over by Luo Yun could not be taken by himself, but that you should also feel it.

of sharpness.

Cai Dongfan immediately shook his head, blinked his little eyes, and replied: "What Ronaldinho said is what I think. Ronaldinho was previously in charge of the joint patients in our group."

After finishing speaking, Cai Dongfan felt that he should speak more safely, and added: "Xiao Zhou also assisted in handling it."

"It just depends on whether Director Li thinks there are any other tests that need to be supplemented?"

"After all, the patient belongs to Director Li, so I can't just do it for him."

Cai Dongfan felt so happy in his heart at this moment, Luo Yun really gave him some face.

When Li Changhong called him before and said that Luo Yun did not need to come again, Cai Dongfan actually had objections in his heart.

You ran into trouble, I sent someone to you immediately, and you still called me to say it was wrong of me. Did I perfunctory you?

It's hard to say these words clearly, but at this moment, I can just use metaphors to give you a look and you can understand it yourself.

What is professionalism?

The two people I took care of were very professional.

Li Changhong had no intention of trying to figure out Cai Dongfan's hidden meaning at the moment. As Cai Dongfan said, the patient belonged to him, and he just wanted to solve the patient's dislocation as soon as possible. Asking professors from outside hospitals was the solution, and internal solution was also the solution.

He quickly whispered: "Since Luo Yun is a professional, let's listen to the professional's assessment, push the C-arm, and do fluoroscopy."

"After the fluoroscopy, the results are OK, so I can go and explain to the patient's family as soon as possible."

This is already a different kind of giving in and being convinced.

Hearing this, Cai Dongfan didn't know much to say. Zeng Yi immediately asked the circulating nurse to prepare for fluoroscopy, and then went to push the C-arm machine himself.

Upon seeing this, Li Changhong immediately volunteered to push the C-arm machine.
To be continued...