Transverse fractures mostly occur in limb bones and are a relatively stable type of fracture.
This patient's injury seems serious, but as long as the operation is done properly, it can be successfully restored.
It just has very high operational requirements for the operator.
Dr. Xu's physical condition is extremely poor today and he is unable to do the operation himself, so Li Jingsheng can only do it for him.
Clinically, because transverse fractures are difficult to reduce, even top-level hospitals often can only resort to surgical reduction. When it comes to the treatment of orthopedic injuries, sometimes the top tertiary hospitals are not as good as local specialized orthopedic hospitals in many technical fields.
"Doctor, what about me? I arrived before him!"
The patient with wrist soft tissue adhesions, fractures and joint displacements became anxious at first sight.
No patient wants to be queued.
"Don't be anxious yet. After treating him, he will be treated naturally."
Dr. Xu comforted the patient who had been 'jumped in line'.
"Why can't you treat us first?"
The patient's wife was still a little unconvinced.
Whose time is not time?
"Because your tissues are adhesions, it is more difficult to treat, and you need to do a skin test first to apply anesthesia. Sit there and wait patiently, it won't take long. Of course, I can understand your eagerness, but it's just a matter of treating the disease. There’s no rush!”
Dr. Xu's attitude towards ordinary patients is very easy-going.
After listening to his explanation, the patient and his wife showed a relieved smile on their faces.
Both expressed understanding.
On the treatment bed in the back room, the patient was already lying on his side under the guidance of Li Jingsheng.
It can cause arm bone fractures, and the trauma is naturally not minor.
It can be seen that the patient's left arm has scary bruises. According to his description, he was hit by a door opener while riding his bicycle. Fortunately, he was wearing a helmet. After going to the hospital for examination, it was found that only his left arm was seriously fractured.
The other parts are just scratches and are not in the way.
Although I say it's not a problem, the bruises on my knees, wrists, etc. are actually quite serious.
Superficial injuries that damage the dermis are not easy to recover from.
It can take as little as a week or more and as long as more than half a month. And to prevent infection.
The most terrifying thing is the occurrence of scar hyperplasia.
Some people have a scarring constitution and are prone to scar hyperplasia after the epidermis is injured. Parts such as the knees are high-risk areas for scarring.
Later treatment will be difficult beyond imagination.
An injection costs several hundred, and the cost of treatment may be more expensive than treating bone injuries.
"Teacher, let me set his bones first and then do traction. Do you think that's okay?"
"fine."
Doctor Xu nodded in confirmation.
"Dr. Chen, please be my assistant later. The main task is to maintain the stability of the traction and then gently swing the distal end of the fracture. I will remind you in which direction to swing."
Seeing that the opportunity was rare, Li Jingsheng no longer looked forward and backward, and directly took the lead.
Anyway, with Dr. Xu standing by, I am not afraid of messing up.
"No problem, no problem."
Dr. Chen is extremely eager for every learning opportunity.
This opportunity to get started is even more precious to him.
What's more, this patient's fracture is very serious and the reduction is extremely difficult. If he can participate in part of the actual operation, I believe the benefit will be greater.
At this moment, Dr. Chen was as happy as an intern who got a chance to draw a hook in the operating room.
Li Jingsheng began to reset the patient.
After touching the bones again and constructing a bone map in his mind, he used traction, extension, rotation, flexion and extension and other advanced bone-setting reduction techniques to successfully connect the patient's broken bone ends.
It's just that this reset still falls short of the ideal docking state.
It is impossible to achieve a tight fit between the two ends of the broken bone.
Even if Dr. Xu performs it, it is impossible to set the bone in place in one go.
"Dr. Chen, give the patient's left hand traction! I use both hands to fix the fracture that has been initially reduced."
"good!"
Dr. Chen was already ready, and Dr. Xu was by his side, giving him the rare opportunity to carefully guide Dr. Chen on some essentials of traction operations.
Soon, the traction was done.
As the steel cable continued to tighten, Li Jingsheng felt the tension.
"Stop, stop! This strength is just right."
Feeling that the pulling force was almost there, he quickly shouted to stop.
"Dr. Chen, try swinging the patient's left hand left and right, but not too hard."
It would be better if this operation is done by Dr. Xu.
Although Dr. Xu is not in good physical condition, there is no problem at all with the assistance of this kind of strength.
But Li Jingsheng did not call Dr. Xu, but gave Dr. Chen some opportunities to get started.
There are obvious differences between him and Dr. Xu in terms of ideological concepts.
Dr. Xu keeps his skills very tight and is very taboo about spreading his bone-setting skills to many people.
Li Jingsheng feels that if medicine wants to thrive, it must pass on these advanced medical skills from generation to generation.
Dr. Chen is very attentive.
Carefully swing the patient's left hand while trying to keep the traction stable.
It can be seen that he cherishes this training opportunity given by Li Jingsheng.
"The strength can be a little stronger."
Li Jingsheng can understand Dr. Chen's caution.
As the patient swings his left limb, a bone fricative sound is clearly audible.
Li Jingsheng concentrated on feeling the connection between the two ends of the patient's broken bone through bone palpation.
"Okay, good, rock gently back and forth."
The bone fricative is slowly decreasing.
"Swing it from side to side again, but not too much."
"A little smaller."
…
Finally, the bone fricative sound from the patient's fractured end had completely disappeared.
"The cooperation was great, and it was finally connected. Come over with the splint and help him immobilize it!"
After the manipulation is reset and connected, if it is not fixed, it will be in vain.
This time, Dr. Chen didn’t need anyone’s guidance when it came to splinting.
Because what he does most is splints and plasters.
The specific fixation method to be used is flexibly determined by professional doctors based on the situation.
After the splint was completed, Li Jingsheng felt the bones to check the effect of the reduction technique.
Quite satisfied.
The bone line at the broken end of the fracture is almost invisible.
It shows that the osteosynthesis reduction is very successful.
"Teacher, please check it."
Li Jingsheng said to Dr. Xu.
Dr. Xu touched the patient's broken end of the fracture, then fixed the splint at the fracture with one hand, and gently tapped the distal end of the fracture with the other hand.
Fortunately, he was given anesthesia, otherwise the patient would have fainted from pain countless times.
"Xiao Li, please touch me again."
After Dr. Xu finished the percussion, he asked Li Jingsheng to touch the patient's bones again to feel the changes in the fracture site.
After Li Jingsheng touched it, a look of understanding appeared on his face.
The bone line at the fracture point has almost completely disappeared, and the fit of the broken end of the bone has obviously improved to a higher level than after he reset the patient. The reconnected humeral end becomes more stable.
It's like a broken stick, which is gently butted together and then broken again when touched.
If you butt them together hard enough to achieve a tight fit, and then pick it up, the jointed parts will not move at all and are quite stable.
At this moment, the patient's humeral stump has achieved this joint effect.
A teacher is a teacher!
The level is obviously stronger than that of his apprentice.
However, Li Jingsheng has been able to independently complete the manual reduction of bone transverse injuries after only learning it for about a month, which is already very impressive.
Dr. Xu is a master who has been practicing for decades.
If Li Jingsheng were allowed to practice for decades, he would definitely be much better than Dr. Xu.
"Your arm has been reattached, but you must pay attention to its maintenance. It is best to rest for about a month. You need to come to our hospital for a review every half month."
Dr. Xu made some requirements for the patient.
This patient has been treated.
After the patient left, Dr. Xu looked at Li Jingsheng.
"Do you know the usefulness of tapping the distal end of the fracture just now?"
"It should be to make the fracture ends more closely embedded and increase the stability of the fracture ends."
Dr. Xu was very satisfied with Li Jingsheng's answer.
A rare smile of relief appeared on his face, "You have excellent bone-setting talent, and your comprehension and practical abilities are first-rate. You said it would be great if you could wholeheartedly follow me to learn bone-setting!"
He also knew that Li Jingsheng had no such idea at all, so he said a few words and stopped mentioning it.
"Did you get a better grasp of the two techniques of swinging and touching the broken end of the bone during the operation just now?"
"Well, I think I can give it a try to the patient outside who has severe soft tissue adhesions."
Li Jingsheng's expression revealed a hint of anticipation and excitement.
He understood Dr. Xu's intention from the moment Dr. Xu gave him priority to treat this patient with humeral transection.
He was deliberately allowed to further master the two techniques of rocking and touching when treating this patient.
Because the patient with wrist soft tissue adhesions needs to use two bone-setting techniques, rocking and touching.
"It's not about trying, but you have to go all out. If you fail to reset him, he will have to go to the inpatient department and wait for surgical treatment."
Doctor Xu said with a serious expression.
After saying that, regardless of whether Li Jingsheng agreed or not, he shouted outside.
"Li Li, let the patient with wrist bone displacement and fracture come in!"
Not resetting the patient in the surgical room outside, but letting the patient go inside for treatment. This is obviously taking care of Li Jingsheng.
If you mess up, you won't be embarrassed in public.
Try to minimize the negative impact.
"Finally it's my turn!"
The patient came in happily.
His face was filled with expectant joy.
If he had known that the doctor who was about to operate on him did not master the key technical skills and was just using him as a 'guinea pig' for training, he would probably not be able to laugh.
"Lie down on the bed, just lie down on your back."
Dr. Xu directed the patient to lie down on the bed.
Then he looked at Li Jingsheng.
There is only one meaning revealed in the eyes, leave it to you.
Li Jingsheng felt a little frightened at this moment.
Faced with this kind of uncertain disease, no matter what the doctor is, he will definitely feel discouraged.
There are only a handful of doctors who really don't treat patients as human beings.
"Dr. Li, the anesthetic has taken effect."
Nurse Li Li stood nearby to remind him.
Director Hua had been sitting on a small round stool outside watching, without saying a word the whole time.
The patient with a humerus transection was cured by Li Jingsheng, which shocked Director Hua quite a lot.
Although I learned from nurse Li Li and Dr. Chen that Li Jingsheng has made great progress and can cure some patients alone. But now seeing with his own eyes that Li Jingsheng was able to manually reduce humeral transection, Director Hua was still shocked and surprised.
He looked at Li Jingsheng with more appreciation and affection.
Li Jingsheng was focused on performing manual repositioning on the patient.
His left hand was seen grabbing the patient's forearm, and his right hand was grabbing the patient's palm, like a handshake.
"I need to shake your wrist to release the adhering soft tissues. If you are nervous, just close your eyes."
After Li Jingsheng finished speaking, he grabbed the patient's wrist and began to swing it.
This scene is actually very scary.
The patient himself has already suffered fractures and carpal joint displacements. At this time, most people's idea is to keep resting and not to add more injuries to the injury.
As a result, in the hands of doctors, patients are not treated as human beings at all.
Instead, treat it as a machine.
Even though the patient was a man in his fifties, he was still so frightened that he closed his eyes and turned his head away.
Li Jingsheng held the patient's hand and shook it for a while, feeling that it was almost done.
Then feel the patient's bones.
It was found that some soft tissue adhesions still existed.
The shaking just now had a certain effect and relieved some of the adhering soft tissues.
But this is certainly not enough.
"It's okay if you move a little harder!"
Doctor Xu was watching from the side. He could make a rough guess about the patient's condition without even touching the bones.
He spoke up at the right time to embolden Li Jingsheng.
"clear!"
Li Jingsheng increased the strength of his swing this time, and boldly and flexibly added extension and bending techniques while swinging.
This is actually not the first time that he has flexibly split and combined advanced bone-setting techniques.
It's just that I have just mastered the swing method, and my level is still very limited.
After a moment of rocking and stretching, he tried to examine the patient again.
There is still a small part of the adhesions in the soft tissue that has not been released.
That small part is close to the joint, and his swing method itself is not particularly good. He only has a preliminary grasp of it. In addition, it is the first time for him to hold a fractured limb with joint displacement and do such a large-scale movement.
It’s inevitable to feel nervous.
What if the patient’s bone injury is aggravated?
Wouldn't that be causing trouble?
So I can't let go.
He had been shaken twice and still failed to cure the patient. He knew that the patient's patience had been exhausted.
If you still can't get it right the last time, it will most likely make the patient angry.
Just like the time Dr. Chen grabbed the patient's injured limb and walked around in circles and was scolded.
Li Jingsheng instinctively checked the attribute panel.
Because based on experience, he has probably already mastered the fifth advanced bone-setting technique, Swinging Touch.
In the skill column, it's in the bone-setting technique category.
When he found out that there was really an additional 1/10 introduction to the swing touch method, he was instantly overjoyed.
I finally got started with this advanced bone-setting method, and I successfully reached the entry-level level at this critical moment. It was like giving me a pillow when I fell asleep.
Without any hesitation, he directly spent 99 health points to upgrade his proficiency in this medical skill from beginner to master.
It's safe this time.
He already has a junior attending level in understanding the swinging touch method and mastering various techniques.
"This young doctor's hands don't seem to be very strong. Would it be better for me to be treated by an older doctor?" The patient was already a little unhappy when he saw that Li Jingsheng had done it twice and still couldn't get it right.
But the words were polite.
"I was afraid of hurting you just now! Use more force this time, please relax!"
After Li Jingsheng finished speaking, he grabbed the patient's hand and shook it again.
This time it was like a different person was operating it, and the movements were more than ten times more skillful. The force is strong and the range is astonishing.
"Hey, stop it, don't mess with me!"
The patient's arm was anesthetized and he felt no pain.
But when he saw the young doctor holding his injured hand and shaking it like a piece of rag, he was so frightened that he almost sat up from the treatment bed.
This is too scary.
As expected, doctors cannot be offended.
If he kept shaking it like this, his hand was already injured. I wonder if it was disabled by the shaking?
"Don't move, don't move!"
After Li Jingsheng finished shaking, he grabbed the patient's wrist and played with it twice, squeezing, lifting and pressing.
"alright."
he said to the patient.
"This, this...did you really cure me?"
The patient obviously couldn't believe what he was saying.
"You can't feel the anesthesia now, but it doesn't matter. I'll fix your wrist first. You can take a picture later to check whether it's fine or not."
Li Jingsheng is full of confidence.
Dr. Xu came over and touched the patient's wrist bone with a serious look on his face, with a satisfied and relaxed smile on his face.
"All the adhesions in the soft tissues have been released, the joints are smooth, the bone position has returned to normal, and the two fractures have been reduced. This couldn't be better. You will be able to see the reduction after the X-ray is taken." Effect."
After hearing Dr. Xu say the same thing, the patient's expression softened much.
But he is still afraid that doctors are colluding to deceive him.
After the fixation, he took the initiative to take another film for review.
More than half an hour later, the patient came back happily.
Apparently the medical technician responsible for taking the film had been asked.
"Doctor, the doctor who took the X-ray said that it has been restored. Let me show it to you again."
In terms of professional level, the reading ability of specialists is more authoritative.
In the medical technology room, some doctors are very knowledgeable and have strong ability to read pictures. Some people with connections and dawdles basically have a coping style job.
When describing the test results, I often just take a casual look and copy a few sentences from the textbook.
Dr. Xu took it and looked at the light carefully.
"The reset is very successful. You just need to go back and take good care of it and come back for a review after four weeks."
"Haha, I'm completely relieved this time."
The patient got a positive answer twice, and the last trace of doubt in his mind was eliminated.
"To be honest, when this young Dr. Li was operating on me, he shook me so hard that it really scared me. It seems that the technology of the big hospital is very good and guaranteed. You are the right person to come to."
The patient apologized to Li Jingsheng tactfully.
After all, he misunderstood the young doctor not long ago.
"You know now, are you right? In your situation, except for us, there are very few places that are willing to perform manual reduction on you, and basically all require surgery. Now that the manual reduction is successful for you, you can just have fun! Save it. Not to mention spending a lot of money on treatment, people can still suffer less and don’t need to be hospitalized.”
Doctor Xu's words were clearly addressed to his apprentice.
However, the treatment of this patient is indeed very difficult.
He himself went to two major hospitals and asked, and they both said that surgery was needed to cure it.
"Thank you! I can finally have a good night's sleep when I go home today! To tell you the truth, these days I can't sleep at all when I think about the possibility of being disabled. What if my hand becomes disabled? What will happen to the whole family in the future? How about living? My wife only has more than 3,000 yuan a month, and I have four children to support, and there are also elderly people at home."
"It's not like you want a boy and you have to give birth to a son! Now you know it's difficult to raise a boy?"
His wife complained nearby.
(End of chapter)
