This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 78 Skill Points That Can't Be Saved!
【外科基础术式：骨折切开外固定术（熟练1/10）、骨折手法复位术（熟练2/10）、骨折切开复位内固定术（熟练0/10）、关节脱位手法复位术（专精4/20）……】

Now, more than ten days have passed since Qixi Festival, and when Lu Cheng was on duty later, he behaved properly and did not interfere with the orthopedic surgery and treatment...

For fracture patients who cannot be treated with Lu Cheng's manual reduction technique, they will still be advised to seek treatment at the orthopedics department.

After all, Lu Cheng's basic theory of trauma surgery has reached the level of expertise, but his proficiency in manual reduction of fractures is still at the level of proficiency.

After his understanding improved, Lu Cheng felt more and more the profoundness of manual repositioning techniques.

Furthermore, the manual reduction techniques of modern medicine are quite different from the bone-setting reduction techniques of traditional Chinese medicine.

Lu Cheng didn't dare to easily venture into this field. But it seemed that Xiang Kuihua, the deputy director of the orthopedics department, wanted to take advantage of Lu Cheng and teach him a "lesson," and he did it again and again.

Even a clay idol has some temper, and Lu Cheng was utterly speechless.

Actually, the situation that day was very simple. Our emergency department invited you to come for a consultation. All you had to do was make a trip and get the patient an inpatient admission certificate.

The orthopedic specialist gave professional advice, and even though Lu Cheng knew that Mason type II fractures of the radial head could be treated well without surgery, he didn't say anything more.

But the orthopedics department insists on getting an inpatient certificate from the emergency department. Isn't it just that the emergency team doesn't want to make a trip on Qixi Festival and wants the on-call doctor in the ward to 'admit and treat' them instead?
Lu Cheng had encountered a doctor specializing in trauma surgery who knew that surgery was not as effective as conservative treatment for Mason type II fractures. How could Lu Cheng possibly issue a hospital admission certificate to the patient again?
Doubting one's own professional knowledge and disregarding one's own abilities for the sake of personal relationships? Lu Cheng could not do that.

"Well, at least I have 18 skill points, I might as well use them all..."

The panel changed—

【Manual reduction of fractures (Specialty 0/20)】.

A barely perceptible stream of coolness rose into Lu Cheng's mind, making him feel refreshed. A warm current flowed through Lu Cheng's hands, making his muscles and bones feel more relaxed...

After carefully reviewing the basic theories on fracture treatment, Lu Cheng retrieved a new surgical mask from the nurses' station, put it on, and went to find the patient.

While Du Daihua was still seeing other emergency patients, the fracture patient was temporarily placed in the corridor between the observation ward and the nurses' station.

After reviewing the patient's basic information, Lu Cheng asked, "Which one of you is Zhang Hongchun, the patient with the fracture?"

Although he could immediately spot the person on the far left with their hands in their pockets, Lu Cheng no longer acted according to experience.

"Doctor, it's me!" The patient said, supporting his left hand with his right and raising his chin to indicate.

He came to the doctor alone, without anyone accompanying him.

"Have you taken the X-ray? Come with me to the doctor's office in the ward. There are a lot of patients in the emergency room, and I'm afraid I'll run into you." Lu Cheng stepped forward to help the patient up by supporting his elbow.

"The X-ray has been taken, but it will take an hour to retrieve it. Doctor, do I have to wait?" Zhang Hongchun is a middle-aged man in his forties, thin, with dark skin and a few strands of gray hair at his temples.

His lips were thick, which suggested he worked outdoors.

"It's alright, I'll pull up the images on the computer. You didn't get any cuts, did you? You weren't bleeding, were you?" Lu Cheng looked carefully and didn't see any blood, but he still asked patiently.

The treatment principles for open fractures and closed fractures are completely different.

"I didn't get any cuts. I fell from upstairs while I was tiling someone's exterior. I should have worn a safety rope." Zhang Hongchun said, full of regret.

"Be more careful in the future. It's too late to think about these things after you get injured. We often treat accidental fractures like yours here. Safety ropes are still very necessary, even though they are a bit troublesome and affect your movement." Lu Cheng helped the patient into the office.

Zeng Huanqi, who was on regular ward duty, immediately looked over and, thinking it was a surgical patient brought by Lu Cheng, stood up immediately!

Upon seeing the deformity of the patient's left hand, Zeng Huanqi kindly and warmly said, "Come and sit down, did you accidentally break it?" "I fell down during the renovation," Zhang Hongchun replied kindly, seeing that Zeng Huanqi was not young.

Lu Cheng said, "Don't rush. Judging from the deformity of your left forearm, there is definitely a fracture, but I need to carefully assess the extent of the fracture."

As Lu Cheng spoke, he typed out the pinyin of Zhang Hongchun's name and accessed the first page, showing the X-ray of the left forearm from the front and side.

Whether a fracture requires surgery depends on the fracture type and the assessment. Depending on the type and individual capabilities, surgical indications may be considered accordingly.

Upon examination, Lu Cheng immediately recognized the diagnosis: the fracture line was clearly visible.

"Your fracture is type A3.2, an extra-articular radial fracture, presenting as a wedge-shaped bone fragment."

"Nearly one-third of the fractures are due to bone fractures, and the angular deformity is approximately 5 degrees..."

While reviewing the case, Lu Cheng carefully searched for indications for manual reduction of fractures of both the radius and ulna.

Fractures are a major category and the cornerstone of trauma surgery because there are numerous subtypes of fractures, regardless of the location.

1. Suitable fracture types: closed fracture, stable fracture, and controlled displacement.

2. Adequate reduction conditions: fracture time ≤ 2 weeks. No soft tissue embedding, high patient cooperation!
Lu Cheng confirmed that this was within the indications for manual reduction, and that his specialized manual reduction technique had a chance of achieving reduction, so he cautiously spoke:

"Your fracture is a double fracture of the radius and ulna. The situation is not simple. We can try manual reduction, but there is a certain probability that it will not be reduced, and then surgery will be necessary."

"Of course, if you wish, you can choose to have surgery in the orthopedics department. After surgical fixation, the healing will be faster than with manual reduction..."

Zhang Hongchun nodded blankly, licked her dry lips, and asked, "Dr. Lu, what are the specific chances of a successful manual reduction of my fracture?"

Lu Cheng shook his head: "It's hard to say specifically. Generally, we only recommend that you do it if we judge the success rate to be above 60%."

"If it can't be repositioned, then we'll wait for surgery. If the repositioning is satisfactory, we'll put on a cast and go home. I haven't kept track of the exact values."

Lu Cheng hadn't actually done the statistics. The success rate of manual reduction varies from person to person; if someone is skilled in manual reduction, the success rate can be over 99%...

"It's up to you whether you're willing to endure the pain and let us try to reset it for you. That way, we can save you some money."

“However, if it’s not properly repositioned, then you won’t save this money. You’ll have suffered for nothing.” Lu Cheng spoke frankly, informing the patient of the corresponding risks.

If a patient strongly requests surgical treatment, then it is an indication for surgery, not a indication for manual reduction.

The patient hesitated for a moment, then asked, "Approximately how much will this surgery cost?"

Lu Cheng was an orthopedic surgeon before, so he remembered the approximate cost: "In our hospital, it would cost around eight or nine thousand."

"Because you have a double fracture, the cost will be much higher than for a single fracture. After insurance coverage, it should be around four to five thousand..."

Zhang Hongchun then asked, "What about manual reduction?"

"If it's manual reduction, the whole procedure should cost around 1,000 yuan. With some medication, it should be around 1,100 or 1,200 yuan. After reimbursement, it will be around 500 or 600 yuan."

Lu Cheng would never belittle the value of his technology...

(End of this chapter)