Zhou Cheng's words were very beautiful, but Luo Yun didn't take them all seriously!
The patient's family members chose not to trust Zhou Cheng because of his age and professional title, which was one of the reasons why he was able to avoid misdiagnosis.
However, Zhou Cheng is able to think outside the box, which is not something ordinary people can do.
Especially in the medical industry, some practitioners, including Luo Yun himself in many cases, like to show off their knowledge. Based on the fragments of information provided by the patients, they will try to figure out the medical history that the patients themselves may have ignored.
or symptoms.
For example, just today, Zhou Cheng deduced the fracture that even Lao Ao's daughter-in-law and even herself had forgotten based on the patient's plain radiograph.
This is the derivation ability you will have based on a huge knowledge base and walking according to precise rules. It represents your understanding and control of a disease!
And sometimes, precisely because of these powers of control, you will unconsciously apply formulas to some of the patient's symptoms!
why is that?
Because that’s how the questions came out during the exam.
“Fracture triad = fracture!”
“Progressive dysphagia = esophageal inflammation or cancer.”
"Dorsal elevation of ST segment on electrocardiogram = myocardial infarction..."
There are really too many examples of this.
As for the diagnosis of radial head subluxation, this diagnosis needs to rely on medical history and the most common people with this disease.
The child + parents bring + trauma history + elbow joint pain!
It can almost be diagnosed as radial head subluxation.
This is how I got started when I was learning about this disease. What does getting started mean?
It is the teacher or the textbook that leads you into this industry. Under normal circumstances, you will not doubt that the teacher led you into the door in the wrong way!
So Zhou Cheng and Luo Yun have been asking for a definite medical history.
…
Of course, this kind of questioning is likely to stop halfway, because in many cases, the reason is not important, but the solution is important.
Under such psychological control, what if Zhou Cheng performed radial head subluxation on the child?
Then check the dislocation and reduction——
Once the range of motion is restored, the patient can be sent away directly.
Just as Luo Yun glanced at Zhou Cheng.
Zhou Cheng was secretly rejoicing in his heart.
I have always walked within the rules and have not taken the initiative to add definitions to patients based on my own understanding and experience!
He didn't show off his extensive knowledge, nor did he argue with the patient's family that although he was only a resident doctor, he was very good. Otherwise, Zhou Cheng felt that he might have stepped on this patient's trap.
…
Things have come to this point,
Qiqi's mother could only go to take her child for examination with tears in her eyes.
She originally thought that when she came to the hospital today, she would just show the child the symptoms after the injury and that he would be cured immediately.
Can?
Although in the current situation, my mother-in-law and my husband may not blame me for sending their children to have problems. After all, if you are not careful, you cannot invite cancer.
However, Qiqi's mother really hopes that it was because she went to see Qiqi off that she accidentally suffered trauma, and not that thing...
She walked briskly, and then called her husband who was on duty quite helplessly...
After this.
Zhou Cheng and the other two started the consultation step by step!
Because Luo Yun prescribed an emergency MRI scan for Qiqi, the examination was completed quickly.
Half an hour later, Qiqi's mother came up again holding her in her arms.
However, there are no other family members accompanying him yet.
Zhou Cheng and Luo Yun had always thought about this little girl, so they immediately visited the little girl after she returned to the clinic.
Reviewed the NMR carefully!
However, after reading it, Luo Yun and Zhou Cheng both looked stunned for a while.
He exhaled slowly.
Then he looked at Qiqi and Qiqi’s mother.
When Qiqi's mother saw this, she became even more nervous and quickly asked: "Doctor, my Qiqi, what is going on here? Is there something wrong?"
Luo Yun turned around and said: "There is a problem. But this shouldn't be a bone tumor. There are no signs related to bone tumors. It looks more like bone fibrous dysplasia!"
When Zhang Zhengquan heard about this disease, he was confused again. He even doubted whether he had received training in orthopedics. Why didn't Luo Yun know anything about it?
It’s so hard to have a good meal today!
He looked at Zhou Cheng innocently, and Zhou Cheng also saw the meaning in his eyes. He just turned his head and looked at Luo Yun, meaning, after Luo Yun finished speaking, we will explain this disease.
Medical treatment and teaching can be intertwined, but not at the same time.
Luo Yunze continued:
"Mother Qiqi."
"Actually, this kind of bone fibrous dysplasia usually occurs in the tibia, but hers is the humerus, which is extremely rare."
"The probability is less than one in a thousand." Luo Yun is not a doctor specializing in bone diseases, so he is very conservative.
Qiqi's mother quickly asked: "What kind of osteofibrodysplasia is this? Does it have serious sequelae? Is it important? How to deal with it?"
This is what she focuses on, whether it is rare or not rare.
"Poor bone fiber structure is a structural problem."
"You can think of it this way, where we build roads, where cement should be used, mud is used, so it is very soft and the bones are very brittle!"
"This is not a tumor. It is because this part of the bone is relatively fragile, so there are symptoms, and only a small amount of stress can cause pain."
"It's just that although I have certain symptoms now, I don't need surgery. Don't worry."
When Qiqi's mother heard Luo Yun's words, she felt relieved. She moved Qiqi to her legs, rubbed her nose, and said in a broken voice: "Doctor, how can I be so relieved? What should we do now?
?”
How big of a heart must I have to not care about my child's illness?
Although it was not cancer, she hoped that it would be a good thing if it came to her and not harm her daughter.
Luo Yun continued: "No need to do anything, and there is no need for special treatment now."
"This is a common clinical bone development abnormality, and it is only common in children."
"And just because she is a child, we can expect her bones to reshape automatically. We can expect her bones to recover on their own, and the chance of malignant transformation is very low!"
"Of course, if you are really worried, you have to wait until she is a little older and then check again. If you find that there is still such a structural groove, then you can do bone curettage to remove it."
"She is still too young and her epiphyses are not fully grown. If we deal with it rashly now, it may affect her normal growth. If the upper limbs are not equal in length, it will be troublesome." Luo Yun patiently explained that no treatment will be carried out now.
s reason.
When Qiqi's mother heard this, her expression immediately changed and she said decisively: "Qiqi is a little girl. It's not okay if her hands are not the same length."
If it really looks like this, it will be difficult to find a partner, not to mention making a living in the future!
Luo Yun nodded: "Yes, we just have to wait until she grows up and the epiphysis is full, and then we can perform curettage depending on the situation."
"I'm still too young now, and I'm afraid of damaging the epiphysis and affecting the growth of this hand."
"Then, the most important thing now is to protect her hand. You have to tell Qiqi herself not to use this hand too hard, not to be too naughty, and not to fight with other children. After wrestling,
It’s even worse if it’s similar.”
"Because her bones are very loose, this piece is very brittle, maybe even brittle than rice crackers."
"Only after she grows into a normal structure, she will be able to resume normal activities."
Qiqi's mother breathed a sigh of relief and asked, "Does that mean we don't do anything now and just wait?"
At the same time, the stone in my heart fell to the ground.
Just when Luo Yun was about to reply, the woman's phone rang.
At first glance, it turned out that the call was from her husband. After the call was answered, her husband cursed on the phone and said: "Honey, how is Qiqi doing now?"
"Poke your ass (these liars)."
"It's dark under the lamp!"
"That teacher Wu, when she saw our Qiqi arguing with other children this morning, she pulled Qiqi hard, grabbing her elbow. She thought she would be fine if she kept it hidden, but I asked
A few of her colleagues and a few children."
"Oh shit!"
"How is Qiqi doing now?"
Qiqi's mother was stunned when she heard this.
At the same time, the expressions of Luo Yun and Zhou Cheng also changed severely!
The cause of radial head subluxation is coming.
But fortunately, it came too late!
Just call it a coincidence.
Originally, to determine the trauma, the direction of subluxation of the radial head was considered, but the teacher disagreed.
Since it was confirmed that there was no trauma, I considered bone disease.
As a result, there was another history of trauma!
If the teacher is being honest, the two of them thought it was a subluxation of the radial head from the very beginning, and then once it was reset, the child could move around.
When the range of motion is restored, it means the joint dislocation has been restored!
But in fact, the child's pain has not been relieved...
And if this child does not have bone fibrous dysplasia but other diseases, after this delay, he will not know what will happen next time he comes to the hospital.
After the woman listened to her husband yelling, she hung up the phone and asked Luo Yun with a slightly weird expression:
"Dr. Luo, if my child is injured, does that mean he has bone fibrous dysplasia?"
"Actually, it's still dislocation?"
Luo Yun's expression flashed, and after a moment of squirming at the corner of his mouth, he replied: "That's not the case, the bone fiber structure is poor, and this diagnosis is the fact!"
"But now this diagnosis has little to do with whether there is a history of trauma."
"However, the reason why your child is experiencing pain may be because there is a structural problem here, and then being pinched like this, micro-fractures that cannot be shown on X-rays appear."
"That's why the pain occurred, so you should be more careful in the future!"
The woman was obviously a little disappointed.
She didn't quite understand why Luo Yun said that a history of trauma was another diagnosis before, but now it was no longer this diagnosis. It was going around and around, making her feel a little dizzy.
But he still nodded, looked at his daughter, and sniffed helplessly.
"Thank you, Doctor Luo, then I will still have to come to you for check-ups frequently, right?" Qiqi's mother asked politely.
"Well, it's best to check again once a year to see the changes. Don't be too diligent," Luo Yun said hurriedly.
Then the woman walked out with her child in her arms.
Looking at the woman's back, Zhou Cheng and Luo Yun looked at each other again.
They all saw a more solemn look in their eyes.
This happened today.
It can be regarded as a coincidence.
Wrong among mistakes.
Then TM was wrong and right.
But this also shows that clinical diseases are mostly unpredictable. If your thinking remains unchanged, you will suffer sooner or later.
At this moment, Luo Yun did not dare to say that he really knew about joint surgery.
Is this considered joint surgery?
Strictly speaking, it doesn't count, but it happens near the joints, and it's so rare and so hidden that if you don't pay attention, it's likely to be a disaster.
But, no matter how solemn my heart is!
It was only because of Zhou Cheng's caution that this patient was able to take the correct path that was most erroneous.
This is also the first time Luo Yun has a different view on Zhou Cheng's stability...
It's better to be more stable, okay?
Have I been taught a lesson?
…
But no matter what, the time for the outpatient clinic is still very tight, so after Qiqi's mother took the people out, Luo Yun immediately called in new outpatients.
Today's 100 numbers have been registered, so you must read them all.
However, Luo Yun suddenly stood up and said to Zhou Cheng: "Xiao Zhou, come and try to see one?"
"Shall I take a little rest?"
Luo Yun decided to change his strategy. This morning, he took the initiative to attack. Therefore, he could not find Zhou Cheng's weakness and give him a heavy blow. And what he said could not make Zhou Cheng feel surprised or surprised.
!
It seems that what he talks about is very ordinary. This makes Luo Yun feel very unfulfilled.
So Luo Yun prepared to turn his initiative into a passive one and let Zhou Cheng attack him. He knew he was in the dark and was waiting for an opportunity to strike hard!
If Zhou Cheng makes a mistake during the consultation, isn't it clear that he should correct it himself?
Zhou Cheng didn't know what Luo Yun was thinking, and his face was slightly happy: "Teacher Luo, can I do it?"
In fact, I am quite looking forward to it.
The skills I picked up last night can be put to use. How many gratitude points can I get today?
The new copy is just around the corner.
"Just watch it if I ask you to. Where does all this nonsense come from?" Luo Yun can't stand Zhou Cheng's character, which is like a turtle with a shrunken head. I've already said so. You have to ask again. This is not a waste of time.
What?
So Zhou Cheng sat in Luo Yun's seat, with the mask covering his mouth and nose. He turned over his name badge again, and Luo Yun also turned over his name badge.
Zhang Zhengquan was responsible for bringing the patient in, and then his eyes widened when he saw Zhou Cheng sitting and Luo Yun standing up.
Brother Zhou Cheng, you have such a big air?
Are you about to start a consultation?
Perhaps his appearance disrupted Luo Yun and Zhou Cheng's arrangements. Otherwise, Zhou Cheng might have started the consultation immediately?
It's possible.
What Zhang Zhengquan brought in at this moment were two young girls. They looked about twenty years old. Their short hair looked quite capable. Although their skin was slightly tanned, it could still be seen that their outlines were quite good. They were two
A beautiful girl.
The two people seemed to be cheerful people. They restrained their white shirts after coming in. After one of the girls sat down obediently, she politely said to Zhou Cheng: "Hello, doctor."
As Zhou Cheng was sitting and the other two were standing, she naturally felt that Zhou Cheng was the oldest doctor.
His eyes were fixed on Zhou Cheng, but after watching for a while, his eyes seemed to light up.
Her companion was also a girl of the same age, probably a classmate. At this moment, she suddenly became quite reserved, and her face seemed to be slightly red.
A man's instinct is to like to look at beautiful women, and he also likes to look at girls.
Women are actually the same, they like and appreciate handsome guys.
The relationship between the two is very good. Both of them are wearing jeans and white shirts. It is not very cold in Shashi in November. They expose their delicate arms and forearms. They are tall and have slender necks, but they look a little green and immature.
After seeing Zhou Zhou grow up to be a bit handsome, he started to feel shy.
"What makes you uncomfortable?" Zhou Cheng asked.
"Ah! Oh!"
"My knee has been hurting recently. It has been hurting for a long time, but in the past few days, the pain has become more severe." The girl who sat down heard Zhou Cheng ask her, and then she realized that she was here to see a doctor.
So he quickly pointed to his left knee and said to Zhou Cheng, his voice was very thin and he was a little embarrassed.
Zhou Cheng then asked pointedly: "Have you ever been injured? What have you done recently? What do you do?"
Still the same sentence, the diagnosis of fracture must first be defined, that is, the patient in the ward.
First define, then position, then finalize, finally decide on classification or classification, and finally talk about treatment!
But patients in outpatient clinics need to slightly adjust their approach to consultation.
First locate, then define, then finalize, classify, and then treat.
Zhou Cheng also had a vague guess in his mind. It might be a meniscus injury, and he should have a history of trauma.
But in view of Qiqi's previous reasons, Zhou Cheng decided to ask more detailed questions.
"When I was training some time ago, I had a little pain, but it wasn't serious. But then it became more and more painful, and now it's even more painful." The girl frowned tightly when she talked about her condition.
"Are you a student? What kind of training do you have?" Zhou Cheng continued to ask.
"Yeah." The girl nodded: "I am a student at the National University of Science and Technology. I am a freshman this year and I have a lot of training."
"It's just the regular training in school." She might not be able to explain it well, or it might be inconvenient to reveal it, but after she finished speaking, she suddenly asked nervously: "Doctor, am I serious about this?"
"I haven't been able to participate in the recent training. I still asked for leave today, and I may have to go back in a while."
Students from National University of Science and Technology?
This is a heroine.
No wonder the hair is styled short. If it were longer, it would look better, and it would be understandable if you have dark skin.
Zhou Cheng looked at Luo Yun and found that Luo Yun had no intention of speaking, so he asked Zhang Zhengquan: "Quanzi, can you do a meniscus examination?"
In fact, there is still a lot that can be covered by consultation, but the outpatient clinic is not a ward, so we should not waste time by being too detailed.
Although Zhang Zhengquan saw that the two girls looked good and knew that Zhou Cheng asked him to do a physical examination, Zhou Cheng's words made him a little confused.
He smiled and touched his head.
"You go for a physical examination, mainly to examine the meniscus and front fork." Luo Yun directed Zhou Cheng to avoid further delaying Zhou Cheng's time.
"I'm going to do a physical examination on you. You lie flat on the bed with your feet facing the door." Zhou Cheng stood up quickly and pointed to the examination table next to him.
While giving instructions, she closed the curtain again, and then shouted to her companion: "You come in too, and stand beside her head."
When Luo Yun heard this, he couldn't help but sigh in his heart, this guy is really too stable.
Humanistic care is taken to the extreme.
Of course, this is a good thing.
Otherwise, check it out alone with a young girl. If she sues you for molestation, there will be no one to testify.
You can't tell clearly. Either there are family members or nurses accompanying you, so that you can avoid accidents to the greatest extent.
When the two girls walked that way, they looked at Luo Yun unexpectedly, because it was Luo Yun who was instructing Zhou Cheng to do things just now. So, was this handsome guy with a silver gun and a wax head?
Isn’t it useful?
However, they didn't understand either, so they asked Zhou Cheng to do a detailed physical examination.
After some inspection.
Zhou Cheng walked out first, washed his hands and disinfected them again.
After the girl sat down, he wrote in her medical record and said: "Your medial McFarland sign (+), medial knee joint tenderness, lateral stress test (-), and anterior and posterior drawer test (-)."
"In this case, you may need to do an MRI scan."
The physical examination is only an indication, and the diagnosis requires auxiliary examinations, namely X-rays and MRI.
X-rays mainly look at bones and joint spaces to rule out fractures, avulsion fractures, osteophytes, etc.
McLean's sign points to the meniscus and can only be seen with MRI.
MRI can detect soft tissue injuries!
Zhang Zhengquan immediately started writing the MRI checklist.
However, these words immediately made the girl's eyes turn red, and the classmates behind her were also extremely nervous...
"Why are you crying?" Zhou Cheng quickly stopped writing and looked up to ask.
But the girl seemed to know the situation and said anxiously: "Doctor, is my situation so serious that I won't be able to train in the future?"
"If I fail to graduate in the end, I will be kicked out of school."
She was full of fear, but fortunately her classmates were comforting her in a low voice!
Well, Zhou Cheng didn't fully consider this at first.
The National University of Science and Technology is not far from the Eighth Hospital, it should be said that it is very close.
But Zhou Cheng had never been to such a school, and he didn't actually know what the rules were like at the National University of Science and Technology.
Zhou Chengcheng quickly explained: "Okay, don't cry. Nothing has happened yet. Whether we can train or not will not be known until after the examination. The physical examination I am doing now is just a directional diagnosis, and it is not
It’s not the final result.”
The girl's sobbing stopped.
He looked at Zhou Cheng eagerly, with such innocent eyes. He gritted his teeth and asked weakly: "Doctor, what should I do?"
Zhou Cheng continued: "First do an examination and make a clear diagnosis! Then based on the diagnosis, I can tell you what to do. Otherwise, you ask me to make a guess, and what if it's not what I said?"
"Then you suffered a big loss, didn't you?"
"You go to make an appointment for an MRI first, and then rest until you come to my place for follow-up consultation after the MRI. Then we can figure out a solution together, okay?"
The girl asked nervously: "Can the MRI be done today? I just took a leave soon, and I have to go back to training later."
It's not easy to get into college, and it's even more difficult to get into the National University of Science and Technology. It's not just something you can get in with good grades.
She couldn't imagine what she would do in the future if she was dropped out of school or unable to graduate due to poor health.
After Zhou Cheng heard this, he wrote something on the girl's examination sheet: "Take this to the MRI room for examination. Just say it is an emergency examination. After the examination, you don't need to wait for the results. Come directly and we will make a decision based on the situation."
What should we do next!”
"No matter how you train, your body comes first. If you don't have enough time off, just extend it a little. This is the best way I can think of."
"Okay!" The girl then walked out worriedly.
Although Zhou Cheng looked at the girl's back and felt a little inexplicably complicated, there was nothing he could do about it.
Sports injuries occur more often in young people.
This may affect her for the rest of her life and even her future.
But this has become a fact.
Putting your body first is easy to say but hard to do!
Aren’t most young people paying for their bodies?
Zhou Cheng looked at Luo Yun, who didn't say much.
I just thought to myself that there seemed to be nothing wrong with him. He didn't say anything that shouldn't be said. He said everything that should be said. As for any words of comfort, Luo Yun couldn't say it at the moment.
Just because the patient's condition will have a great impact on their life, we cannot exaggerate or minimize the consequences of their own disease.
This is extremely unprofessional.
Zhou Cheng, a shy guy, would definitely not make this kind of mistake.
Alas, the patient's condition is still too simple.
Wait for the next one.
Find another chance.
…
"Next."
The next patient was also a young man, about twenty-four or five years old. He was accompanied by a girl, who seemed to be a couple or a couple.
But when they came, they still had flat films in their hands, which seemed to be from Shaxian First People's Hospital.
Did you come here after seeing a doctor in another hospital?
That must be quite troublesome, and Luo Yun began to feel excited.
Zhou Chengcheng asked about the medical history.
Then I found out that this was a couple who had just held their wedding two days ago.
The patient is a young man.
According to his story, he was injured while breaking in while going to pick up his bride.
At that time, the red envelope rain opened the door, and he stretched his legs in, preparing to physically refuse to close the door. Then he was pinched hard by the bride's support group!
After the young man finished speaking, the woman next to him said a little embarrassedly: "Doctor, is my husband's condition important?"
"After our wedding ceremony was held, we went to the hospital yesterday."
"After taking the X-ray, the doctor over there said that we might need surgery. We are worried about it, so we plan to come here to have another look." The woman replied a little helplessly.
Welcoming a bride is a traditional ceremony in China. Opening the bride's boudoir door is a pleasure in the wedding process. She can't care about other people. She is just a little apologetic.
Lu Cheng took the film bag from the family member's hand, then sorted the front and back one by one and hung them on the film reader.
Lu Cheng opened the medical record and glanced at it briefly.
After picking out the positive signs and negative signs, I turned my attention to the MRI.
Make a mental summary.
"The patient has a history of trauma."
"Currently, I have knee joint pain, and there is no osteophyte or fracture line on the X-ray. The joint space is normal, the patellofemoral joint space is normal, and there is no high or low patella. So soft tissue damage is considered."
"At present, the patient does not have any special positive signs, so."
Lu Cheng looked at the T2 phase of the MRI again.
The reading of MRI scans is hierarchical.
An entry-level doctor will only look at black and white when looking at an MRI, looking for signs of edema! Anyway, they just want to ask where the swelling is?
But when doctors reach a certain level, they will watch the anatomy directly from the film.
There was so much information revealed by the MRI that even the movements of nerves could be read. Therefore, Zhou Cheng did not read the MRI report...
In addition to being able to read anatomy, reading MRI scans of the knee joint also requires its own reading skills!
First look at the anterior and posterior cruciate ligaments, then the medial and lateral collateral ligaments, and then the meniscus.
However, when he saw the front fork, Zhou Cheng frowned severely.
The anterior fork, the full name of the anterior cruciate ligament of the knee joint, originates from the front and medial side of the intercondylar eminence of the tibia, merges with the front corner of the lateral meniscus, and runs obliquely posterior, upward and lateral, and its fibers are attached to the medial side of the lateral femoral condyle in a fan-shaped manner.
On the plane of nuclear magnetic resonance, the conventionally displayed signal is——
Black.
It's pale now, and there must be edema, but is it continuous?
broken!
There is also edema in the rear fork.
The medial collateral ligament is broken. The lateral collateral ligament is normal.
Look at the meniscus again.
The meniscus is also damaged, which is also a classic medial meniscus rupture. III degree injury.
Meniscal damage is classified into three degrees on MRI. First-degree damage is a point or a white line and does not rupture to the top or bottom of the meniscus. Second-degree damage is a rupture of one edge, which is a half-layer tear. Third-degree damage
A high-grade injury is a full-thickness tear.
When visiting an outpatient clinic, the required knowledge reserve is much higher than in the ward.
While Zhou Cheng was reading the film, Luo Yun also finished reading the film. His mouth under the mask made a strange shape, and his eyes glowed with light.
It's coming, it's coming.
It’s sports medicine’s medial triad of knee injuries, and here it comes.
Zhang Zhengquan pretended that he knew very well, and used his hand to look for white traces on the MRI plane. Finally, he pointed at the fat pad inside the knee joint and rolled his eyes at Luo Yun. He meant, Teacher Luo, is there something wrong here?
Luo Yun was so angry that his chest heaved violently.
"We'll talk about it later." He cursed in a low voice, but he didn't want to reveal the answer to the mystery in advance. If the answer to the mystery was revealed, what should we do?
Zhou Cheng thought for a while before asking the young man again: "Have you ever felt a sudden pinch when you were walking?"
I secretly thought to myself, how hard was this guy pinched, to be like this?
That's it. Zhou Cheng felt that there was something fishy about this matter.
Although the damage can be seen now, if the ligament is broken when the door is pinched, it is easy to say that it is just the meniscus that is pinched. How coincidence is that?
Therefore, Zhou Cheng felt that this young man might have been injured before, and the ligament might not have been broken at that time, but there was still some residue, and then the pinch just wiped away the last trace of it!
"Or do you feel unsteady?"
Auxiliary examinations are only auxiliary examinations, they still need to determine whether the patient himself has symptoms!
"No." The woman answered helpfully.
Then she looked at her husband: "Isn't it?"
"It seems not." The young man recalled.
Then he said uncertainly: "But I haven't walked much since I got married. But the night before the wedding, when I was playing ball, I suddenly felt a twitching sensation."
"But it's not as painful as it is now." The man said confidently.
Zhou Chengcheng said: "Then you must have been injured while playing ball?"
The young man squinted his eyes and said, "When playing basketball, it's normal to bump into each other, so I don't pay much attention to it!"
"And I often jump to catch the ball, dribble, and collide with each other. Does this matter? I have been playing basketball for more than ten years and I have always been pretty good." The young man frowned.
He likes to play ball, there is no reason, he just likes it.
If Zhou Cheng wanted to deprive him of his current hobby, what would he do?
Zhou Cheng licked his lips and said, "Yes, you play ball often. That's right."
"But your MRI showed a rupture of the meniscus, and the rupture was in the body, not the front foot."
"At the same time, you also have a ruptured anterior cruciate ligament and medial collateral ligament."
"These two are not the same injury mechanisms."
"So, I guess it's possible that an isolated playing injury didn't break your ligaments, but it broke your meniscus."
"The meniscus is like our insole, and it is very brittle. If you exert too much force, it may break. However, your ligaments may not be completely severed at that time, and then you are caught in the door."
"The ligaments that were still fine were pinched," Zhou Cheng explained.
When the young couple heard this, they were immediately stunned.
"Is that so? Doctor?" The young man touched his head, his face looking uncertain for a while.
The woman also looked at her husband with suspicion on her face.
"You didn't say before that you were injured playing basketball?"
It seemed that the two of them were a bit at odds. Maybe the young man felt that he was hurt because of his wife, but the woman seemed to have confirmed part of her innocence at this moment.
When Luo Yun heard Zhou Cheng's words, he frowned tightly!
Because this was something Luo Yun had not considered before.
How the injury occurred is not helpful in understanding the patient's condition. No matter how the injury occurred, the ligament is still broken. Should surgery be performed or should surgery be performed?
However, although it does not affect the patient's treatment, Zhou Cheng's theory seems to be able to truly explain the root cause of the current symptoms!
Eh?
Good guy, I didn’t even expect this!
This Zhou Cheng?
How did he come up with this idea?
Although tracing the source of the disease is not important for the treatment of the patient itself, it is very important for the doctor to accurately interpret the type of disease and to understand the disease itself more deeply!
How you were injured and the mechanism of the injury can guide subsequent functional exercises and the associated symptoms and injuries that need to be considered when encountering other types of diseases!
Will it be done this week?
How could he think in this direction?
Luo Yun himself, after seeing the patient's MRI results, had been thinking about how to perform the operation.
When you encounter a problem, solve it first. This is natural logic!
However, this is a good thing for the patient. Thinking carefully about how to treat it is conducive to the patient's recovery, but it is not conducive to one's own understanding of the disease and improvement of diagnostic capabilities.
It is also not conducive to case analysis.
Luo Yun's eyes kept spinning. At this time, Luo Yun considered too many things.
seemingly?
Zhou Cheng pretended to be here again!
Zhou Cheng also saw the change in the expressions of the two people. He didn't have time to see the change in Luo Yun's expression.
He quickly said: "Actually, the specific cause is not too important now. What is important is that the current situation must be treated with surgery, otherwise, the damage to your joints will be great."
"It is very likely to affect your normal walking later."
Zhou Cheng didn't dare to worry about the reason anymore. Don't divorce this newly married couple, which would be more than worth the gain.
The knee joint is unstable and the meniscus is ruptured. If this cannot be solved without surgery, then we should wait until we are in our thirties to have the joint replaced.
However, Zhou Cheng's words made the young couple a little wary and asked, "Doctor, do I need an operation? Can your hospital do it?"
They were a little suspicious that Zhou Cheng was trying to trick them into having surgery, so he told them such a large list of possibilities!
Zhou Chengcheng looked at Luo Yun.
As for whether this can be done, Luo Yun said he doesn't know how to do it yet, so it's hard to go back.
Luo Yun quickly said: "In your case, you may still need to go to Annex 1 or Annex 2. Our hospital does not have such equipment. If we open the surgery, we can do it, but the incision is too big, and it will not save money."
"No need."
Make bricks without straw.
Joint replacement does not require special equipment, but sports medicine requires at least arthroscopy. The Eighth Hospital does not have this thing. It costs hundreds of thousands or millions to purchase a set. If the department does not come forward and the hospital does not buy it, Luo Yun must not
Maybe I can do this kind of surgery.
After hearing Luo Yun's sincere words, the young man really believed Zhou Cheng and others.
Said: "Thank you doctor, we thought it was nothing serious, so let's go to Annex 1 or Annex 2 and have a look."
After saying that, the young couple walked out in a hurry.
While walking away, the two seemed to be arguing about how they were injured...
After the two left, Zhou Cheng stood up, looked at Luo Yun, and asked, "Teacher Luo, I didn't say anything wrong just now, right?"
Zhou Cheng was afraid that Luo Yun would not be able to say anything and point out his mistakes in front of the patients and their families.
And Zhou Cheng doesn't mind at all if Luo Yun can point out his mistakes. It would be best if he could point them out.
It's just that the speaker has no intention, but the listener has intention.
Zhang Zhengquan also looked at Luo Yun with admiration in his eyes.
Brother Zhou Cheng is already pretty awesome, and Teacher Luo Yun is even better. I’m so fucking ‘happy’. Big brothers, I just want to ask when are you going to eat? Why don’t you ask me to come when you don’t want to eat?
I don't want to be stepped on and rubbed by you two.
I was wrong!
I was really wrong.
Zhang Zhengquan regretted it.
It’s hard to find food.
Luo Yun looked carefully to see if Zhou Cheng was deliberately teasing him, but when he saw Zhou Cheng's sincere eyes, he nodded slightly and said, "It's okay! I've said everything I need to say, it's okay, you continue reading!"
"Keep watching."
Luo Yun was a little lucky at the moment. He was so clever and could turn from light to dark in time.
Otherwise, Zhou Cheng would probably laugh at him in private or add some points that he had not thought of in what he had just said, right?
Zhou Cheng is really dangerous!
I'm too southern!
Live in Bengbu!
…
From Zhang Zhengquan's perspective, Luo Yun just nodded up and down for a long time.
Say ‘it’s okay’!
I can do this too. Zhang Zhengquan thought...
If you don't prevent theft for a few days, you will lose a lot of subscriptions. Please bear with me!