Thursday, afternoon.

Doctor's office.

After a routine preoperative discussion, Lin You was in front of the computer to check yesterday's post-operative orders.

On the long table in the office, after Lu Cheng prepared the materials for the preoperative conversation and put them away one by one, a middle-aged man and a middle-aged woman knocked on the office door at the door.

Both of them had worried looks on their faces.

"Hello Dr. Lu, are you looking for us?" said the middle-aged man, who is also a family member of the 18-bed.

Lu Cheng stood up and said, "Please come in, find a place to sit first, let's sit down and talk slowly." ”

When he said this, Lu Cheng glanced at Lin You, feeling a little nervous.

This is not the first time he has had a preoperative conversation, but in front of his boss, it is the first time, and he doesn't know if he will be scolded by the master if he wants to say something wrong halfway. He deliberately stayed here today, did he have any special intentions?

The two walked in one by one, and then found a place to sit down, facing Lu Cheng on the side, and the man was slightly closer to Lu Cheng.

Lu Cheng sat down with the two, and then put the first page of the surgical consent form on the top, and pushed it forward a little so that both of them could see it.

Lu Chengdao: "That's the case, tomorrow the 18th bed, that is, your son, will have surgery, and I called you over today just to tell you something about surgery." ”

"Hmm. The middle-aged man also knew that preoperative talk was the usual practice, and he actually searched for some relevant knowledge on Baidu, but there were different opinions on it, so he couldn't tell what Lu Cheng would say for a while.

Lu Cheng continued to speak: "First of all, you are family members, you must understand the diagnosis after admission, and then I will explain to you the purpose of the examinations you have done after admission and the corresponding examinations. ”

"Next, I will talk about the surgical method of this operation and the problems to be solved, some problems you may encounter after the operation, and guide your recovery plan in advance. ”

Lu Cheng pointed his finger at the preoperative diagnosis column: "According to the medical history information you provided to me and the examination I gave to the patient, combined with our reading, the first consideration for preoperative diagnosis is the rupture of the medial and lateral discoid meniscus of the right knee." ”

"What is a discoid meniscus?"

"The meniscus, you can understand it as a piece of soft tissue inside our knee, between the femur and the tibia. ”

"Under normal circumstances, they are shaped in the shape of a half-moon wedge, that is, a form of one side high and one side low, and its main function is to protect the upper and lower bones of our knee joint from colliding directly. ”

"But it's normal, and it's in the crowd. ”

"A large proportion of people have a special type of meniscus that is congenital. For example, the disc-shaped meniscus, as the name suggests, is equivalent to the meniscus changing from a wedge shape to a disc shape. ”

Such a change may still be too professional to say, and we can make an analogy. ”

"Succulents, have you seen them?"

"Can you imagine that the leaves of succulents are more brittle than the normal leaves? Well, they are brittle, that is, who is more likely to break when they are squeezed?"

"Don't think about it, it must be the leaves of succulents, right?"

"The discoid meniscus is the leaf of such a succulent. ”

"So, after understanding this basic structure, let's review the medical history you mentioned, 18 beds were injured after the long jump, and then I have been feeling the dull pain in the knee joint, and it has gradually worsened, and there is even a history of occasional compression, right?"

"Ordinary long jump sports belong to the normal sports category, if it is an ordinary person's meniscus, it will not produce damage, but the discoid meniscus is a structure that is easily damaged, so even if it is a normal sport, it is easy to be injured. ”

"Our suspicions were confirmed by the physical examinations we did at the clinic and after admission, as well as the MRI. ”

"In addition, we only found that he had a problem with his lateral meniscus through physical examination, but through reading the radiograph, we also found that his medial meniscus also had a ruptured injury. ”

"In this case, we also consider that it may be only because the patient's lateral symptoms are more severe, and the symptoms of the medial meniscus injury may be masked to a certain extent in the physical signs, so the physical examination cannot be detected, which is also the reason why the medial McCephalis sign may be negative. ”

Speaking of this, Lu Cheng paused and asked, "You probably understand, right?"

Lu Cheng's words are mixed with examples in the profession, of course, it is easy to understand.

Both of them nodded, and in an instant, their thoughts turned from the various messes of queries on the Internet to reality, and it seemed that the doctor in front of them explained better than the experts on the Internet.

Lu Cheng continued: "Then the next thing is the problem of treatment. ”

"The treatment of meniscal injuries is based on the grade, and injuries with 3 to 4 degrees of pain and entrapment require surgery, and we also recommend surgery. Conservative treatment is unlikely to be effective, but will aggravate the wear and tear of the knee joint. ”

"It's like the insoles you wear, which are always on the diaphragm, and it's useless if you don't get rid of the rolled up. ”

"For the rupture of the meniscus, we also perform three surgical methods: partial excision, shaping and suturing depending on the location. ”

"Partial excision is actually for forming, mainly to deal with the breach that is not at the edge. The discoid meniscus is easy to be injured because of its shape, so we will do plasty, that is, repair it to the general shape of a normal person. to reduce the chance of secondary damage. ”

"Then, considering that the patient is only 13 years old after all, he is still very young, we will not remove the meniscus completely, otherwise it will definitely aggravate the inter-articular wear and tear, and he may have a worse chance of arthritis in the future......"

"The patient's postoperative rehabilitation is divided into the following two situations: if the suture is sutured, then the flexion cannot exceed 90° in a short period of time because it is ......"

"If there are no sutures, then the patient's movement can be unrestricted. ”

"Stitching, no stitching, the scope of exercise, you must figure it out, I will tell you after the operation. Remember?"

"Then, there are a couple of things you have to pay attention to after the surgery. ”

"There is a chance of infection if there is a wound, so it is also necessary to protect the wound, and what you need to do is ......"

Then, let's talk about some of the things that can happen after the patient. ”

"The numbness in some areas is due to damage to the cutaneous nerve. ”

"Joints may be swollen ......"

“……”

As Lu Cheng's explanatory words gradually deepened, the expressions of the middle-aged man and the middle-aged woman seemed to gradually stretch.

In the end, the middle-aged woman couldn't help but ask: "It is said on the Internet that the disc-shaped meniscus will cut off all the meniscus, and then cause osteoarthritis to occur early, so what about us?"

Lu Cheng was also prepared for this, and explained again: "As I just said, the patient's current age is still young, and we will only do partial excision and suturing of the meniscus, and even if it is partially removed, there is a possibility that the meniscus will grow back, which will not affect him too much." ”

"But there is one point, that is, even if the meniscus grows again, it may not be in a normal form, so when you do sports in the future, try to warm up in advance, and avoid similar exercises such as long jump and high jump to avoid re-injury. ”

"Exercises to strengthen muscles after surgery also help to protect the meniscus. ”

"With our current medical understanding, there is only so much we can do, the most important thing is to pay attention to and strengthen the toughness of the muscles around the knee joint on a daily basis......

Lu Cheng's in-depth summary gave the two confidence again.

The gloom on the middle-aged man's face disappeared in an instant, and he just thanked him repeatedly: "Doctor Lu, if you want to say that we understand, we must not understand it very well, but we also understand what you told us, especially in detail." It is well-founded and easy to understand. ”

"Don't worry, we will cooperate well, I just hope you can do a good job in the operation......"

The two walked out again and again thanking and please, and at the same time, Lin You also walked out lightly, without saying a word, but when he arrived at the door, he nodded to Lu Cheng and said that he was very satisfied.

The last time, it was yesterday, I said it with my mouth.

This time, although it was silent, there was still a smile of relief on his face.

This student, if he can thoroughly understand the surgical informed consent form to this point, his understanding of this will definitely not be bad, if most people will basically only read the template on the consent form once, and don't think about why at all.

That's not the right posture to learn.