Poor Zhuang Zihao's little friend, less than half an hour after the first reset, has to be reset again. This time, he looked very open, but his eyes were full of tears, and he said to Sun Lien in a milky voice, "Brother, this time it should be lighter!"

Although the verbal promise must be lighter, after all, the joint reduction does not require enough strength, and the dislocated joint cannot return to its original position. Therefore, although Sun Lien promised to "be lighter", he still did not dare to reserve his strength. After making sure that the reset was successful, he let go of his hands.

Zhuang Zihao cried again, he jumped on the ground, and even wanted to raise his hand to hit someone in pain, but in the end he held back his movements, hugged his arms and bowed to Sun Lien, gritted his teeth and said, "Thank you, uncle!" and then ran out without looking back.

From an older brother to an uncle, this is probably the biggest dissatisfaction that children can make. Sun Lien smiled absently, and carefully explained the precautions after the child's reset to Zhuang Zihao's mother, who had paid the reset fee twice, and then let the child leave first - she had to send the child to her grandmother's house first, so that she could come back and continue to take care of Zhuang Tao.

After Zhuang Zihao left, experts from the Department of Orthopedics also arrived. The person who came was none other than Zheng Guoyou, who was wearing a hospital gown.

"Director Zheng, why are you here?" Seeing Zheng Guoyou appear in the rescue room, Sun Lien was startled, and hurriedly made a stool over, "You sit first." ”

Zheng Guoyou glanced up and down at Sun Lien dissatisfiedly, "What do you mean kid, think that my old Zheng can't even walk now?" he snorted, "What about the patient?

Zheng Guoyou put on a shelf as a deputy director, and Sun Lien felt a little unexpected. After all, when Lao Zheng's heart attack was electrified, he didn't look like a person who likes to put on a show. Although he felt that something was wrong, he obediently brought the X-ray from the duty desk. Just as he was about to say something, he suddenly found that the iron door of the rescue room was not completely closed. A gap peeked through the middle of the iron door, and an eye was peering through the crack to peek into the rescue room.

Because there are many seriously ill patients in the rescue room, the rescue process may be busy. And this kind of hecticism, in the eyes of the family, is definitely a big deal. In order to prevent the patient's family from breaking into the emergency room in a hurry and interfering with the doctor's rescue work, this iron door is generally directly locked by an electromagnetic lock.

Sun Lien was a little uneasy, and when he was about to close the door, he saw Zheng Guoguo's eyes constantly coming at him.

"Don't lock the door. Zheng Guoyou squeezed out such a sentence from between his teeth, "My wife is peeking outside." ”

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It has been the third day since Zheng Guoyou was transferred to the general ward. This old man has long been accustomed to arranging himself as a first-line doctor, but now he suddenly enjoys the treatment of a second-line attending doctor, Director Zheng not only did not feel comfortable, but felt as if a kitten was scratching its paws in his heart. He couldn't afford to be idle.

Just when Director Zheng Guoyou was lying in the ward, idlely wanting to see an X-ray to relieve his boredom, Lin Tianshun, a student who came to visit him, rang. Sun Lien called the Department of Orthopedics to ask for expert consultation, and now there is still time to go directly to the rescue room of the Department of Orthopedics, and Lin Tianshun is the only one left.

"Why are you going?" Zheng Guoyou heard that there was a consultation, and immediately jumped up from the bed. He snatched Lin Tianshun's mobile phone, listened to the content on the other end of the phone, and hung up the phone directly. Then he instructed Lin Tianshun, "Okay, okay, you do your work, I'll go to the rescue room to see what's going on." ”

"Teacher Zheng ......" Lin Tianshun knew that he would definitely not be able to persuade Comrade Zheng now, so he felt that he would intervene from a different angle, "Director Xiao said, I won't let you go to the front line." ”

"I'm not going to break someone's arms!" Zheng Guoyou replied with confidence, "It's just a consultation." The little grandson is young and strong, even if he wants to straighten his bones, it won't be my turn to get started!"

Lin Tianshun moved out of the great god without any arrogance, "Anyway, I will definitely not listen to you, but if you leave this ward, Director Xiao will definitely know." ”

"If you know, you know. Zheng Guoguo was really choked enough, and when he heard that there was a rare and difficult situation, he didn't even pay attention to his wife's small notebook. "I've done a lifetime of healing and saving people, and I'm addicted to it! I can't force me to retire just because I had a heart attack five days ago!"

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After the bold words, Zheng Guoyou slipped to the first floor with his hands behind his back. But halfway through, I saw Xiao Lirong who was about to come to the ward round. Director Zheng is worthy of seeing big scenes and has rich experience in the battlefield. simply pretended not to see it and swaggered into the rescue room. Let's have a consultation first, and then think of a way to do the rest when the disaster comes.

"Director Zheng ......" Sun Lien had no choice but to follow Zheng Guoguo's intention and accompany him to continue acting. "This is the X-ray I just got. ”

Zheng Guoyou took the X-ray, first glanced at it nonchalantly, and then widened his eyes. "Huh?"

Zheng Guoguo's reaction had long been expected by Sun Lien. To be honest, when he saw this X-ray for the first time, Sun Lien also reacted in this way. When the ankle joint was completely dislocated and the talus body was detached from the ankle point, Zhuang Tao did not have a fracture, not even a fibular and tibial separation.

"Look at this again. Sun Lien handed over another X-ray taken from the front, and he pointed to the part of the patient's arch on the picture, "Judging from the shape of the arch, this patient should have flat feet." ”

"Flat feet can cause ankle instability. Zheng Guoyou understood what Sun Lien meant, "Have you asked about your medical history?"

Sun Lien was a little embarrassed, "I haven't had time to ...... yet"

"Why don't you ask directly?" Zheng Guoguo taught Sun Lien a lesson in righteous words, "Medical history is the fastest and most direct means to obtain the basic information of the patient. You can't ignore the history just because there are ancillary tests!"

Sun Lien nodded in response, and he could also see that Lao Zheng was probably still acting. As long as he acts like he is here to "guide the diagnosis", Director Xiao probably won't come in directly to interrupt Lao Zheng, and then the intensity of cleaning up Zheng Guoyou may be a little lighter.

But if Zheng Guoyou plans to roll up his sleeves and work directly, then I'm afraid Director Xiao will have to come in and pinch Lao Zheng's ears - orthopedics are hard work after all, and Zheng Guoyou's heart is still not capable of heavy exercise.

Sun Lien didn't explain Zhuang Zihao's matter, but Zhuang Tao, who was lying on the hospital bed, hugged Sun Lien upset, "Dr. Sun is very responsible, he was busy dealing with my son's injury just now, so he didn't have time to ......"

"It was a mistake on his part and it had nothing to do with the injury. Lao Zheng didn't care much about Zhuang Tao's explanation, he asked directly, "Have you sprained this foot before?"

"Twisted a few times. Zhuang Tao replied, "I am a project runner, and I often run in leather shoes on the construction site, and it is common for the ground to be uneven and sprain my ankle." ”

"This ligament is in trouble. Zheng Guoyou looked at the X-ray and sighed, "The ligaments are loose when I have a habitual sprain, and I have a complete dislocation this time, even if I directly reduce it back, I may still have to dislocate it later." ”

Zhuang Tao himself has flat feet, which means that his ankle joint is a little more "valgus" than ordinary people. This kind of valgus can cause the ligaments in the ankle to be looser, and the ankle joint is more likely to lose instability when walking. And the consequence of instability is that his ankle is more likely to sprain than ordinary people.

After multiple sprains, Zhuang Tao's ankle ligaments will be more relaxed, which led to his accidental fall this time, and he completely dislocated his right ankle joint. But fortunately, probably because of the lax ligaments, he only showed a complete dislocation of the ankle and showed no signs of fracture.

"Is it possible to do this manual reduction?" Zhuang Tao's diagnosis is not difficult, the real difficulty lies in the treatment method. "I just did a general examination, and the patient did not have tendon rupture, no nerve damage, no blood vessels or anything like that, it was just a simple dislocation. ”

Zheng Guoyou looked at the X-ray, groaned for a while, shook his head and said, "It's impossible to do a simple manual reset." He pointed to the tissues around the picture and said, "The patient's musculature is relatively developed, and if you look at the density shadow here, he has a lot of muscles in his legs." Now in a dislocated state, these muscles are tense and stressed. Purely by technique, let alone me, an old man, you may not be able to pull it open if you replace it with three or four young men. ”

Zheng Guoguo's worries are very reasonable, after all, he often runs to the construction site, and Zhuang Tao's legs do look very strong. In addition, if manual reduction is performed directly, the tight muscles need to be directly lengthened to reduce the detached joint, so that the tendons that were not injured may also be damaged.

"Then ......" Sun Lien was a little unsure of the treatment plan, "After incision, surgical reduction, and then directly on the K-wire for external fixation? Will this be too big?" "K-wire is a steel needle fixation device that can be inserted directly into the bone and exposed outside the skin. The exposed nails are eventually attached to a steel frame outside the body to immobilize the bones. K-wire itself is actually a relatively common solution, but because it looks too penetrating, doctors and patients generally don't like to use it.

"Not really. Zheng Guoyou shook his head and said confidently, "Send people to the operating room and do an inhalation anesthesia." Then the upper muscles are relaxed, and when the muscles are relaxed, manual reduction is done. Zheng Guoyou also made a special comparison on the X-ray picture, "Here, let the assistant fix it, and then the attending doctor pulls his leg down, and then twists his ankle in the opposite direction." ”8)