top student at medical school

Chapter 76 This is what you call professional (Please add to your favorites and read on)

"Shoulder Apprehension test: Have the patient lie on their back with their arm extended to the side and elbow bent at 90 degrees. The doctor places their palm on the patient's shoulder and then uses their other hand to pull the patient's arm forward and rotate it while observing whether the patient experiences fear or shoulder discomfort."

"If signs of anterior shoulder dislocation appear, it is likely that the diagnosis is anterior shoulder dislocation."

"Relocation test: For patients with a positive Apprehension test, a relocation test is required to confirm the diagnosis. Based on the Apprehension test, the doctor gently pulls the patient's arm backward and then observes whether the patient experiences shoulder pain and fear. If the symptoms are relieved, the diagnosis of anterior shoulder dislocation can be confirmed."

"Release test: For patients with a positive relocation test, a release test is required. Following the relocation test, the doctor removes the hand that was pulling the arm backward and observes whether the patient experiences shoulder discomfort and anterior dislocation symptoms again. If the shoulder symptoms reappear, anterior shoulder dislocation can be diagnosed..."

"These are the things I determined when I examined the last aunt."

“Patients like her, who are quite stubborn, and whose daughter seems to only have a superficial understanding of the disease, require the utmost care. Therefore, a very clear diagnosis and assessment of the specific injuries are essential before manual reduction can be performed,” Fang Ziye explained to his junior apprentice, Xiao He.

Xiao He nodded hurriedly and replied with a smile, "Senior brother, you know so much!"

"Hey, what's the big deal? This is just the most basic physical examination in sports medicine. The joint examination in sports medicine is really complicated and meticulous."

"Besides, what I know is also what your senior brother Xiong Jinhuan knows. Just read more books, finish reading the textbooks on orthopedic trauma surgery, and thoroughly understand them, and that'll be about right." Fang Ziye smiled casually, not daring to be arrogant.

These are indeed just the basics.

Fang Ziye left the ward only after reviewing the X-ray results of the two patients.

Just then, Jin Hongzhou called to ask, "That patient agreed to let you reduce the size, right? The second X-ray shows the reduction result?"

His tone was full of admiration.

Who wouldn't love a junior brother like that?

He can handle things and report in a timely manner. After the reassignment is successful, he still works steadily and provides him with the results for review. If everyone were as reliable as Fang Ziye, his workload would be reduced by at least one-third.

"Yes, Brother Zhou, I'm worried that if I don't handle it well, then Brother Zhou will have to clean up my mess."

"Brother Zhou, that aunt's dislocation X-ray is the first one before the reduction!" Fang Ziye continued to explain.

"Okay, I understand. Ziye, you're great. You explained it very clearly in your message."

"That's all for now. Brother Nuo will cover for me. I'm going to the operating room for a minor open fracture. You can go to the emergency operating room to find Luo Tingzhu for now."

"It just so happens that you, Tingzhu, and another resident trainee—what's his name? You three are in one group. Today, you'll be responsible for minor debridement and suturing in the emergency operating room, as well as any cutting or scraping. We'll handle all of that."

"OK?"

"If you feel tired, give me a call and I'll send someone over to relieve you. We'll wrap up perfectly at 4 PM. Brother Nuo and Brother Luo from your group will treat us to dinner. Let's all improve together and gain weight together."

"Hahaha!" Jin Hongzhou was in an exceptionally good mood.

With the bosses away, I can practice any kind of surgery I want, big or small, as long as nothing goes wrong.

For Jin Hongzhou, a simple open fracture open reduction and internal fixation procedure was already a piece of cake.

Even if all else fails, Zhongnan Hospital still has some senior staff members remaining, though they are all retired elderly men in their sixties and seventies. But once they take action, they can usually handle cases and surgeries that even senior-level doctors like Professor Deng Yong cannot manage.

There shouldn't be any problems with handling minor procedures like the small carambite surgeries that junior doctors like them want to perform.

After all, every teaching hospital has some big names and veterans, but these veterans no longer need to be active in clinical practice.

"Okay, Zhou-ge, see you tonight." Fang Ziye's knowledge points income for the day had already reached 20+ points, and the income was still flowing in. Fang Ziye couldn't be more excited.

This is comparable to conducting a large-scale experiment in a laboratory.

Delicious.

When they arrived at the emergency operating room, Luo Tingzhu was leading Lan Tianluo in an Achilles tendon rupture surgery. At that moment, Luo Tingzhu was skillfully performing preoperative diagnostic examinations.

Thompson's test, or gastrocnemius squeeze test, involves the patient lying prone with both feet extended beyond the edge of the bed. The examiner squeezes the gastrocnemius muscle in the calf. Normally, this will cause plantar flexion of the foot. If plantar flexion does not occur, it suggests a ruptured Achilles tendon ligament. This test is a specific sign of acute Achilles tendon rupture.

Lan Tianlu nodded: "Senior Sister Luo, yes. That's how it's diagnosed as an open Achilles tendon injury."

Luo Tingzhu, now exuding confidence, straightened up and asked in a clear, articulate voice, "What are the methods for Achilles tendon suturing? What are the indications for suturing in different locations?"

Lan Tianlu was completely dumbfounded.

It's already quite remarkable that he, a self-taught doctor, knows the procedure for the gastrocnemius muscle compression test, a specialized orthopedic test.

Upon hearing this, Fang Ziye quickly sought advice. Luo Tingzhu's theoretical and practical experience was better than his own, so he figured he should learn as much as he could: "Junior Sister Luo, would you like to learn from me? This is exactly what I've been learning about."

Lan Tianluo and Luo Tingzhu each turned around and called out to Senior Brother Fang.

Luo Tingzhu slightly toned down her 'superior aura' and said with a smile, "Senior Brother Fang, you are too modest. I don't actually know much either. I only know the Kessler suture method for suturing Achilles tendon ruptures, which is just right for this patient."

"There are several other methods for suturing Achilles tendon ruptures, for example."

"The Kessler suture technique is suitable for general Achilles tendon ruptures, especially in cases of minor Achilles tendon injuries. This suture technique provides high stability and strength and is suitable for situations that require the tendon to withstand greater pressure and tension."

"The Bunnell suture technique is typically used for moderate to severe Achilles tendon ruptures, especially in cases of distal Achilles tendon injury. It helps ensure that the distal Achilles tendon remains in contact, which aids in postoperative healing."

"The Krakow suture technique is suitable for internal Achilles tendon ruptures, especially in cases of injury in the middle of the Achilles tendon. It helps reduce postoperative scab formation and scarring because the sutures are mostly located inside the Achilles tendon during this suturing process."

"The Buster suture technique is typically used for complex Achilles tendon ruptures or situations requiring additional support, such as multiple tendon tears. It can provide more structural support and stability."

"Achilles tendon reinforcement surgery is suitable for severe Achilles tendon injuries or other special cases, such as repair after partial Achilles tendon resection. Methods such as using nails, screws, or implants can enhance the stability of the Achilles tendon, but usually require a longer recovery time."

As Luo Tingzhu hooked her finger, she explained the science to Fang Ziye, Lan Tianluo, and the patient.

The patient, who hadn't received local anesthesia yet, couldn't help but turn to look at Luo Tingzhu and exclaim, "Beautiful lady, you're not only good-looking, but you're also incredibly professional!"

(End of this chapter)