System Came When the Doctor was Thirty
Chapter 67: Meticulous Thinking and Theoretical Framework
Tong Yuan'an picked up chopsticks after Lu Cheng responded, tapped Lu Cheng's right finger bone, and lowered his voice, his round face serious:
"Sentiments are sentiments, but sentiments without ability and martyrdom are just fooling around!~ Do you understand this reasoning?"
"Fracture, joint dislocation, tendon suturing are completely independent medical conditions!!" Tong Yuan'an, being a professional orthopedic doctor, immediately advised Lu Cheng after the fact.
Lu Cheng, having been reprimanded, still accompanied with a smile, being honest and straightforward: "Thank you for your guidance, Teacher Tong, but I wasn't messing around either."
Chen Song put down the cup and poured Tong Yuan'an a cup of tea. Unfamiliar with the taste, he called the waiter to change it to a pot of self-paid green tea.
"Go ahead." Tong Yuan'an crossed his arms, seriously watched Lu Cheng's expression.
"Teacher Tong, I won't discuss the overall situation, but I'll talk about the shoulder joint dislocation I treated."
"First, performing a physical examination allowed me to suspect her diagnosis, which was anterior shoulder dislocation, then through examination, I determined the position and distance of the humeral head to specify the classification."
"Later, I reviewed the films and confirmed the location of the humeral head, excluded fractures, proceeded with grading, observed that the joint capsule hadn't dislocated, and the shoulder acromioclavicular joint gap was narrowed, remaining under the category of first-degree injury."
"Non-second-degree injury, largely without accompanying rotator cuff or ligament injury in sports medicine, as the grading enables backtracking of the force encountered during injury."
"The diagnosis type is clear, shoulder joint dislocation, classification clear, it's simply anterior-inferior dislocation."
"The determined grade is secondary dislocation."
"The treatment methods are quite standard, options include hand traction method, the hanging method, and the Kocher reduction method. The Kocher reduction method has a higher success rate, if mastered, the treatment outcome is promising."
"So, I performed it." Lu Cheng logically sequenced and analyzed the entire treatment process at a theoretical level.
Chen Song and Tong Yuan'an might not fully understand the specific classification of joint dislocation but were undoubtedly familiar with this method of analysis.
Of course, the theoretically knowledgeable Tong Yuan'an further inquired: "Why did you choose the Kocher reduction method instead of opting for the 'External Rotation-Internal Reduction Method, Milch Reduction Method'?"
Having listened, Lu Cheng carefully contemplated before articulating his thoughts: "Teacher Tong, while the Milch Reduction Method is undoubtedly excellent!"
"It allows zero traction, can complete reduction with just gravity assistance, and the fracture risk is lower than with Kocher method, only one percent."
"Most importantly, the nerve injury risk with this reduction method is lower compared to the Kocher external rotation method."
"It is both energy-saving and low-risk but suits more muscular patients, its sole drawback is it takes longer compared to Kocher method."
Lu Cheng remembered the precise reduction time, the Kocher method averages around five minutes, the Milch method takes around 7-12 minutes.
"This patient is a female, and with the dislocated state, she constantly frowns, indicating a low pain threshold, likely very pain-sensitive."
"Even if the time difference is just 2-7 minutes, it would cause her more painful experience."
"Therefore, I chose the Kocher external rotation reduction method, rather than the Milch reduction method." replied Lu Cheng.
Tong Yuan'an's expression tightened, eyes calm, a thoughtful demeanor.
Upon hearing this, Chen Song looked at Tong Yuan'an: "So, Xiao Lu is indeed a fairly professional orthopedic doctor, hearing him explain the theoretical aspects now, he's on par with seasoned specialists."
Tong Yuan'an did not refute, using his chubby hands to pat the front of his thick thighs: "Alright, he has ability, ideas, theoretical support, theoretical fallback, confidence, orthopedic resumes, and credentials."
"Indeed minimized risks, calculated plans, not recklessly charging ahead."
Tong Yuan'an tapped the table, praised: "Just learned quite broadly, not quite pure."
"Otherwise, with your current technical level, you should be able to conduct quite a few specialized surgeries."
Tong Yuan'an thought Lu Cheng was fearless, deliberately challenging orthopedics, when in fact Lu Cheng had done ample preparation, merely lacking one opportunity."
Now considering the matter, ortho specialists opened this venue for Lu Cheng, closing it in the future won't be easy."
Given the current medical scenario, medical classifications aren't that specific anymore!
As long as the doctor in charge does not perform unqualified surgeries."
The main point is Tong Yuan'an didn't expect Lu Cheng's theoretical level had reached such systemic heights. Otherwise, he wouldn't have slapped Lu Cheng's hand."
Thinking of this, Tong Yuan'an grabbed his scalp with chubby hands, expression conflictedly said: "Xiao Lu, my project probably ended halfway."
"Through your confirmation, ensured one point, it's useful, surpasses Professor Tajima's Suturing Technique, but merely equals the force. Yet, Professor Tajima developed it first, seizing the advantage."
"I consulted my teachers after returning, indeed hard to alter, surrender when necessary."
"Oh…" Tong Yuan'an effusively sighed."
Then, Tong Yuan`an explained: "Other hand surgery conditions conducted in your emergency department could lack legitimacy, replanting amputated limbs are far beyond your current reach."
"Flap suturing is feasible, but currently, Peng Kun's technical accumulation barely anticipates skin defect treatments, being an orthopedic specialist, do understand my meaning?"
Lu Cheng nodded, acknowledging: "Teacher Tong, both skills you taught me are quite practical, I've greatly benefited!~"
"My accumulation isn't enough, haven't entered the replantation of amputated limbs…"
Tong Yuan`an said: "You could perform finger and palm deformity ligament excision reconstruction surgery. However, it's scheduled type, rarely seen in your emergency department."
"In my view, you could opt for a transfer back to orthopedics…"
Chen Song tapped the table: "Tong Yuan'an, continuing this rhetoric, have you really dismissed the importance of Long County's emergency patients?"
"You've pointed out deformity as scheduled type, issues like splenic rupture and cholecystitis, bile duct stones are life-threatening emergency conditions."
"Lu Cheng's Spleen Preservation Surgery and Gallbladder Preservation Surgery are quite adept, during this time, having him return to your orthopedics for deformity treatment?"
"To save money, neglect the organs like spleen and gallbladder?"
"Is saving money more important, spleen ought to be removed, gallbladder too? Easy perspective if not your orthopedic patients?" Chen Song formally vented with sarcasm."
Tong Yuan'an helplessly: "That's not my intention…"
Chen Song indignantly retorted: "Then isn't this settled? If you truly care, instruct him on the path to suturing basics accumulation, aiding Xiao Lu's potential to attempt the amputated limb replantation orthopedics can't reach in the next decade."
"Why ponder scheduled deformities?"
Chen Song still paved the way for Lu Cheng, hoped Lu Cheng could leverage Tong Yuan'an to enter the provincial skill competition."
The National Microsurgery Skill Competition is in December, the province begins selecting candidates in October, only two months later."