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

Chapter 79 You guys just did it already?
Five or six hundred and five or six thousand are quite different.

Lu Cheng carefully reviewed the hospital's charges. The cost of open reduction and internal fixation for a radius and ulna shaft fracture plus fracture lever reduction and internal fixation was 1690 + 145. Adding the cost of the steel plate, the cost of the surgery alone was over 2000.

Adding in the anesthesia costs, the total for that day was close to four thousand.

Zhang Hongchun hesitated: "Dr. Lu, if this manual repositioning technique fails to achieve the desired repositioning, will there still be a charge?"

Upon hearing this, Lu Cheng frowned: "Yes! So you need to think it through and understand it clearly."

Zhang Hongchun then asked, "Dr. Lu, you're still charging even though it wasn't properly repositioned? Isn't that unreasonable?"

Lu Cheng explained, "If you think it's unreasonable, just choose surgery. Surgery can 100% reposition it. Moreover, the risk of recurrence is much lower, and postoperative recovery will be faster!"

Medical services are chargeable, and the inherent risks of manual reduction are not included in these charges.

During the surgery, the surgeon will also perform C-arm irradiation multiple times, requiring the circulating nurse to be called over, as well as an assistant. It takes a long time to arrange, and it's actually quite physically demanding...

"Let me think about it some more and discuss it with my family." Zhang Hongchun wasn't sure either.

His thought was that if manual reduction was unsuccessful, he wouldn't have to pay...

Lu Cheng didn't try to persuade him, saying, "You can think about it some more. I still need to do a simple physical exam to rule out the possibility of compartment syndrome..."

Lu Cheng then conducted a systematic examination of the patient's distal limb sensation, blood circulation, and local tension at the fracture site. After initially ruling out compartment syndrome, Lu Cheng asked Zhang Hongchun to discuss the matter with her family.

After the patient left, Zeng Huanqi looked up at his dark face and asked, "Xiao Lu, are you really going to do manual reduction of the fracture?"

"Aren't any of the orthopedic specialists coming?"

“According to the consultation rules, I’ve already done my duty to these senior doctors by not directly calling the medical affairs department to find an orthopedic doctor,” Lu Cheng said.

The emergency department called for a consultation, but no one showed up? If Lu Cheng really wanted to take this seriously, he could give them a run for their money.
Fortunately, if it was an open fracture, the orthopedic department wouldn't dare to delay, so Lu Cheng didn't need to completely break off relations.

"What if something goes wrong?" Zeng Huanqi asked hesitantly.

"Therefore, it is necessary to write down the risks of manual reduction of fractures in advance as a template so that patients can make their own choices. Moreover, it is important to emphasize the risks of refracture and redisplacement of fractures."

“Our emergency room’s interview area is recorded by the security office! I don’t entice patients, so nothing will happen,” Lu Cheng replied.

If you're confident you can do something, then do it; if you're not confident, then honestly admit defeat. This has always been Lu Cheng's principle.

Of course, if his skills weren't up to par and the success rate of manual repositioning was less than 50%, Lu Cheng wouldn't risk it.

With a success rate of 80% or even 90%, patients are willing to try to save money, and Lu Cheng is happy to help patients.

Manual reduction is not something Lu Cheng is obligated to do, but rather something he can do at his discretion...

Fifteen minutes later, Zhang Hongchun walked in, her eyes sincere:

"Dr. Lu, I'd like to have a manual reduction done first. Please do it well and try to get it back in one go."

"Okay, come talk to me and sign the papers first. We need to discuss the specific risks in detail."

"There are a few main points. First, manual reduction and external fixation with plaster casts are not as stable as internal fixation with plates, and there is a risk of recurrent fractures and displacement."

"Secondly, the pain after repositioning will be more intense and last longer than during surgery..." An hour later, Zhang Hongchun went into the doctor's office for another X-ray. His left hand was clearly in a supination cast, but he was still very nervous and worried:

"Dr. Lu, how are my results? Have you looked at them?"

"It looks pretty good so far. The fracture lines have narrowed, and the fracture fragments are held in place because your hand is in a supination position."

"The soft tissue will protect the fracture alignment, so it's a relatively good manual reduction. Postoperative recovery is expected," Lu Cheng assessed very professionally.

He added, "You can come and see. After the surgery, the edges of your radius and ulna are basically not displaced anteriorly or laterally. This alignment means that the reduction was successful with confidence."

"Under normal circumstances, as long as you don't suffer external injury, re-dislocation is rare. However, if you do suffer external injury, even a normal person would suffer a fracture..."

Zhang Hongchun was relieved: "Dr. Lu, thank you!"

"Thank you for your hard work. I thought this repositioning technique was just a matter of you touching it a bit and that was it. I didn't expect it would take so much effort!" Zhang Hongchun recalled how Lu Cheng and Zeng Huanqi were covered in sweat in the operating room, and felt that the money was well spent.

"I've remembered everything you told me, including how to take these medicines."

"It doesn't hurt as much now. Actually, the manual repositioning didn't hurt that much either. Thank you so much." Zhang Hongchun bowed slightly, his face full of a simple, honest smile.

The money-saving method is effective, which is a stroke of luck amidst today's misfortune.

If surgery is really needed, it will cost several thousand dollars, and at least ten days of work will be wasted!
Lu Cheng said, "Be careful on your way back. Make sure you don't fall. If you experience any numbness, swelling, or worsening pain, be sure to come to the hospital for a follow-up appointment immediately!"

"Your fracture is only externally fixed, not internally fixed, so it's not very stable. Be careful." Lu Cheng took a few steps forward again and nagged him.

"That's all. You've added me on WeChat, so you can contact me anytime if you have any problems after the surgery."

“Except when I’m sleeping at night or in the early morning,” Lu Cheng added.

"Okay, thank you, Dr. Lu." Zhang Hongchun smiled and waved to Lu Cheng while carrying the medicine bag.

Lu Cheng turned around and carefully reviewed the manual repositioning technique he had performed that day, without any other concerns.

Actually, manual reduction of radius and ulna fractures is relatively simple.

A proficient level is sufficient, with a success rate of at least 80%. A specialized level of manual repositioning technique has a success rate of around 90%.

Whether the reduction is effective or not can be seen after the operation. The fracture ends are aligned neatly, the fracture force line is flat, the fracture is fixed in place, and the external fixation is reliable.

Moreover, the fracture itself was not a comminuted fracture with a large tendency to displace, so Lu Cheng was still somewhat confident.

After finishing these tasks, Lu Cheng returned to the ward and began to write down the patient's 'manual reduction' surgical record in great detail.

Just as I was finishing writing, a slightly cold voice came from the door of the general ward: "Did you take care of that fracture patient in our orthopedics department directly?"

Lu Cheng looked up and saw Xiang Kuihua's burly figure. He stood up. Although he was half a head taller than Xiang Kuihua, Lu Cheng's voice was low: "Yes, Director Xiang, I performed the manual repositioning."

Xiang Kuihua was tall and burly, but his face was relatively small in comparison, his skin was slightly dry, and he had a stern demeanor: "You... Lu Cheng, I'm not trying to be mean, but what kind of repositioning techniques do you know?"

(End of this chapter)