System Came When the Doctor was Thirty

The dressing room of the surgical ward is spacious and dim, its lighting blurred, even inferior to the small dressing room of the emergency surgical ward.

This room is several times the size of the small dressing room, offering more privacy.

Lan Yuan waited for Lu Cheng to change and started explaining the case: "Director Wu suspects this patient is currently experiencing a type of difficult-to-reduce shoulder dislocation."

"Three attempts have already been made to reposition… Dou Ge and I both suggested surgery, but this patient was admitted through Director Wu's connections and appears to be quite close, which is why Dr. Lu was invited to try once more."

Wu Xiang is an attending physician. When his relatives seek medical care at the hospital, he can step in to find relatively better and more suitable doctors for them.

If the timing is right, he might even be able to invite in specialists.

Lu Cheng was already wearing a mask, lifted his chin, and chuckled softly: "I'm just afraid I might disappoint Director Wu again."

Lan Yuan reassured: "It's just another disappointment, Brother Lu, you might as well consider this as one last struggle with us."

"Of course, during today's repositioning, Director Wu was always thinking of you, Dr. Lu, saying things like 'if only I had brought you in earlier.'"

Lan Yuan's words were not taken seriously by Lu Cheng, as those matters were already in the past:

"Brother Lan, which operating room is it?"

"Brother Lu, follow me." Lan Yuan quickly stepped forward to lead the way.

By the time they arrived in the operating room, five or six big, burly individuals and a few muscular middle-statured men were already standing there.

Lu Cheng had met Director Wu Xiang once during an emergency surgery with Xiao Zhaoxi, recognizing him the moment he entered.

Director Wu Xiang was discussing the reasons for the failed repositioning with another middle-aged man.

"Director Wu, repositioning like this is futile; it's highly possible that the humerus is trapped by the tendon of the biceps muscle."

"Unless the humerus can be released from the entrapment manually, normal repositioning techniques cannot place the humerus into the glenoid cavity."

"The tendon hangs downward, forcibly pushing inward not only risks rupturing the tendon but also causes secondary injuries."

Lan Yuan softly explained to Lu Cheng that the speaker was Professor Huang Jianjun.

Wu Xiang and Huang Jianjun both noticed Lu Cheng's arrival but didn't offload all the pressure on Lu Cheng.

"Difficult-to-reduce joint dislocation either means the dislocation angle is extremely severe or there is an obstruction."

"In this current situation, there isn't an extreme separation angle, and we can confirm there isn't a bone spur, so the entrapment is likely due to either adipose tissue or a tendon, with the latter being more probable…"

"Of course, we can't rule out the possibility of a labrum tear causing obstruction for the humerus entering the glenoid cavity."

"Should we get an MRI?" Wu Xiang's voice was calm, carefully considering each statement.

Huang Jianjun analyzed: "Director Wu, it would have been more cost-effective to do an MRI as soon as the patient was admitted!"

"After three failed attempts, further examination doesn't offer practical benefits."

Conducting examinations upon admission enables immediate acquisition of more data, providing patients more trial and error opportunities.

Now that there have been three failed repositioning attempts, additional failures could necessitate direct surgical intervention, making an MRI at this juncture not particularly significant.

The inadequacy of comprehensive examination information is a challenge when handling cases involving hospital staff relatives.

"Dr. Lu, what are your thoughts?" Wu Xiang finally turned to Lu Cheng to inquire.

Wu Xiang wasn't intentionally being sarcastic with Lu Cheng; rather, Lan Yuan and others frequently praised Lu Cheng's repositioning technique.

Wu Xiang long ago ceased seeking a sense of achievement through belittling Lu Cheng, nor did he need to elevate his own presence.

Lu Cheng was still reviewing the patient's X-ray films.

While the main observation purpose of X-rays is the alignment of bones and joints, Lu Cheng, under Professor Chen Song's tutelage, heard of skilled radiologists and specialists who could even deduce muscle and tendon arrangements from X-rays.

Lu Cheng's X-ray reading proficiency was specialized, and he didn't mind spending twenty skill points to upgrade it to expert level, proceeding immediately in that manner.

Enhancing diagnostic capabilities is especially crucial in a trauma center and isn't regarded as wasteful.

After applying the extra points, it seemed a warm current flowed into his eyes, making Lu Cheng's thought process nimble, transforming his vision as he looked at the X-ray films.

This change didn't allow Lu Cheng to see things others couldn't; rather, it enabled him to discern muscle shadow stratifications.

These stratifications weren't as detailed as MRI or CT scans, but they were sufficient for Lu Cheng to clearly deduce the approximate muscle arrangement.

Determining whether difficult-to-reduce joint dislocation involves tendon entrapment requires confirming presence or absence, followed by assessing extent.

Having an MRI is the most time and labor-saving; whereas X-ray information is still somewhat scant.

But for the moment, it's barely adequate; Lu Cheng indeed located part of the biceps tendon's false shadow amidst the overlapping X-rays.

Lu Cheng didn't respond to Director Wu Xiang's inquiry, instead immediately using his hand to illustrate the discernible direction of the biceps to fathom its potential path through anatomical knowledge.

"Director Wu, currently, the humerus is unusually situated between the long head tendon and the short head tendon, differing from the usual alternation, with an inversion in position between them."

"It's as if the two tendons have locked the dislocated humeral head."

Lu Cheng's voice was not loud, yet it startled Wu Xiang and Huang Jianjun, widening their eyes.

"You? Really?" Huang Jianjun's lips, pursed tight, lifted the surgical mask.

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