Chapter 350 Confrontation between geniuses! (Please subscribe!)

After the third outpatient was sent out by Fang Yun, Zhou Cheng felt that Fang Yun's basic knowledge and basic skills were really good, so he made an impromptu decision.

"Xiao Fang, please give a brief explanation to the patients outside, and don't call the next patient in for now," Zhou Cheng ordered.

Hearing this, Fang Yun immediately nodded and said to the next patient: "Sisi, wait a moment. The patient who just went for the examination still has some problems on the film. My teacher said he wants to take another look. Please wait for two or three minutes.

That’s fine, I’m sorry.”

After explaining and getting consent, Fang Yun pushed the door open and came to the computer at Zhou Cheng's greeting.

Zhou Cheng looked at it calmly for a while, then tilted his head slightly. Seeing Fang Yun also reading the film carefully, he asked, "Can you understand it?"

Fang Yun nodded: "I can understand a little bit."

"How much do you understand? What do you understand about the diagnosis and surgery of fractures?" Zhou Cheng continued to ask. He really cared about this student. This time the question was from a professional perspective.

This is a patient who underwent fracture surgery. Before the operation, he was also treated in a traditional Chinese medicine hospital. This time he came for a review and consultation on the time to remove the internal fixation device.

Zhou Cheng saw that Fang Yun had a good foundation, so he retrieved all his previous plain radiographs and examinations. These were the radiographs taken when the patient was injured and admitted to the hospital a year ago.

Fang Yun's expression immediately became tense. After looking carefully again, he organized his words a little and replied ably: "The diagnosis of fracture, by definition, is the interruption of the continuity and integrity of the bone."

"In imaging examination, you can see the discontinuity of the bone. The existence of the fracture line is the destruction of the bone continuity, and the bone fragments represent the destruction of the integrity to a certain extent."

"Physical examination shows swelling at the fracture site and limb deformity. Palpation can feel bone friction at the fracture end, and occasionally abnormal movement can be seen." Fang Yun replied very decisively, and every word was true.

"What about the indications for surgery?" Zhou Cheng was obviously not surprised that Fang Yun could answer these questions.

Fang Yun's brows suddenly frowned. Zhou Cheng was asking about the indications for surgery. In fact, it should also include contraindications for surgery, so he replied: "Failed manual reduction, unstable fractures, and fractures that cannot be stabilized by plaster external fixation.

All require surgical treatment.”

"This fracture is classified as type B2.21, which is an unstable fracture type and a femoral fracture. Even after manual reduction and plaster external fixation, it is difficult to achieve fixation. Therefore, surgical treatment is required."

"If there is no concurrent shock or serious medical disease, surgical treatment can be performed."

Fang Yun did not make a long speech, but picked out the key points.

He knew that simply memorizing simple concepts in front of people like Zhou Cheng would definitely not make him happy. Besides, it had been a long time since he had memorized anything conceptual.

The answer is concise.

And it was also very layered. One was for surgical treatment, and the other was for surgical treatment. The answers were different things. He thought that Zhou Cheng would definitely be able to hear the difference and the details he noticed.

"Fracture treatment?" Zhou Cheng was satisfied with Fang Yun's answer, so he continued to ask.

"The treatment principles for fractures are reduction, fixation, and rehabilitation exercises."

"Reduction includes manual reduction, surgical reduction, external fixation and internal fixation with internal fixation devices. Rehabilitation treatment is a follow-up rehabilitation training plan for patients after reduction and fixation." Fang Yun's answer was still decisive and capable.

"Are manual reduction and surgical reduction completely separate? How do you define reduction?" What Zhou Cheng asked now was beyond the content of the textbook, and even beyond the scope of general specialist content.

Fang Yun has a good foundation and wants to teach.

Now these questions should be what the attending and deputy chief physicians need to think about.

Fang Yun turned his head and glanced at Zhou Cheng, still hesitating in his heart. Mr. Zhou, your question is a bit over the top, but he still replied: "Surgical reduction is actually a combination of manual reduction and internal fixation-assisted reduction. The purpose is to

Achieve anatomical reduction and restore normal bone structure."

"There is no distinction between high and low, they all achieve the purpose of reset. It should be viewed holistically. Fixation is just to maintain the reset."

"How to distinguish fracture reduction techniques?" Zhou Cheng's eyes suddenly lit up. Fang Yun is very good. This is no longer a basic skill, this is already a skill.

Fang Yun looked at Zhou Chengyiyan again, his eyes flickering, as if hesitating. Shouldn't he answer this question? After all, it would be inappropriate for Teacher Zhou Cheng to be unable to come to the stage during their first meeting.

"Answer." Zhou Cheng gestured to Fang Yun to continue.

Fang Yun lowered his head slightly and glanced at Zhou Cheng's expression with his peripheral vision: "Teacher Zhou, reduction is the purpose. When resetting, the principle of attention is to fully traction first to separate the broken ends of the fracture and then reduce it. During this process,

It is the power of borrowing that makes the distinction and difference.”

"Binding force can be used to use the operator's pure physical strength to counteract the contraction of the muscles, so that the affected limb can be fully tracted, and the fractured ends can be separated before the reduction operation is performed."

"Using Qiao Jin, experienced and skilled surgeons will skillfully use the muscle strength of the patient's affected limb and analyze the muscle deformation, and use Qiao Jin to make the reduction easier."

"Then you can use your own energy to stimulate the contraction of many muscles under non-anesthesia and the patient's own pain. With this force, you can achieve reduction without much effort. If it is during the operation or under anesthesia, the surgeon must find the appropriate position.

Position to stimulate the muscle’s own strength.”

"I also heard that I can't figure out what kind of energy can be used..." Fang Yun looked at Zhou Cheng and his tone became lower and lower.

When the skill reaches this level, according to Professor Chen Xueliang, it has reached a new level. It is a world-class technique reset operation, which is perfect in the world.

Zhou Cheng frowned when he heard this.

According to Fang Yun, entry is brute force, proficiency is skill, and mastery is strength, then the perfect level is what he calls Hua Jin.

However, this method of energy transfer is actually not completely accurate. A perfect level of manual reduction should be based on borrowing force, but it can only borrow force from the wrong position, not simply relying on the strength of muscles and ligaments.

However, my current redefined fracture reduction technique has a bit of a meaning of energy. This kind of strength comes from the anatomy of the bone. Depending on the location of the fracture, it is different from the anatomy of the surrounding muscles. Through the bone itself, it can

Conduct force to reset on its own.

This is our body's self-protection mechanism.

Zhou Chengcheng nodded and said: "I agree with the first few points you mentioned, but I think you can change the point you mentioned about transforming energy."

"Further up, there is ectopic force borrowing. For example, if we want to reduce a tibial fracture, the location of the tibial fracture is very strange, and if there is no muscle anatomy nearby to borrow force, then we may have to use the femur and above the femur.

Use the muscles at other locations, such as the ilium and pubic bone, to borrow force."

"This is also a kind of borrowing power."

"Further up, there is the bone resetting force. Our physical body will have a self-protection mechanism to a greater or lesser extent after suffering a blow. This is still the case after a fracture."

"This is also related to the precise anatomy of our human body. When we are injured, our existing anatomical structures will tend to restore our bodies to their original structures. If this power is used well, some

Complex, short bones and even fractures that cannot be reduced by conventional fields can be reduced manually.”

"Take the femur as an example. Traditionally, we believe that the femur cannot be reduced by simple manual reduction or external fixation with plaster. This is because even after reduction, the fracture still remains unstable. Simple external fixation with plaster cannot achieve fixation.

To maintain the reset effect.”

"However, I have done it myself. After the femur fracture is reduced, the reduction effect can be achieved and the reduction effect can be sustained." Zhou Cheng said and laughed.

His last words were a bit annoying. They became the words he liked to use when he was a junior doctor and when the senior doctors were bragging, "What have I done?"

"You can ignore the last sentence." Zhou Cheng himself didn't like this, so he hoped that Fang Yun could filter it out.

When Fang Yun spoke to Zhou Cheng, his eyes suddenly shrank, and then he was extremely surprised, and his tone was particularly exciting: "Thank you, Teacher Zhou!"

You know, Fang Yun is also a person who has seen the world. He was an undergraduate at Seoul University before. He had the opportunity to stay in the university. The professor also appreciated him and taught him a lot. However, he was quite greedy and wanted to study more.

Good hospital for graduate school.

He was admitted to graduate school and had no money to borrow, so he had no chance to go to school. However, during the internship rotation, the professor showed him a lot of things, such as the complicated path of medicine that is different from what ordinary people understand. Chen Xueliang introduced this medical

The different realms and levels have been classified in an easy-to-understand way, but it is not perfect yet.

Even during the postgraduate re-examination, his teacher Bu Haoran and the teachers there were not completely classified. Unexpectedly, Zhou Cheng found a follow-up.

The weekly results are truly extraordinary.

What the teacher said before was right. There are indeed great opportunities in Chang City.

"It seems you understood and didn't think I was talking nonsense."

"Okay, let's call the next patient first. This kind of discussion and learning will be done one type at a time. You learn slowly and I teach you slowly." Zhou Cheng also felt very accomplished.

MD, if all medical students had Fang Yun’s qualifications and understanding, that would be great and easy to teach. I just need to list the skill scoring standards for different proficiency levels, and they will automatically follow them.

.

However, Zhou Cheng also knew that this was almost impossible.

Every subject requires talent.

Mere efforts can only achieve the height of mastery, and it is absolutely impossible to achieve perfection!

Fang Yun was not in a hurry, but was even more enthusiastic. He hurriedly went out and called the next Lao Sua in. Then, Fang Yun became even more diligent...

In the afternoon, the clinic ends.

Zhou Chengcheng asked: "Xiao Fang, where are you going to eat at night?"

"Teacher Zhou, I brought some fermented bean curd from home. It will be good to mix it with takeout and eat it. I will discuss the article with Brother Li later." Fang Yun hurriedly followed Zhou Cheng out as he went out.

He said that at this moment, his eyes were full of strange colors.

"Just call him Xiaoyue. Li Zhongyue's scientific research talent is good, but his clinical work is a mess. You are good enough to be his teacher." Zhou Cheng confessed to Fang Yun, hoping that Fang Yun would not put his attitude too low. This is not suitable.

The fit of the atmosphere within the group.

Li Zhongyue was called to Changshi by Zhou Cheng for two purposes. In order to facilitate his discipline, he was afraid that Cai Dongfan would not be able to discipline him. Furthermore, Li Zhongyue was a person who was good in theory but poor in operation. His current level was too high.

High, and the threshold for entry into teaching is high.

Maybe it would be better if Fang Yun taught him, but Zhou Cheng didn't know what Fang Yun's basic skills were now.

However, according to Yang Yifeng, Fang Yun's surgical reenactment skills are a bit incredible and should be good! It's just that he can't reach the level of the ceiling of his skills, so he's not high enough yet...

He taught Li Zhongyue and raised his technical level by himself, each taking what he needed.
To be continued...