top student at medical school

Chapter 74 External Rotation Reduction Method (Please add to your favorites and read on!)
After the young man agreed, Xiao He took him to talk, sign documents, and pay fees. They then went into the operating room to prepare the forearm sling and other equipment after the successful repositioning.

The daughter, one of the family's three, asked, "Doctor, what do we do? Are you just going to leave me here? Can't you call an older doctor?"

Upon hearing this, Fang Ziye took a deep breath: "Although the following sentence is not particularly pleasant to hear, it is quite awkward at this point in time."

"The Chinese Orthopedics Annual Meeting is a large-scale academic conference, and professors and associate professors from almost all major hospitals' orthopedics departments will attend. There is a relative shortage of manpower in the department, which is unavoidable."

"Although the professors have all left, elective surgeries in the department must continue as normal, and emergency patients like you must also be treated as usual. Dr. Jin is currently unavailable because he has another patient who is in more danger, even life-threatening, waiting for him to see him."

"This is indeed a rather awkward point in our department right now, and we can only ask for your understanding."

Fang Ziye explained patiently.

"What about Tongji Hospital or the Provincial People's Hospital?" the daughter asked again.

She just checked, and the level of trauma surgery at Tongji Hospital, Union Hospital, and even the Provincial People's Hospital is probably better than that of Zhongnan Hospital.

"Of course you can go and ask, but basically, whether it's Tongji Hospital, Peking Union Medical College Hospital, or the Provincial People's Hospital, as long as it's orthopedics, they all attend the national orthopedics conference around this time, right?"

"I'm sorry, I need to go and prepare some forearm slings for post-reset fixation. You may have to wait a little longer, but it won't be long."

"Dr. Jin will be back as soon as he finishes that urgent consultation. I've already sent him a message," Fang Ziye replied.

The message was also sent in person.

After Fang Ziye explained, the three of them stopped arguing. Fang Ziye had explained things very clearly and had no guilty conscience at all.

They could understand that the patient on one side was in critical condition, while their own mother was only suffering from pain; the concepts were completely different, and going to other hospitals now would undoubtedly be a waste of time.

She also checked the COA, and it was indeed recently held in Xiamen, Fujian Province. The timing matched perfectly, and the first day of the conference was today. Fang Ziye wasn't lying.

After the young man agreed, he readily signed his name and was then led by Xiao He into the control room.

It's just a simple anterior shoulder dislocation. Reduction is relatively simple with this type of dislocation. It only requires external rotation reduction, also known as Kocher reduction, which was first used in 1870. The success rate of reduction is about 80% to 100%.

Fang Ziye currently estimates his own success rate in repositioning to be at least 90%, but telling patients it's around 70% is naturally a conservative estimate.

After entering the operating room, Fang Ziye instructed the patient to lie flat.

The Kocher reduction technique requires no assistant; only the surgeon needs to perform the procedure.

Hold the patient's wrist with one hand and bend it to about 90 degrees. This is to relax the patient's biceps.

With the other hand, starting from the elbow, use traction to loosen the space between the patient's shoulder joints.

This process requires continuous traction until the joint space is completely released.

Fang Ziye immediately abducted his forearm slightly and gradually externally rotated his upper arm, while his other hand was brought inward so that his elbow was close to the midline of his chest wall, and then his upper arm was internally rotated!

Immediately after the procedure, the patient's shoulder joint snapped, followed by a popping sound as the humeral head of the joint entered the glenoid fossa.

"Bang!" The sound was rather muffled, but quite natural.

At the same time, the young man let out a soft "ouch," and his lying position changed to a slight tilt of his body towards the affected side.

Fang Ziye released his strength and asked, "The deformity at the shoulder joint has disappeared, and the joint has returned to its socket. How is the pain?"

"It's much better, but it still hurts a bit." The young man's injury was to his right shoulder joint, and he placed his left hand on his arm, gently stroking it.

"Stand up and move your shoulder joints, mainly doing abduction and extension, then flexion and raising overhead. If you have no problem with these active movements, put on a forearm sling and wear it for about half a month, then you can take the forearm sling out." Fang Ziye instructed while demonstrating.

The young man didn't really trust Fang Ziye, but he was determined to give it a try and get back to work as soon as possible.

But Fang Ziye's actions and confidence led him to follow without hesitation.

The more he did it, the more he felt the pain in his shoulder joint gradually ease. After slowly raising his right hand above his head, his eyes lit up: "It really doesn't hurt much anymore, Dr. Fang."

"Once the manual repositioning is achieved, the pain and discomfort caused by the joint dislocation will naturally be relieved."

"Just to be on the safe side, you should go downstairs and get an X-ray of your shoulder joint for a follow-up examination. We'll both be at ease knowing the joint has repositioned itself. Okay?"

"We'll put another forearm sling on you. The doctor has already ordered the follow-up X-ray. Go down to the emergency room and get an X-ray done. You don't need to wait for the results. Just come back up. If there are no problems, you can leave immediately."

"No medication is needed. If you still experience chronic pain after the repositioning, it may indicate a rotator cuff tear, in which case you should come back for a follow-up examination."

"However, based on the current dislocation and assessment of the severity of the injury, the chance of a rotator cuff tear is not high. But nothing is absolute. As doctors, we can only do a statistical analysis based on the injuries of other people, and we cannot guarantee anything for you."

"Even if only one in a hundred people has a rotator cuff tear, we doctors wouldn't dare say you're one of the ninety-nine," Fang Ziye joked, while instructing Xiao He to help put on a simple forearm sling.

The forearm slings used in trauma surgery are already standardized and do not need to be made by tying knots in bandages, making the procedure exceptionally simple.

"Thank you, Dr. Fang. I'll come back to see you later."

"This morning, I was indeed going to meet a rather important client in the vicinity. I was planning to ride a small electric scooter, but unexpectedly, I fell down as soon as I got to the bridge on Han Street."

"That step over there is too inconspicuous," the young man complained.

Fang Ziye smiled upon hearing this: "Then I think you can report it to the road administration. Our hospital has recently seen at least two people fall down there..."

"Everything else is fine. After you go back, just keep up with the functional exercises and don't think of yourself as a patient. You will still need the forearm sling for additional fixation, just in case."

"Don't lift heavy objects, that's the most important thing."

"If you twist it by a hundred or eighty pounds right after it's been put back in place, or if you go to the training room for long-distance training, that won't work." Fang Ziye joked with the other party in this way, thus completing his instructions.

The young man who came with him was his colleague and assistant. He was riding a different electric scooter. When he saw his boss fall, he quickly braked to avoid falling himself and then hurriedly brought the person out.

Fang Ziye was delighted to see that he had gained another 10 knowledge points.

(End of this chapter)