medical simulator

I ran over to take a look, and immediately saw abdominal trauma, so I immediately called a doctor from the general surgery department for a consultation, and then completed the relevant examinations...

About twelve past two.

Luo Yun finally arrived at the first ward of the orthopedic department, before he had time to change his overalls, he slipped into the ward, and immediately apologized to Zeng Yi and Li Changhong: "Director Zeng, Director Li, I rushed to the department when I received the call .”

"There is a little traffic jam on the road."

Zeng Yi saw Luo Yun take two steps back and glanced at the time.

It was only 44:[-], and the time I called Cai Dongfan was [-]:[-].

Within 9 minutes, Luo Yun rushed from home to the department in a traffic jam, and there must have been no delay.

As for the temporary calling of Zhou Cheng to come to the orthopedics department to 'insult people', Zeng Yi didn't want to bother.

The most important thing is to solve the problem first.

Li Changhong looked back to see Luo Yun, and didn't repeat the angry words he said after calling Cai Dongfan. Today is the person in his team who is on duty.

He just took a step back and said to Director Zeng: "Director Zeng, take Xiao Luo to watch the movie first, I am here to communicate with patients and their families."

"Director Wang is already on his way."

"Okay!" Zeng Yi didn't hesitate, and immediately brought Luo Yun to the doctor's office, saying as he walked.

"The plain film of this patient looks like a conventional dislocation of the wrist joint, but both Wang Yaoxiang and Li Changhong were reset twice, but they failed to reset. The patient and his family refused to receive nerve block anesthesia, so we insisted on finding a way. "

"I also refused to conduct further examinations. Although the tone is loose to a certain extent, it is possible to agree to open reduction surgery."

"But I thought I'd try to use manipulation to reset his dislocation."

Before the manual reset, Wang Yaoxiang had already talked with the patient and his family members. After all, it was a routine manual reset for the second joint dislocation in the department, so he dared not be careless.

It's just that it's one thing to have a conversation, and it's another thing for the patient to understand.

Hearing this, Luo Yun frowned tightly: "Did Director Li also reset it twice? Then this wrist dislocation is probably unusual."

"What type of dislocation is it?" Luo Yun asked as he walked.

Zeng Yi's expression changed: "Wang Yaoxiang said it was type 2. I watched the film and thought it was type 2 - dislocation of the radiocarpal joint and intercarpal joint."

Luo Yun immediately glanced at Zeng Yi with a bit of confusion, a little embarrassed.

I thought to myself, Director Zeng, such a simple classification is not enough.

In the eyes of non-joint surgery, there are only two types of wrist joints——

Type I, simple dislocation of the radiocarpal joint; type II, dislocation of the radiocarpal joint and intercarpal joint.

But in the eyes of joint surgeons, there are more than ten types of wrist joints.

"Well, let's watch the film first, shall we?" Luo Yun didn't blame Zeng Yi. Although Director Zeng is the chief director of the orthopedics department, he specialized in surgery. The reason why joint surgery can be separated from the trauma surgery of the orthopedics department and become a separate department.

It is precisely because of the specialization of joint surgery that it is no less than the difference between spine and orthopedics.

When I came to the office, a computer had already listed the patient's films on the computer screen, and there was only a simple front and side view of the wrist joint.

In fact, it should be an NMR.

Luo Yun was conflicted in his heart, but he didn't say it out. He is in the second department of orthopedics, and he is only attending now.

When Luo Yun saw it, he frowned fiercely!

Radiocarpal dislocation!

And separation of the inferior radioulnar joint——

and.

2 to 5 metacarpal joints are also dislocated.

Look at the fracture line again, good guy, there is no fracture yet, what a rare case is this?

Those that can lead to dislocation of the radiocarpal joint are generally high-violence injuries, and most of them will be complicated by fractures, but this patient happened to have no fractures.

Also, the most common types of wrist dislocations, such as lunate and perilunate dislocations, were absent.

Instead, the high energy was somehow transferred to the radioulnar joint and the metacarpal joint——

As a result, fractures and lunate perilunate dislocations, which are relatively easy to treat, were all missed by patients, and instead became what they are now.

After reading it, Luo Yun turned his head, his face squeezed into a chrysanthemum face, and stammered: "Director Zeng, this wrist dislocation does not belong to the conventional type II wrist dislocation—dislocation of the radiocarpal joint and intercarpal joint. "

Luo Yun didn't embarrass Zeng Yi, and gave him some more classifications of joint surgery that only specialists in joint surgery would pay attention to.

For example, the words such as lunate dislocation, transscaphoid perilunate dislocation, transstyloid process and scaphoid perilunate dislocation, volar perilunate dislocation, etc. are extremely difficult to pronounce.

"If you have to give this a name, it should be called atypical multiple wrist joints and metacarpal joint dislocation."

"Is the patient's and family's willingness to perform the surgery great?" Luo Yun simply gave up doing the manipulation reset.

Hearing this, Zeng Yi frowned fiercely: "This patient, can't he do manual reset?"

"It's best to reset her with manual reset."

Zeng Yi wondered to himself, whether this Luo Yun was secretly instructed by Cai Dongfan to disgust him on purpose.After all, he and Yan Haihan were also taking advantage of Cai Dongfan's enthusiasm.

Both Zeng Yi and Yan Haihan didn't know what Ding Changle and Cai Dongfan had said in private, anyway, they only made one phone call.

So Zeng Yicai and Yan Haihan discussed with each other, how about we do joint dislocation manipulation together, if there is a topic, there is an article, at least you can mention a name, and express your attitude to Professor Ding Changle by the way.

We can provide the same platform that Cai Dongfan can provide. Of course, as long as Professor Ding is willing, our whole department of orthopedics is willing to provide you with a bigger platform.

That's what happened this morning.

"Director Zeng, it's hard to say, how should I put it? It's like our conventional classification of fractures, which can cover most types of fractures, but there are also very few special fractures that are not included in the conventional classification."

"This patient's dislocation is that extreme type. I estimate that it is difficult to find the same reference even if I search the literature. This type is extremely rare."

"Originally, dislocation of the radiocarpal joint is an extremely rare high-energy injury, accounting for only 0.2% of all joint dislocations. If the remaining dislocations are combined, I estimate that such a coincidence may not happen in 20 years."

What Luo Yun said was quite conservative and cryptic.

But Zeng Yi's expression was a bit ugly, the corners of his mouth twitched and twitched, and he said, "So we just happened to meet?"

Such a coincidence?

"Yes. It's almost like this." Luo Yun also felt that this was really a coincidence.If the patient has any fractures, then there is no need to talk about it, and open reduction can be done directly.

But there is no fracture, and there is no dislocation around the lunate, which proves that the ligament structure inside the wrist joint is actually okay. It is just a misplaced shift and deviation, and there is no need for repair such as fracture. In principle, It should be able to be reset manually.

but?

Ability is ability, and theory is theory. I have never done it before, and I have never encountered it before. This is not a theoretical thing.

Zeng Yi's face was a little dark, and he called Li Changhong in private, saying, "Changhong, Luo Yun has watched the film, and said that he would try to talk about surgery. Wait until Director Wang comes, and we'll see the situation." Let’s explain it to the patients and their families.”

"This dislocation is very unusual."

Li Changhong replied on the other end of the phone: "I said it and explained it, but the patient's husband insisted that since it is unusual, why didn't he make it clear when he first came here? Is it because our doctor messed him up now?" Average?"

"And, Director Zeng, there seems to be something wrong with this patient's family. He is calling to ask many people. There are several calls, which must be made to doctors in other hospitals. I don't know what happened."

"Are you sure? How did he know so many doctors?" When Zeng Yi heard this, he felt a bit of a jerk.

"I don't know. If it's the health system, even if I don't know it, at least I know it. I don't know why." Li Changhong said.

Suddenly someone whispered in his ear for a while, saying that Zeng Yi didn't hear clearly.

Li Changhong immediately walked away, and said to Zeng Yi: "Director Zeng, I found out that this patient's husband works in the 120 emergency team, and seems to be the person in charge, not just the captain..."

"Damn it." Zeng Yi cursed.

I also heard the high-profile family members on the opposite side: "I trust your No. [-] hospital to come here. You can't fool our patients like this. We are here to treat diseases, not to quarrel."

"My wife and I understand that it's not easy for your doctor. Otherwise, we would not agree to your operation four times, but now you tell me that you need an operation, and I can't accept it for a while. You have clearly evaluated it before and then said it's OK. Manipulative therapy..."

Zeng Yi hung up the phone with a gloomy expression.

The other party is enough to save face. It is estimated that the other party already knows how to report and which relevant units to report these things to. However, the reason why he has not taken this step is that he still hopes to solve the matter.

"Is there really nothing you can do? How about you send the film to your teacher and let him see it?" Zeng Yi rubbed his aching head and gave an immature suggestion.

Luo Yun closed his eyes and thought for three seconds, then nodded and said, "Okay, Director Zeng, let me ask first."

He also heard the phone call just now. If there is something wrong with the first department of orthopedics, the second department of orthopedics is also connected. Although he hasn't bothered his teacher for a long time, he still needs to bother what should be disturbed.

Luo Yun then said: "Director Zeng, I'll make a phone call first, I don't know if my teacher will answer."

Zeng Yi nodded, then suddenly glanced at Luo Yun, and asked, "Luo Yun, didn't you study in Shashi as a graduate student?"

"No, I'm from Shashi. I came back to work." Luo Yun answered casually, and then walked out.

For a moment, Zeng Yi also forgot which hospital Luo Yun's graduate student was in, but the matter of this patient was more important, so he didn't ask again.

About 10 minutes later, Director Wang Yongjin came to the department and the office first.

But Luo Yun hasn't come back yet.

Wang Yongjin asked Zeng Yi about his condition again, and watched the film at the same time. Zeng Yi explained his condition while explaining what Luo Yun just said.

After Wang Yongjin finished reading, he also scratched his hair and said, "In such a situation, if Director Liu is still in the hospital, he may try to reset it again. Now Xiao Wang has reset it four times!"

"I suggest to talk about surgery directly. Such a reset is very rare. I have been doing it for so many years, but I have never seen it."

"Previous dislocation patients rarely came to the department."

Zeng Yi smiled bitterly and said, "Director Liu is almost ninety this year, and it's not appropriate to invite him to the department."

Director Liu is from the old director's generation, and he is the only living figure in that generation. No matter how courageous Zeng Yi is, he dare not bother him.

"Director Wang, thank you for your hard work. I'll go talk to the patient's family." Zeng Yi didn't tell Wang Yongjin about the identity of the patient's family so as not to disturb him. Director Wang is about to retire, so let him have a good rest That's the business.

Wang Yongjin said: "Don't be in a hurry, wait for Ronaldinho to call back, and then make a decision."

Just as Wang Yongjin was talking, Luo Yun came in feeling his head.

"How is it? Luo Yun, what did your teacher say?" Zeng Yi hurriedly asked.

Luo Yun struggled and said: "My teacher said, reset can be done! But I haven't done it yet."

"If the patient strongly refuses surgical treatment, it is recommended that we transfer to another hospital and do not touch it again. Otherwise, ligament rupture and wrist osteoarthritis will easily occur."

"My teacher has only seen this situation once."

Zeng Yi's expression changed.

With a wry smile, he shrugged his shoulders: "This?"

"Huh!~"

"Director Wang, do you suggest transferring to another hospital, or invite a professor of joint surgery from the Affiliated Hospital of Shonan University to come over for an evaluation?" Zeng Yi lost the straw of Luo Yun, so he could only admit that he was unlucky and pay for someone himself Come here for treatment.

Wang Yongjin nodded: "That's all I can do now, but I'm not very familiar with the young people in the Affiliated Hospital of Shonan University. Do you know anyone?"

"When I called, they were all old people. We asked someone to help, and it would not be appropriate to transfer the call from someone from the previous generation." Wang Yongjin explained.

"Yes, Director Wang, you go to rest first! I'll arrange the rest of the matter. Today is our young people who are causing trouble for you, so you have to take a trip."

Wang Yongjin smiled and said: "I'm old, and my body is indeed not as strong as it was a few years ago. It's just that I can't help you here."

Only then did Wang Yongjin call to ask for foreign aid. Originally, he also thought about asking for foreign aid, but he would wait until the people in the department really had no other way to do so.

Spending money is one thing. If you always ask professors for foreign aid, this is also inappropriate. It will make others think why your hospital is so busy?What kind of monsters and monsters are they?Can't handle anything?

……

At 12:30, after Zeng Yi called, Luo Yun told Zeng Yi that he had to go to the department to check the situation first.

There is only a young man like Zhou Cheng sitting in his department, so he is not at ease.

Zeng Yi can also understand that now both departments are treating patients with large-scale joint dislocations on the first day. If this happened in the first department of orthopedics, the second department of orthopedics must take precautions. Take on the responsibility of being on duty.

"Go ahead, you need to be more cautious. Don't let this happen again, communicate more, check more, and get a clear diagnosis." Zeng Yi confessed.

In fact, he felt a little bitter in his heart. He thought that Wang Yaoxiang from his department would not be weaker than Luo Yun.

After all, Wang Yaoxiang participated in the joint surgery competition for young doctors in the province and won an award, while Luo Yun was just a graduate student in joint surgery and had no outstanding achievements.

But now it seems that Wang Yaoxiang may not be able to compare with Luo Yun.

……

"Ms. Luo." In the second orthopedic department, Du Ruiqi was eating, and when he saw Luo Yun, he immediately called out politely, "Have you eaten yet?"

Luo Yun saw that there was a fast food box next to Du Ruiqi, and the food was quite messy, but he looked like he hadn't finished eating, so he asked, "I've eaten. Is the situation in the department okay? Where did Zhou Cheng go? "

Du Ruiqi hurriedly sent the contents of his mouth into the esophagus, and then wiped his mouth while replying: "The situation in the department is all right, and two patients with fractures came here, closed. You don't need to go on stage."