Pure doctor Wu Xie

Chapter 80 Congratulations and Appreciation (for collection, for follow-up reading)
Hearing this, the corners of Lin Peiyuan's eyes twitched.

After being registered, a doctor can practice in a medical and health institution according to the registered place of practice, type of practice, and scope of practice, and provide corresponding medical and health services.

Before coming here, everyone knew that in Shazhen, there is only one registered Chinese medicine clinic, and it just so happens that the person in charge of the Chinese medicine clinic is applying for cancellation.

Therefore, strictly speaking, there are other Chinese medicine centers that provide medical and health services before they are registered.

What is not seen is pure. It cannot be said that in order to promote culture and protect inheritance, you just turn a blind eye and close one eye. If you just see it and ignore it, then it is impossible to allow such chaos to exist.

Either this Chinese medicine hall is particularly awesome, and the background is very comfortable.

Or they are completely blind to the law and don't take the rules seriously!

The buddy who started to spin the ball heard Wu Xie make the question so serious, so he restrained his smile and asked, "Doctor, it's not that serious, is it? Don't scare us."

Wu Xie explained: "As long as you didn't mess with it yourself, bear with the pain, it will be a little bit."

There will be pain during the physical examination. This young man has been subjected to physical examination or "reset" pain stimulation after dislocation before, so he will form a defensive conditioned reflex, which can't be helped.

The physical examination is still to be done.

There is no way to check the range of motion. The patient has severe pain after dislocation and cannot cooperate with the inspection of active and passive range of motion.But you can help determine the relative position of the dislocation and the shoulder joint by touching the position of the acromion and humeral head!

Only the humeral head is dislocated. The acromion, scapula, and other structures of the shoulder joint are relatively fixed. The difference in dislocation is actually the deviation and displacement of the humeral head relative to these structures.

Wu Xie felt that the position of the humeral head was at the front and bottom of the acromion, and preliminarily deduced that this was an anterior dislocation of the shoulder joint.

However, before conducting a definitive physical examination, Wu Xie had to take a look at the plain film to rule out dislocations accompanied by fractures, or fractures accompanied by dislocations.

A complete diagnosis of anterior dislocation of the shoulder joint can rely on three quite professional physical examinations - shoulder joint Apprehension test, Relocation test and Release test.

Wu Xie has done it before.

But knowing that the purpose of these examinations is to determine the anterior dislocation of the shoulder joint, it is also necessary to evaluate whether these physical examinations can be performed, for example, to rule out fractures.

If there is a fracture with dislocation, and you perform a physical examination for the diagnosis of anterior dislocation, then you are a layman.

Patients not only suffer from unbearable pain, but also may lead to redisplacement of fractures and aggravate soft tissue damage.

It is difficult to study medicine. It seems that these things are in the process of diagnosis and treatment, but in fact there are many places to be evaluated. There must be no mistakes in every step, and it must be evaluated in advance.

"Your dislocation must exist, but it is difficult to judge the fracture with the naked eye."

"I'll go to see your film again, so I can do the next physical examination. You come in with me, and the physical examination will be performed on the examination bed later." Wu Xie confessed to the injured young man in this way.

Listening to Wu Xie's words with a bit of professionalism, the young man glanced at Lin Peiyuan, who was the oldest and looked the most famous doctor, and followed Wu Xie into the consultation room.

Lin Peiyuan and Guo Lixiang also followed in.

When the X-ray shows the level of the shoulder joint, the best thing to see is the fracture, and then the dislocation, and through the degree and angle of the dislocation, the possibility of soft tissue injury can be inferred without MRI-assisted diagnosis!
This is not difficult, I have done it once for my old watch before.So it's just a repetitive operation...

After the diagnosis of fracture was ruled out by X-ray, the diagnosis of anterior shoulder dislocation was further supported by physical examination, and the angle and magnitude of dislocation listed on the X-ray were further supported.

Wu Xie glanced at Lin Peiyuan, and then confessed while writing the medical records: "In your case, the temporary diagnosis is very clear. It belongs to mild to moderate injury of anterior shoulder dislocation."

"What is mild to moderate? It is an anterior dislocation of the shoulder joint. There is a severity assessment."

"Mild is: an anterior dislocation of the shoulder involving only the anterior part of the lower rotator cuff, the upper part of the rotator cuff remaining in the glenoid socket, mild muscle or ligament damage.

"Moderate is: the upper part of the rotator cuff protrudes out of the joint socket, while the front part of the lower part of the rotator cuff has been displaced, and the muscles and ligaments are severely damaged."

"You're not moderate yet, but between mild and moderate."

Although some of the terminology, young people do not understand, but mild to moderate, he can probably have an understanding!

And listening to Wu Xie's eloquent words, and the old doctor watching the battle beside him, he trusted him a little more: "Doctor, what should I do now?"

"There are two types of treatment. Our hospital has limited conditions. The first is that you perform manual reduction in our hospital. After the reset, observe for a period of time. If there are still soft tissue injuries, such as rotator cuff injuries, there will be occasional injuries. Painful symptoms, you have to go to a better hospital for further treatment.”

"The second is that you go directly to the county hospital or the state hospital now, and all the examinations, such as MRI, are done, and then they are all processed at one time. After all, you are young, so it mainly depends on your own thoughts."

"If you choose to reset in our hospital and then continue to observe, then we will sign an informed consent form for the operation. Let me tell you in advance that the level of our township hospital is limited, and you may not be able to get in through manual reset. You may still be transferred to the county hospital. Yes." Wu Xie explained in detail and earnestly.

After all, Lin Peiyuan is here, so the diagnosis and treatment procedures must be more objective, and there are some things that cannot be said, for example, it will cost more to go to the county or state.

How much other people spend is none of your business?
"so serious?"

"So? What kind of soft tissue injury do I have, and is there a high chance of rotator cuff injury?" The young man plays basketball and often watches the NBA. He knows that sports injuries, such as ligament rupture and rotator cuff rupture, require surgical treatment.

"From a large-scale statistical point of view, there is only a certain possibility, but for you personally, if you exist, you exist, and if you don't exist, you don't have it. Because your damage has reached a level close to moderate." Wu Xie answered ambiguously , but is actually extremely professional.

"And you play ball. If you watch the game, you should know that if there is such an injury, it may require further surgery, otherwise there will be many sequelae."

"Like the Black Mamba..."

Statistical significance is only useful under big data. For individuals, every possibility is 100%!

Wu Xie happened to know the Black Mamba, the famous NBA player Kobe Bryant had a rotator cuff injury before, so give him an example, I believe he will understand.

"Then? That's really nothing to do. If I can't reset it, it will cause other damage, right?" The young man asked again, obviously wanting to be more on the safe side.

"You decided to deal with this problem here. I will talk about it when I talk to you about the operation. Don't you rush to make a decision. Before the operation officially starts, you can stop it at any time and choose to go to the county. Those who are inside or higher-level hospitals, we need to discuss this in detail, I will print out the informed consent form for the operation, okay..."

"Okay!" The young man nodded and asked again: "I don't need family members to come..."

"If you're not in the hospital, you don't need your family members..." Wu Xie said so, borrowed the printer from the emergency room, found the corresponding template, and after making revisions, he talked with the young man and his good friends on the spot signature.

During this process, Lin Peiyuan, Guo Lixiang and others all left the consulting room to avoid.

Lin Peiyuan's eyes shot out a deep sense of relief and appreciation.

(End of this chapter)