medical simulator

Chapter 142 Bengbu Lives! (Please subscribe!)

What Zhou Cheng said was beautiful, but Luo Yun didn't take it all seriously!

The patient's family 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's ability to think outside the box is not something that ordinary people can do.

Especially in the medical industry, some practitioners, even Luo Yun himself in many cases, like to show off their profound knowledge. Based on the fragmented information provided by the patients, they try to figure out the medical history that the patients themselves may have ignored. or symptoms.

Just like today, based on the plain film of the patient, Zhou Cheng deduced the fracture that even the old woman and daughter-in-law, and even herself, had forgotten.

This is the deduction ability you will have when you walk with a huge knowledge base and precise rule awareness, which represents your understanding and control over a disease!

And sometimes, precisely because of these controls, you will unconsciously formulate some symptoms of the patient!
Why is that?
Because during the exam, the questions are like this.

"Fracture Triad = Fracture!"

"Progressive dysphagia = esophageal inflammation or cancer."

"Elevation of ECG ST segment arch = myocardial infarction..."

There are too many examples of this.

In the diagnosis of radial head subluxation, the diagnosis needs to rely on the medical history, and there are the most common populations of this disease.

Child + parents brought + trauma history + elbow pain!
It can almost be diagnosed as radial head subluxation.

This is how to get started when learning about this disease, what is called getting started.

It is the teacher or the textbook that led you into this industry. Under normal circumstances, you will not suspect that the teacher led you in the wrong way!
So Zhou Cheng and Luo Yun have been asking for definitive medical history.

……

Of course, this kind of questioning may stop halfway, because in many cases, the reason is not important, and the important thing is to solve the problem.

Under such psychological control, Zhou Chengruo performed a subluxation of the radial head on the child.

Then check the dislocation and reset——

Once the activity is restored, the patient can be sent away directly.

While Luo Yun was scanning Zhou Cheng.

Zhou Cheng was secretly rejoicing in his heart.

I have always walked within the rules, and did not take the initiative to add definitions to patients based on my own understanding and experience!

I didn't show off my wide range of knowledge, and I didn't argue with the patient's family that although I was only a resident doctor, I was very good at it.Otherwise, Zhou Cheng felt that he might have stepped on the patient's thunder.

……

Things have come to this point,
Qiqi's mother could only take her child for an examination with tears in her eyes.

She originally thought that when she came to the hospital today, she just showed the child some symptoms after an injury, and she would recover immediately.

Can?
Although in the current situation, maybe my mother-in-law and my husband will not blame me for sending the child to have problems. After all, if I am not careful, I can't provoke cancer.

But, at this moment, Qiqi's mother really hopes that it is because she went to send Qiqi off, which caused her to be injured accidentally, and not that thing...

She walked briskly, and then called her husband who was on duty rather helplessly...

After this.

Only Zhou Chengsan started seeing the doctor step by step!

Because Luo Yun gave Qiqi an emergency MRI plain scan order, so the examination was done very quickly.

Half an hour later, Kiki's mother came up again with her in her arms.

However, there are no other family members accompanying him for the time being.

Zhou Cheng and Luo Yun had been thinking about the little girl all the time, so the first time the little girl returned to the consulting room was.

Carefully reviewed the NMR!

However, after reading it, both Luo Yun and Zhou Cheng looked stunned for a while.

Slowly let out a breath.

Then he looked at Kiki and Kiki's mother.

Seeing this, Qiqi's mother became even more nervous, and hurriedly asked, "Doctor, my Qiqi, what's going on here? Is there a problem?"

Luo Yun turned his head and said: "There is a problem. But this should not be a bone tumor, and there are no signs related to bone tumors. It looks more like bone fibrous dysplasia!"

When Zhang Zhengquan heard about this disease, he was stunned again, and even a little doubted whether he was in orthopedic training, why Luo Yun didn't know anything about it.

It's so hard to get enough food today!

He looked at Zhou Cheng innocently, and Zhou Cheng also saw the meaning in his eyes, but turned his head to look at Luo Yun, meaning that after Luo Yun finished speaking, let's explain this disease.

Seeing a doctor and teaching can be intertwined, but not at the same time.

Luo Yun continued:

"Mom Kiki."

"Actually, this kind of bone fibrous dysplasia usually occurs in the tibia, but hers is in the humerus, which is extremely rare."

"The probability is less than one in a thousand." Luo Yun is not a doctor specializing in orthopedics, so he said it a lot conservatively.

Qiqi’s mother hurriedly asked: “Then what kind of fibrous bone defect is this? Is there a serious sequelae? Is it important? How to deal with it?”

This is what she focuses on, whether it is rare or not.

"Poor fibrous structure is a structural problem."

"You can think of it this way, where we built the road, where cement should be used, mud was used, so it is very soft and the bone is very brittle!"

"It's not a tumor. It's 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 couldn't really feel at ease. She pulled Qiqi away from 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 do you have to be to not care about your child's illness?
Although it wasn't cancer, she hoped that it would be good for her to transfer it to herself, so that her daughter wouldn't be harmed.

Luo Yun continued: "There is no need to do anything, and there is no need to deal with it now."

"This is a clinically common bone dysplasia, and it is only relatively common in children."

"And because she is a child, you can expect her bone to reshape automatically. You can expect it to recover on its 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 come back for a review. If you find that there is still such a structural groove, then do bone scraping to deal with it."

"She's still too young now, and her epiphysis isn't fully grown. If you deal with it rashly now, it may affect her normal growth. If the upper limbs are not equal in length by then, it will be troublesome." Luo Yun patiently explained not to deal with it now s reason.

Qiqi's mother immediately changed her expression when she heard the words, and said decisively: "Qiqi is a little girl, and her hands are not the same length, so it's not okay."

If you really look like this, not to mention making a living in the future, it will be difficult to find a partner!

Luo Yun nodded: "Yes, we just need to wait for her to grow up and the epiphyses are full, and then perform curettage depending on the situation."

"I'm still too young now, 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 that this hand should not be too forceful, not too naughty, and not fight with other children. It’s even worse.”

"Because her bone is very loose, just this one is very brittle, maybe even more brittle than crispy rice."

"Only after she grows into a normal structure, will she be able to resume normal activities."

Qiqi's mother breathed a sigh of relief for a moment, and asked, "So don't do anything now, just wait?"

At the same time, the stone in my heart fell to the ground.

When Luo Yun was about to answer, the woman's phone rang.

After seeing it, it was her husband who was calling. After connecting, her husband cursed and said on the phone: "Honey, how is Qiqi now?"

"Click on (these liars)."

"Playing in the dark under the lights!"

"That Teacher Wu, she saw our Qiqi had a dispute with other children this morning, so she pulled Qiqi hard, and she grabbed her elbow. She thought it would be fine to hide it, but I asked killed a few of her colleagues and a few children."

"Oh shit!"

"How is Qiqi now?"

Qiqi's mother was taken aback when she heard this.

At the same time, the expressions of Luo Yun and Zhou Cheng changed drastically!
The cause of subluxation of the radial head, it came.

But thankfully, it came too late!
Just say it was a coincidence.

Originally, to determine the trauma, consider the direction of subluxation of the radial head, but the teacher strongly disagreed.

Because it was determined that there was no trauma, I went to consider the direction of bone disease.

As a result, there was a history of trauma!
If the teacher is honest, the two of them felt that the radial head was subluxed from the very beginning, and then the child could move around after it was reset.

The range of motion has been restored, which means that the joint dislocation has been reset!

But in fact, the child's pain has not been relieved...

And if the child is not caused by fibrous dysplasia, but other diseases, after a delay, he will not know what will happen next time he comes to the hospital.

The woman hung up the phone after listening to her husband yelling at her, and asked Luo Yun with a slightly weird expression:
"Doctor Luo, my child is injured, so is it because the bone fiber structure is bad?"

"Actually, is it still dislocated?"

Luo Yun's expression flickered, and the corner of his mouth twitched for a while, before replying: "That's not the case, the bone fibrous structure is poor, and the current diagnosis is the truth!"

"The current diagnosis has nothing to do with whether there is a history of trauma."

"However, the reason why your child has painful symptoms may be because there are structural problems here, and then he was pinched, so there are micro fractures that cannot be shown on the X-ray."

"That's why it hurts, so you guys have to be more careful in the future!"

The woman was visibly disappointed.

She didn't quite understand why Luo Yun said that having a history of trauma was another diagnosis, but now it's not the same diagnosis, and she went around and around, making her a little dizzy.

But he still nodded, looked at his daughter, and sniffed helplessly.

"Thank you, Dr. Luo, from now on, I still have to come to your place for reexamination, right?" Qiqi's mother asked politely.

"Well, it's best to review it once a year to see how it changes. Don't be too diligent." Luo Yun said hurriedly.

Then the woman walked out with her baby in her arms.

Looking at the woman's back, Zhou Cheng and Luo Yun looked at each other again.

They all saw a more dignified look in their eyes.

this thing today.

It can be regarded as a mistake.

Wrong in the wrong.

Then TM's is wrong and right.

But this also shows that clinical diseases are mostly unpredictable. If the thinking remains unchanged, sooner or later it will suffer.

At this moment, Luo Yun dare not say that he really understands joint surgery.

Is this joint surgery?
Strictly speaking, it is not counted, but it occurs near the joints, and it is so rare, so hidden, and if you don't pay attention, it is very likely to be Waterloo.

But, no matter how solemn you are in your heart!
It was only under Zhou Cheng's prudence that this patient was able to walk the most erratic and correct path.

This is also the first time that Luo Yun has a different view on Zhou Cheng's stability...

Still have to be steady, okay?

Am I being taught a lesson?

……

But no matter what, the time of the outpatient clinic is still very tight, so after Qiqi's mother took people out, Luo Yun immediately called in new outpatients.

Today's [-] numbers have already been hung up, so you must read them.

However, Luo Yun suddenly stood up and said to Zhou Cheng, "Xiao Zhou, why don't you try to see one?"

"Shall I take a break?"

Luo Yun decided to change his strategy. This morning, he was the one who took the initiative to attack, so he couldn't find Zhou Cheng's weakness and deal him a heavy blow.And what he said did not surprise Zhou Cheng!
It seems that what I say is very common.This made Luo Yun very unfulfilling.

So Luo Yun made preparations, turned the initiative into a passivity, and asked Zhou Cheng to go up. He knew that he was in the dark, and waited for the opportunity to deal a heavy blow!
In case Zhou Cheng made mistakes during the consultation process, he corrected them himself, wouldn't that be clear?
Zhou Cheng didn't know what Luo Yun was thinking, and his face brightened slightly: "Mr. Luo, can I?"

In fact, there is quite a bit of expectation.

The skills I picked up last night can be useful, so how much gratitude can I get today?
A new copy is just around the corner.

"If you tell you to watch it, you can just watch it. Where is there so much nonsense?" Luo Yun is a bit displeased with Zhou Cheng's character like a turtle with a shrunken head. what?

So Zhou Cheng sat in Luo Yun's position, with the mask covering his mouth and nose, and by the way, he flipped over his own badge, and Luo Yun also flipped over his badge.

Zhang Zhengquan was responsible for bringing the patient in, and when he saw Zhou Cheng sitting and Luo Yun standing up, his eyes widened.

Brother Zhou Cheng, what a big shelf ah?

Are you about to start your consultation?
Maybe it was my appearance that disrupted Luo Yun and Zhou Cheng's arrangements, otherwise, Zhou Cheng might have started to see the doctor right away?
Possibly yes.

Zhang Zhengquan brought in two young girls at the moment. They were only about 20 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 Beautiful girls.

The two of them seemed to be cheerful people. After entering, they restrained their white shirts.After one of the girls sat obediently, she politely said to Zhou Cheng, "Hello, doctor."

With Zhou Cheng sitting and the other two standing, she naturally felt that Zhou Cheng was the oldest doctor.

His eyes were fixed on Zhou Cheng, but after a while, his eyes seemed to light up.

Her companion is also a girl of the same age, and should be a classmate.At this moment, he suddenly became quite cautious, as if his face was still a little 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 di.

The two are on good terms, both wearing jeans and a white shirt.It is not very cold in Shashi in November. They show their delicate arms and forearms. They are tall and slender with long necks, but they are slightly green and immature.

After seeing that Zhou grew up to be a little handsome, he began to feel ashamed.

"What's wrong with you?" Zhou Cheng asked.

"Ah! Oh!"

"This knee of mine has been very painful recently. It has been in pain for quite a long time, but in the last few days, the pain has gotten worse." The girl who sat down heard Zhou Cheng ask her, and then she wanted to understand.I came 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?"

It is still the same sentence, the diagnosis of fracture is defined first, that is the patient in the ward.

First define, then locate, then finalize, finally classify or type, and finally talk about treatment!

However, outpatients need to slightly adjust their way of thinking about consultation.

First locate, then define, and then proceed to stereotype, classify, and then treat.

Zhou Cheng also vaguely had a directional guess in his heart. It might be a meniscus injury, and he should have a history of trauma.

But in view of Qiqi's reasons before, Zhou Cheng decided to ask more detailed questions.

"When I was training some time ago, I had a little pain, but it was not serious, but it became more and more painful later, and it is even more painful now." When the girl mentioned her illness, she frowned tightly.

"Are you a student? What kind of training are you training?" Zhou Cheng continued to ask.

"Yeah." The girl nodded: "I'm a student of UCAS. I'm a freshman this year and I've trained a lot."

"It's the regular training in the school." She may not be able to express it well, or it may be inconvenient to disclose it, but after she finished speaking, she suddenly asked nervously, "Doctor, am I serious?"

"I can't participate in the recent training. I still asked for leave today, and I may have to go back later."

Students of UCAS?

This is a heroine.

No wonder the hair was cut short, if it was a little longer, it should look better, and the dark skin can also be understood.

Zhou Cheng looked at Luo Yun, and found that Luo Yun had no intention of speaking, so he asked Zhang Zhengquan: "Quanzi, will you do a meniscus examination?"

In fact, there are still many things that can be consulted, but the outpatient clinic is not a ward, so it should not be too detailed to waste time.

Although Zhang Zhengquan saw that the two girls looked good, he knew that Zhou Cheng's question was to ask him to have a physical examination, but Zhou Cheng's words made him a bit incompetent.

He smiled and touched his head.

"You go for a physical examination, mainly to check the meniscus and the fork." Luo Yun instructed Zhou Cheng, lest Zhou Cheng continue to waste time.

"I'll give you a physical examination. You lie flat on the bed with your feet facing the door." Zhou Cheng quickly stood up and pointed to the examination bed next to him.

While ordering, she drew the curtain again, and then shouted to her companion: "You also come in together, and stand beside her head."

Hearing this, Luo Yun couldn't help feeling inwardly, this dude is really too steady.

Humanistic care is taken to the extreme.

Of course, this is a good thing.

Otherwise, check alone with the young girl, if she goes to sue you for molestation, no one will testify.

You can't even tell.Either have family members or nurses to accompany them, so as to avoid some accidents to the greatest extent.

When the two girls walked that way, they looked at Luo Yun unexpectedly, because Luo Yun was the one who ordered Zhou Cheng to do things just now, so this handsome guy, isn't he a silver spear and wax head? Looks good but not 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, she wrote in her medical record and said: "Your medial McBurney's sign (+), medial knee joint tenderness. Lateral stress test (-), front and rear drawer test (-)."

"In this case, you may need to have an MRI scan."

Physical examination is only an indication, and auxiliary examinations are needed for diagnosis, that is, X-ray and MRI.

X-rays are mainly to look at the bone and joint space, and rule out fractures or avulsion fractures, osteophytes, etc.

The Mai's sign directionally corresponds to the meniscus, which can only be seen by MRI.

MRI can see soft tissue damage!

Zhang Zhengquan immediately began to write the NMR 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 raised his head 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 expelled from 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 crop at first.

The National University of Science and Technology is not far from the Eighth Hospital, it should be said to be very close.

But Zhou Cheng had never been to such a school, so he didn't know the rules in UCAS.

Zhou Chengcheng hurriedly explained: "Okay, don't cry. It's nothing wrong. Whether you 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 necessary to know whether you can train or not. Not the end result."

The girl's sobbing stopped.

He looked at Zhou Cheng eagerly, with such innocent eyes.Gritting his teeth, he asked weakly, "doctor, what should I do?"

Zhou Cheng continued: "Do an examination first. Make a clear diagnosis! Then I can tell you what to do based on the diagnosis. Otherwise, let me guess one, and then what if it's not what I said?"

"Then you are not at a loss?"

"You go to make an appointment for an MRI first, and then rest until the MRI is done and come to me for a follow-up visit. Then we can think of a way together, okay?"

The girl asked nervously again: "Can the MRI be done today? I've been on leave for a while, and I have to go back to training later."

It is not easy to enter a university, and it is even more difficult to get into the National University of Science and Technology. It is not only good grades that can enter.

She couldn't even imagine what would happen to her if she was expelled from school or unable to graduate because of poor health.

Hearing this, Zhou Cheng wrote a st on the girl's checklist: "Take this to the MRI room for an examination, and you can say that you are an emergency examination. After you finish the test, you don't need to wait for the results, just come up and we will make a decision based on the situation." What should I do next!"

"No matter what the training is, the body is the first. If you don't have enough leave, just extend it a little bit. This is the best way I can think of."

"Okay!" The girl walked out worriedly.

Although Zhou Cheng looked at the girl's back, he felt a little inexplicably complicated, but there was nothing he could do about it.

Sports injuries occur more frequently in young people.

This may affect her life, and even affect her future.

But this has become a fact.

Body-oriented, this sentence is easy to say but hard to do!

Aren't most young people paying for their bodies?

Zhou Cheng looked at Luo Yun, but Luo Yun didn't say much.

I just thought to myself, there seems to be nothing wrong with it, I didn't say anything that shouldn't be said, and I said everything that should be said, as for any words of comfort, Luo Yun couldn't say it right now.

Just because the patient's condition will have a great impact on their life, we should not exaggerate or minimize the consequences of their own disease.

This is extremely unprofessional.

This kind of mistake, Zhou Cheng, a shy turtle, would definitely not make it.

Alas, the patient's condition is too simple.

Wait for the next one.

Look for another chance.

……

"next."

The next patient was also a young man, about 24 or [-] years old, accompanied by a girl who seemed to be a couple or husband and wife.

But when they came, they were still holding plain films, which seemed to be from the No. 1 People's Hospital in Shaxian County.

Did you come here after seeing a doctor in another hospital?
That must be quite troublesome, Luo Yun's mood began to get excited.

Zhou Chengcheng asked about the medical history.

Then I found out that this is a couple, and the wedding was held only two days ago.

The patient is a young man.

According to his statement, he was injured when he broke through the door to pick up his relatives.

At that time, Hongbaoyu opened the crack of the door, so he stretched his legs in, preparing to physically refuse to close the door, and then he was pinched 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 situation serious?"

"Our wedding ceremony was completed, that is, we went to the hospital to see it yesterday."

"After taking a picture, the doctor over there said that there might be an operation. We are worried, so we plan to come here to have a look again." The woman replied a little helplessly.

Welcoming the bride is a traditional ceremony in the Hua Kingdom. Opening the door of the bride's boudoir is a joy in the wedding process, and she can't control other people.Just a little bit apologetic.

Lu Cheng took the film bags from the family members, 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 a little.

After picking out the positive signs and negative signs, I turned my attention to the MRI.

Summarize in your heart.

"The patient has a history of trauma."

"There is knee joint pain at present, no osteophyte on X-ray, no fracture line. The joint space is normal, the patellofemoral joint space is normal, and there is no high and low patella. So soft tissue injury is considered."

"At present, the patient has no special positive signs, so."

Lu Cheng then looked at the T2 phase of the NMR.

MRI reading is divided into layers.

Beginner doctors, when looking at MRI, they only look at black and white, looking for signs of edema!Anyway, just ask where is the swelling?
But doctors who have reached a certain level can directly read the anatomy from the film.

The information revealed by the NMR is too much, even the deformation of the nerves can be read, so Zhou Cheng didn't read the NMR report...

In addition to being able to read the anatomy, the MRI reading of the knee joint also has its own reading skills!

First look at the anterior and posterior cruciate ligaments, then the medial and lateral collateral ligaments, and then the menisci.

However, when he saw the front fork, Zhou Cheng frowned fiercely.

The anterior fork, the full name of the anterior cruciate ligament of the knee joint, starts from the front medial side of the intercondylar eminence of the tibia, heals with the front horn of the lateral meniscus, obliquely goes posteriorly and superiorly laterally, and attaches to the medial side of the lateral femoral condyle in a fan shape.

On the NMR plane, the routinely displayed signal is——

Black.

Now it is whitish, there must be edema, but continuity?
broken!

The rear fork also has edema.

Medial collateral ligament, torn.Lateral collateral ligament, normal.

Look at the meniscus again.

There is also damage to the meniscus, also a classic medial meniscus rupture. III degree injury.

The damage of the meniscus is 3 degrees on the nuclear magnetic resonance. The first degree of damage is a point or a white line that does not break to the top or bottom of the meniscus. The second degree of damage is a rupture of one side, which is a half-layer tear.A third-degree injury is a full-thickness tear.

When visiting an outpatient clinic, the required knowledge reserve is much higher than that in the ward.

When Zhou Cheng was reading the film, Luo Yun also finished reading the film. The mouth covered by the mask made a strange shape, and the eyes shone with light.

It's coming, it's coming.

This is the medial knee injury triad of sports medicine, and here it comes.

Zhang Zhengquan pretended that he knew it well, and looked for white marks on the MRI plane with his hands, and finally pointed to the fat pad inside the knee joint, rolled his eyes at Luo Yun, meaning, Teacher Luo, is there a problem here?
Luo Yun was so angry that his chest rose and fell violently.

"I'll talk about it later." Cursed in a low voice, she didn't want to reveal the answer to the mystery in advance. If the answer is revealed, what should I do?

Zhou Cheng thought for a while, and then asked the young man again: "When you were walking, did you ever feel suddenly stuck?"

In his heart, he thought to himself, how ruthless was this f*ck trapped, so forced?
It's like this, Zhou Cheng felt that there was something strange about this matter.

Although it can be seen that there is damage now, if the ligament is broken if it is caught by the door, it is easy to say, but the meniscus will be crushed, what a coincidence?
Therefore, Zhou Cheng felt that this young man might have been injured before, and the ligaments might not have been broken at that time, but there were still remnants, and then the pinch just happened to completely wipe out the last trace of remnants!

"Or do you feel unsteady?"

The auxiliary examination is only an auxiliary examination, and it is still necessary to determine whether the patient himself has symptoms!
"No." The woman replied helpfully.

Then he looked at his 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 my wedding, when I was playing ball, I suddenly felt a twitch."

"But it's not as painful as it is now." The man vowed.

Zhou Cheng said: "Then you should have been injured when you were playing?"

The young man squinted his eyes and said, "It's normal to have bumps and bumps when playing basketball, so I don't really care about it!"

"And I often take off to catch the ball, dribble, and collide. Does it matter? I have been playing for more than ten years, and I have always been pretty good." The young man frowned.

He loves to play, for no reason, just loves it.

If Zhou Cheng wants to deprive him of his current hobby, what should 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 it was still a rupture in the body, not the front foot."

"At the same time, you have ACL and MCL ruptures."

"These two are not the same injury mechanism."

"So, I'm guessing it's possible that, playing alone, it doesn't break your ligaments, but it breaks your meniscus."

"The meniscus is like our insole, and it is very brittle. If you use too much force, it may break open. But, at that time, your ligament may not be completely broken, and then you were caught by the door."

"The ligament that was still good was also pinched off." Zhou Cheng explained.

When the young couple heard this, they were stunned.

"Is that so? Doctor?" The young man touched his head, his expression uncertain for a while.

The woman also looked at her husband with a suspicious look on her face.

"You didn't say before that you were injured while playing?"

It seemed that the two of them were having a bit of a rivalry, maybe the young man felt that his wife had hurt him, but the woman just proved part of her innocence at this moment.

Luo Yun frowned when he heard Zhou Cheng's words!
Because of this point, Luo Yun didn't think about it before.

No matter how the injury was, understanding the patient’s condition is of no help. No matter how the injury was, the ligament is broken or is it broken, should an operation be performed or should it 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 expect this crop!
This Zhou Cheng?

How did he think of it?

Although it is said that the traceability of the disease is not important to the treatment of the patient itself.However, it is very important for doctors to accurately interpret the types of diseases and to understand the disease itself more deeply!

How was the injury, the mechanism of the injury, can guide the follow-up functional exercise, and the associated symptoms and injuries that need to be considered when encountering other types of diseases!

This week?
How could he think in this direction?

Luo Yun himself, after seeing the patient's MRI results, has been thinking about how to perform the surgery.

When you encounter a problem, you should solve the problem first. This is a natural logic!

However, this is a good thing for the patient. Thinking about how to treat it is conducive to the recovery of the patient, but it is not conducive to one's own understanding of the disease and improvement of diagnostic capabilities.

It is also not conducive to analyzing cases.

Luo Yun's eyes kept turning, this time, Luo Yun considered too many things.

seemingly?

Being pretended by Zhou Cheng again!
Zhou Cheng also noticed the change in the expressions of the two of them.There was no time to see the change in Luo Yun's expression.

He hurriedly said: "Actually, what is the specific reason now is not too important. The important thing is that in this situation, surgery must be done, otherwise, the damage to your joints will be great."

"It is very likely that it will affect your normal walking behind."

Zhou Cheng didn't dare to dwell on the reason anymore, don't make this newly married couple divorce, then the loss outweighs the gain.

The knee joint is unstable, and the meniscus is broken. If there is no surgery to deal with it, then wait for the joint to be replaced in your thirties.

However, what Zhou Cheng said made the young couple a little bit on guard, and asked, "Doctor, I'm going to have an operation? Can your hospital do it?"

They were a little suspicious, whether it was because Zhou Cheng tricked them into having an operation, and that's why he said such a big set of possibilities!
Zhou Chengcheng looked at Luo Yun.

Whether this can be done, Luo Yun said, he still doesn't know how to do it, so it's hard to answer.

Luo Yun quickly said: "In your case, you may still need to go to Attachment [-] or Attachment [-]. Our hospital does not have such equipment. We can do it if it is open to the public, but the incision is too big, and it cannot save costs."

"No need."

Make bricks without straw.

Joint replacement does not require special equipment, but sports medicine requires at least an arthroscope, which is not available in the Eighth Hospital, and it costs hundreds of thousands or millions to purchase a set. The department does not show up, and the hospital does not buy it. It is possible to do such an operation.

Hearing Luo Yun's honest words, the young man really believed in Zhou Cheng and the others.

Said: "Then thank you doctor, we thought it was not a big deal, so let's go to Attachment [-] or Attachment [-] to take a look."

After finishing speaking, the young couple walked out, hurrying.

While walking, 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, "Mr. Luo, I didn't say anything wrong just now, right?"

Zhou Cheng was afraid that Luo Yun would not be able to say much to point out his mistakes when the patient and his family were in front of him.

And Zhou Cheng didn't mind Luo Yun pointing out his mistake at all, it would be best if he could point it out.

It's just that the speaker has no intention, but the listener does.

Zhang Zhengquan also looked at Luo Yun, his eyes full of admiration.

Brother Zhou Cheng is already pretty good, and Teacher Luo Yun is even better. I'm so fucking 'happy'.Two big brothers, I just want to ask when to eat, do you want me to come when you eat?

I don't want to be rubbed on the ground by the two of you.

I'm wrong!
I was so wrong.

Zhang Zhengquan regretted it.

It's hard to eat.

Luo Yun, on the other hand, carefully checked whether Zhou Cheng was teasing him on purpose, but when he saw Zhou Cheng's sincere eyes, he nodded slightly and said, "It's okay! We've covered everything we need to say, it's okay, just keep watching!"

"You keep watching."

Luo Yun was a little lucky at the moment, he was so fucking witty, and turned from bright to dark in time.

Otherwise, it is estimated that Zhou Cheng would laugh at him in private, or add in private what he just said that he didn't think of, right?

Zhou Cheng is really dangerous!

I'm too south!

Live in Bengbu!

……

From Zhang Zhengquan's perspective, Luo Yun would just nod his head up and down for a long time.

Mouth said 'okay'!
I will do this too.Zhang Zhengquan was thinking...

　If you don't prevent theft for a few days, you will lose a lot of subscriptions, please Haihan!
　　
　
(End of this chapter)