top student at medical school

Chapter 75 Large-Scale Delivery and Targeting?! (Please add to your favorites and read on!)
Although adding points to the Reset Technique previously consumed more than ten times the knowledge points, once the skill level is up, it's yours to keep. Any extra points earned are pure profit.

As they stepped out of the control room, they saw the family of three standing at the door, curiously peering inside. They noticed the young man playfully teasing Xiao Hehua and looked at Fang Ziye with a hesitant expression.

A few seconds later, the woman spoke first: "Um, Dr. Fang, can you handle my dislocation?"

She changed her name.

“You’re willing to give me a chance to try. I might succeed, but it certainly won’t be as good as Dr. Jin’s.” Fang Ziye lowered his voice even further.

“Give it a try,” her husband nudged her elbow and suggested in a low voice.

"Dr. Fang?" The aunt was still a little embarrassed, so her tone was pleading.

"Auntie, you don't need to be embarrassed. If you're willing to trust me, we can take a look at the X-ray first to confirm the diagnosis. If I'm not capable enough to handle it, then I won't do it." Getting angry with a patient is something only a very immature person would consider.

Solve the problem, even if it's just helping with a diagnosis and confirming that manual reduction can be performed; this can help avoid medical disputes.

Orthopedics is the surgical department with the highest incidence of medical disputes because patients have obvious pain and injury when they are admitted to the hospital.

"Thank you, Dr. Fang!" The three thanked him first, then went into Fang Ziye's office and gave him their medical records.

Dislocation only dislocates the humeral head; the acromion, scapula, and other structures of the shoulder joint remain relatively fixed. The difference in dislocation is that the humeral head deviates and shifts relative to these structures.

When X-rays show the shoulder joint, the best thing to look at is the fracture, followed by the dislocation. Furthermore, by observing the degree and angle of the dislocation, the possibility of soft tissue injury can be inferred without the aid of MRI.
This is not difficult at all; Fang Ziye's X-ray reading skills have already reached level 3...

However, after ruling out a fracture through X-rays, and further examining the angles and degree of displacement listed on the X-rays—

Fang Ziye glanced at the woman and then explained, "Auntie, your condition is currently clearly diagnosed. It's the same as that man's case, anterior dislocation, but yours is a mild to moderate anterior shoulder dislocation."

"What is meant by mild to moderate? It means anterior shoulder dislocation, and there is an assessment of the severity."

"Mild dislocation is: anterior shoulder dislocation involving only the anterior part below the rotator cuff, while the upper part of the rotator cuff remains within the glenoid fossa, with mild muscle or ligament damage. That guy just had that."

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

"Your condition isn't moderate yet, but it's very close, and it's a bit more serious than his, so I need to give you a physical exam."

Fang Ziye explained the professional terms, and although the technical details might not be fully understood, the explanations were at a moderate level, which should give the other party a general idea.

Listening to Fang Ziye's eloquent explanation, the aunt's daughter was stunned:

"so serious?"

"So? What are the chances of me having soft tissue injury or rotator cuff tear?" She probably knew a little about sports injuries. For example, ligament ruptures and rotator cuff tears both require surgery.

“From a broad statistical perspective, it’s only a possibility, but for you personally, it’s either there or it isn’t. That’s because your injury has reached a level close to moderate.” Fang Ziye’s answer was ambiguous, but it was actually extremely professional.

Statistical significance is only useful in the context of big data; for an individual, every possibility is 100%!

"Well? There's really nothing we can do about it. What if my mom's repositioning fails and causes other damage?" the girl continued, her tone much gentler.

"Doctor, you're not trying to scare us because we were rude to you earlier, are you?" the aunt's husband joked with a smile.

Fang Ziye smiled slightly: "That's not the case. Rather than scaring you, I'd rather tell you directly that our hospital's current doctors can't handle it. However, to be more precise, I need to conduct more examinations to ensure the accuracy of the diagnosis. I need to perform several tests to confirm that this is simply an anterior dislocation..."

Fang Ziye then said something very professional, which was also what Fang Ziye was supposed to do—

This is the classic sequential physical examination procedure for diagnosing anterior shoulder dislocation. The procedure and description are quite complex and professional.

The purpose and procedures of the shoulder joint Apprehension test (fear test), Relocation test, and Release test.

After he finished speaking, the other party was a little confused, but Fang Ziye's long string of absolutely professional terms immediately made them trust him more.

After obtaining consent, Fang Ziye took the aunt into the operating room and had the aunt's daughter observe from inside to avoid "medical disputes"—when interacting with female patients and conducting physical examinations, there must be a third-party witness, preferably a family member of the patient or a female employee of the hospital.

Of course, Xiao He was also present when the patient's daughter was there.

Xiao He stood by, observing and making comparisons.

After Fang Ziye finished the procedure, he asked Xiao He to take the family members to have a consultation and sign the consent form: "Auntie, the current diagnosis is clear. It can be treated by manual reduction. Moreover, the degree of dislocation should not be moderate at present, but only mild. Therefore, the chance of soft tissue damage is not high."

"After you sign the papers and pay the fees, we can proceed with the repositioning."

Xiao He left the operating room with her daughter. The aunt was a little confused: "Doctor, the few times you practiced on me just now felt quite good. Could you just do the repositioning for me? Your technique is so good, you can definitely do the repositioning directly."

"No, Auntie. Procedures are procedures. Informed consent, conversations, and signing are necessary steps. These are your legal rights. If I skip them, it would be illegal in non-emergency situations."

"Wait patiently, there's no rush." ​​Fang Ziye wasn't going to fall for it; once he got carried away, he immediately had the repositioning done.

In case your daughter is sensible and knowledgeable, she can report it to the medical affairs department.

There is no risk of skipping a level of surgery, but if the treatment is performed against the patient's consent, they will be severely injured, if not killed!

This is a lesson learned through the blood and tears of many predecessors; there's no need for it, and Fang Ziye wouldn't be so impulsive.

A few minutes later.

After the conversation and signing were completed, Fang Ziye saw the signed consent form and once again performed the external rotation and repositioning method.

This operation took a little longer.

It took more than two minutes to get it back in place!

The auntie cried out in pain at first, then immediately felt the pain subside, and her eyes lit up: "Ouch, ouch, that feels so good..."

"Right, Auntie? We wouldn't target you specifically, but your situation is indeed more serious, and we need to be careful," Fang Ziye replied with a grin as he felt his knowledge points increase by 15.

After all, manual reduction is a complete treatment of a disease, which brings far more knowledge than simply suturing an incision or performing a small debridement and suturing in the operating room!

Large shipment!

(End of this chapter)