Gou is practicing medicine in the clinic

Chapter 180 Difficult Osteophytes, Introduction to Extraskeletal Diagnosis
Sitting on a hot chair that someone else has just sat on, if the other person is carrying some kind of infectious virus, there is a certain risk of infection.

Although the human skin has a strong barrier ability, it is best to be careful.

"Here, you won't dislike the one I used, right?"

She took out a water mattress from the drawer, first put a newspaper on the chair, and then spread the water mattress on Li Jingsheng.

It's actually a cute pink with cartoon patterns painted on it.

"You still enjoy it!"

Li Jingsheng sat on the water cushion, which was cool and soft, very comfortable.

"Hee hee, who doesn't know how to enjoy it! How is your orthopedic diagnosis level? Help me look at this case."

She smiled and invited him to watch a medical case on the computer together.

Li Jingsheng moved his chair a little closer to her.She didn't have any intention of avoiding it, but her pretty face was slightly flushed.

After all, it was in the office, and it was the first time that she sat so close to a person of the opposite sex, so she was somewhat embarrassed.

The medical history is not complicated.

This patient suffered from a car accident more than a year ago, resulting in a fracture of the right radius and a certain degree of defect, and dislocation of the distal radioulnar joint.Then I chose to do surgery in the second hospital.

Looking at the past medical records, the last operation was open reduction, ulnar head transplantation, and internal fixation with plates and screws.

Postoperatively, the patient's bone wound healed fairly well.

However, patients often report pain on one side of the wrist, especially when moving the wrist.

The result of the review at that time was that there was osteophyte formation on the ulna stump.

However, it can be seen from the film that the size of the osteophyte is very small and the density is also very low. The attending doctor suggested that the patient be observed for a period of time before further treatment.

Osteophytes and bone spurs are more common after joint injuries.

Generally, it is due to the hyperplasia caused by repeated friction and stimulation.

It will bring a certain degree of pain to the patient, but generally it will not affect the patient's joint movement function.

Moreover, some patients gradually calmed down after a certain period of adaptation.

In the case of this patient, it is entirely advisable to suggest observation.

It's just that I didn't expect that as time passed, the man's pain not only did not decrease, but gradually increased.Now the patient's forearm can hardly rotate, and the pain is also excruciating when reaching for things.

In desperation, I had to come to see a doctor again.

After X-ray examination, it was found that the patient's ulnar stump osteophytes had increased many times, and the density was close to normal bone quality.

Repeatedly comparing the patient's preoperative, postoperative and one-year follow-up films, as well as the current film, it can be seen that the patient's ulnar stump osteophyte growth is particularly strong.Its length and thickness are close to the ulna.

The whole is conical, and the medullary cavity can be seen.

The fracture site of the distal radius has healed.

"The patient's pain must be caused by the osteophyte. Wouldn't it be enough to directly remove it?"

Li Jingsheng's extraskeletal level is average, but fortunately, his basic knowledge of orthopedic surgery is fairly solid.

In addition, his general surgery diagnosis has reached the proficient level, which is somewhat helpful for the diagnosis ability of the extraskeletal area.

"The difficulty now is not how to deal with the osteophyte, but after the osteophyte is removed, as long as the patient's right hand moves, because the stump bone is unstable, when the swing is slightly larger, it will irritate the surrounding tissues and cause pain. In this way, it can still New osteophytes will regrow."

Ou Qinglan was worried about this.

"I checked the information, and the regeneration of stump osteophytes is almost an inevitable complication of this kind of surgery, and there is no way to avoid it."

For tissue hyperplasia, it really hurts the doctor's brain.

Needless to say, scar hyperplasia is more difficult to eliminate than cancerous tumors.

Bone hyperplasia is also very difficult to deal with.

It is easy to relapse after being cured.

Clinical mammary gland hyperplasia makes lesbians even more frightened, fearing that they will directly become cancer after 4A.

"Didn't you ask the superior doctor for advice?"

"Dr. Ruan said that he wanted to exercise my clinical thinking and let me think on my own."

The Dr. Ruan she was talking about must be the sharp-mouthed monkey-cheeked Dr. Ruan Xiaoqin.

This person is 37 and [-] years old, at least he is an attending doctor.

It has some status in the department.

Ruan Xiaoqin was not seen today.

"Is the patient not yet scheduled for surgery?"

"No. The surgical plan has not been determined yet, and we are going to discuss it this afternoon."

She shook her head.

"Are you from Professor Wu's group?"

"Correct!"

"Didn't your group only study bone cement treatment?"

"Who said that! Bone cement treatment is a special treatment item that Professor Wu specializes in. Our group mainly treats bone trauma cases. We also have a little involvement in joints."

It turned out to be the case.

Thinking about it, there are not many patients treated with bone cement in a year.

If the hospital maintains such a large group of doctors and only treats a few orthopedic patients who are willing to receive bone cement treatment a year, it may have closed down long ago.

It is impossible for hospital leaders to agree.

Bone trauma is a big item, and there are still a lot of patients.

"It's okay, I'll check the information for you."

Li Jingsheng was idle anyway, took out his mobile phone and searched the Internet for relevant literature on osteophyte treatment.

There are quite a lot of research on this aspect, but there is not much relevant treatment experience.

Useful even less.

No wonder Ou Qinglan felt distressed.

Fortunately, Li Jingsheng's English reading ability is not bad, so he entered an international medical exchange forum and began to check related posts.

Because the registration threshold of this forum is very high, only doctors with certain achievements in the field of surgery can become registered members.

He can only flip through the pages as a tourist.

Visitors cannot post, reply, or search, but they can consult some surgical discussion posts that are open to the public.

In order to help his girlfriend, he also put in all his energy.

When opening a clinic, he often went to delve into some surgical clinical knowledge, and finally discovered this website.I feel that the quality of the posts in it is very high, and most of the people who post are top leaders in the field of surgery.

He has kept the website since then.

It's a pity that because of its low status, there are no honors and certifications that can be obtained, so after submitting the registration application, it has been under review.

The forum announcement stated that in order to ensure the quality of this medical forum, there is a high threshold for registered members.

And even if you successfully register as a member, you can't pour water indiscriminately.

If there are serious mistakes in the published posts or replies, points will be deducted, and membership will be canceled if the accumulated points reach a certain point.

After searching with his mobile phone, Li Jingsheng paid off, and finally found an authoritative statement on the formation of osteophytes from stumps.

"Most of the stump has osteophyte regeneration, and in the case of a large size, it is mostly due to subperiosteal osteogenesis."

In this way, the regeneration of osteophytes has a lot to do with the stimulation of the periosteum.

In order to verify whether this netizen's point of view is correct, he quit the forum and began to frantically search for information about periosteum and osteophytes.

After multiple verifications, it can be basically confirmed that the netizen's point of view is accurate.

After finding this step, Li Jingsheng already had a bottom line in his mind.

He noticed that his orthopedic surgery level seemed to have improved, and subconsciously glanced at the property panel.

There is actually a new medical skill in the diagnostic skills column.

Intro to Orthopedic Surgery 0/10.

He was particularly pleasantly surprised to be able to raise the diagnosis of orthopedic surgery to the entry level at this critical moment.

It has been three days since he joined the orthopedic surgery department. Although he has been working in the manipulation clinic, if he can improve the diagnosis level of the orthopedic surgery department, his various abilities will be greatly improved.

It is even more crucial to his promotion in orthopedic surgery.

No matter how good the technique is, it is only because no one can replace it.

But in terms of academics and doctor titles, it is of little use.

If you are exhausted, you will be like Dr. Xu, eat well, drink spicy food, marry a beautiful wife, and live a happy life.

Now, the diagnosis of orthopedic surgery has reached the entry level, which may not be useful to other orthopedic surgeons, just the lowest passing level.

For Li Jingsheng who has an attribute panel, it is equivalent to having a basis for opening and closing.

He checked the balance of his life points, because he had just upgraded his massage skills to the Xiaocheng level in the morning, and spent 490 points of life points, so there are not many left now.

There are only 67 health points in total.

This is only after bone setting and many patients can there be so many patients.

In general, as long as he has the opportunity to work in the orthopedic surgical manipulation clinic, the acquisition of health is guaranteed.

Now that he is no longer an apprentice, he already has the ability to perform medical treatment independently, so the speed of earning life points must be much faster than before.

In the past, it was easier to earn fifty or sixty health points by working for two hours in the morning.

Now working all day, earning one or two hundred health points is completely stress-free.

It's even possible to earn more.

Therefore, without any hesitation, he directly added 10 proficiency points to the newly mastered orthopedic surgery diagnosis.

Orthopedic surgery diagnostic proficiency 10/100.

This medical skill has instantly improved from the level of a junior resident to the level of a senior resident, and it is basically on par with Dr. Qin without any problem.

But Doctor Qin must be stronger.

Because Dr. Qin has been in the general hospital, he will be promoted to attending soon.

Li Jingsheng has just been promoted to the level of a senior resident doctor, so there is still a certain strength gap between the two.

With the proficient level of orthopedic surgery diagnosis ability, coupled with the proficient level of general surgery diagnosis, Li Jingsheng has a little direction when he thinks about the difficult case in front of him.

No longer like before, like a headless chicken, unable to grasp the point.

He began to think about a feasible surgical plan.

The main reason is the lack of surgical experience in the field of orthopedic surgery.

So even though he has found out the cause of the disease and has a rough surgical direction, the specific implementation plan is rather vague.

At this time, Ruan Xiaoqin walked in.

Ruan Xiaoqin's eyes changed slightly when he saw that Li Jingsheng was also there and took Dr. Qin's seat.

But didn't say anything.

After a while, Professor Wu also came in. Standing at the door, he saw Li Jingsheng who was sitting very close to Ou Qinglan, and his face twitched.

The day before yesterday, when Li Jingsheng and Ou Qinglan were sitting side by side at the front door, he was furious.

Today, Li Jingsheng directly sat in Doctor Qin's seat, and even moved the chair so that he was almost next to Ou Qinglan.This completely ignored Professor Wu's warning yesterday.

And there are suspicions of getting worse.

The other doctors in the office couldn't help but sweat for the two of them.

They all shrank their necks, waiting for Professor Wu's thunderous anger to pour out.

It's just very interesting. Although Professor Wu had a gloomy face, unexpectedly he didn't get angry.

This surprised several doctors in the office.

"The doctors of our second group went to the consultation room to discuss two cases together."

Professor Wu is also very helpless.

Facing a lawless and monstrous young doctor, he really couldn't help himself.

The patient the day before yesterday was rescued, and he relied on Li Jingsheng's help.

"Ok!"

The three doctors in the second group agreed in unison.

"Where's Xiao Qin?"

"Director Hua told him to go to work."

"Call Xiao Qin and ask him to go to the consultation room to discuss and study together when he has time. These two cases are very typical, and they are especially worthy of your young doctors' study and research."

After Professor Wu finished speaking, he left directly.

Probably because he was afraid to stay here and see Li Jingsheng and Ou Qinglan flirting with each other to make him angry.

"Doctor Ou, hurry to the consultation room! You call and inform Dr. Qin."

Ruan Xiaoqin deliberately separated Ou Qinglan and Li Jingsheng.

And deliberately created some opportunities for Dr. Qin to get in touch with Ou Qinglan.

"it is good."

Ou Qinglan took out her mobile phone and called Dr. Qin on the spot.

The second group, Qin Fei.

This is her saved phone name.

"Doctor Qin, where are you now?"

"I'm helping Director Hua sort out some patients' medical records. Is there anything I can do for you? As long as I can do it, I will do my best to help you."

Doctor Qin's imagination is really extraordinary.

The heart of being courteous makes people laugh even more.

"Thank you for your kindness. I have nothing to do. Professor Wu just informed all the doctors in our second group to discuss the case in the consultation room. If you have time, you will go there immediately."

"Okay, okay, I'll come right over. Have you figured out a solution for the case of the ulnar stump with osteophytes? Would you like me to help?" Qin Fei immediately regained his energy when he heard the case discussion.

It is estimated that Director Hua temporarily arrested him to sort out the medical records and make a seat for Li Jingsheng, making him want to die.

Writing medical records and medical history is a very painful thing.

Organizing the medical records is equivalent to studying the medical records from beginning to end, and revising where there are problems.This process is rather tedious.

Of course, there are definitely benefits.

Studying a medical record from beginning to end is equivalent to treating a patient clinically.

A large amount of clinical experience can be obtained.

Etiological diagnosis, the effect of medication, surgical plan and prognosis, etc., can be learned.

"Thanks, I'll figure it out myself."

After finishing speaking, Ou Qinglan hung up the phone.

She doesn't give other men the slightest chance.

Li Jingsheng must be very useful in his heart, and at the same time, he was also a little curious, what exactly did Ou Qinglan like in him?
If you want money, you don't have money, if you want status, you don't have status.

In terms of medical skills, there are many young doctors who are better than Li Jingsheng.

"You go to work at the manipulative reset clinic at one o'clock, and there are 23 minutes left. Come with me to the consultation room, okay?"

She extended an invitation to Li Jingsheng.

"Holding hands?"

Li Jingsheng raised his eyebrows, deliberately teasing her.

"If you want to see Professor Wu smashing the table, just do it! Besides, if you really want to experience the romance of holding hands, you can invite me to watch a movie at night or have supper! But let me tell you in advance that I have to come back before eleven o'clock." Home."

She responded unwillingly.

This girl is so passionate.

Just a touch and there will be a response.

This is the importance of two people seeing eye to eye.Closer to the eye, there is almost no resistance when the man pursues the woman.

Li Jingsheng should fit her eyes.

The two had known each other for a while, and through many contacts, she should have a general understanding of Li Jingsheng's character.Judging from her reaction, she must have a good impression of Li Jingsheng.

"today?"

Li Jingsheng should be fine after get off work, the worst thing is that he won't read books or practice surgery tonight.

It's not a bad thing to be able to ask her to watch a movie together to warm up the relationship.

If you want to be happy in life, love, friendship, and family affection are all indispensable.

The best way to get out of the pain of a broken relationship is to fall in love again.

After breaking up with his girlfriend, he has been burying his sadness deep in his heart.

I think about working hard every day, trying to change the operating conditions of the small clinic, and try not to leave myself sad time.

Withdrawing the rented house is not only out of economic considerations, but also because I don't want to hurt the scene.

In the dead of night, loneliness makes him feel very painful.

What I can do is to read and study desperately, or practice surgery until late at night, so as not to let myself think about love-related memories.

If Ou Qinglan can really fill this vacancy, he will no longer have to be afraid of loneliness and loneliness in the middle of the night.

"It doesn't seem to work. Today I have to be on the night shift. Tomorrow will be the night shift. I should be able to get off work the day after tomorrow. Can I do it the day after tomorrow?"

Scheduling doctors, the hardest ones are interns, regular trainees, and residents.

Sometimes there is not enough manpower, and it is not uncommon for us to work 36 hours a day when we are busy.

Especially the emergency department and operating room are often so busy that people can die suddenly at any time.

"Okay, I'll ask you out the day after tomorrow."

Li Jingsheng can't let her take the initiative every time.

"Hehe, I thought you were a big log! It seems that you are not! Let's go, let's go to the consultation room."

She smiled happily, showing her white and neat teeth.

It is undeniable that she looks really charming when she smiles.

I really don't know what that old hooligan Professor Wu is thinking, such a cute and beautiful girl, he is enough to be her father, and he has the nerve to make such a crooked idea.

There are not many such things happening in hospitals, and there are not many.

It is almost an open secret that many of the head nurses are the lovers of the dean in a compound with a slightly worse style of work.

Some professors will get stuck with young female doctors and refuse to graduate or join good research groups.If you want to graduate and join a research group, you have to devote yourself.

Ou Qinglan is now Li Jingsheng's girlfriend, he will definitely not allow that kind of thing to happen.

If Professor Wu didn't know what to do, he wouldn't mind ruining that old hooligan.

This does not require any personal connections, just use the routine he learned from Boss Zhao when he opened a clinic in Chengnan Old Street, and he can teach Professor Wu how to behave with his tail between his legs in minutes.

(End of this chapter)