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

Chapter 68 Meticulous Thinking and Theoretical Systems
After Lu Cheng replied, Tong Yuan'an took out his chopsticks and tapped Lu Cheng's right finger bone, lowering his voice and making a serious face:
"Passion is passion, but passion without ability and acting like a saint are just nonsense! Do you understand this principle?"

"Fractures, joint dislocations, and tendon sutures are completely separate conditions!!" Tong Yuan'an, a professional orthopedic surgeon, immediately advised Lu Cheng afterward.

Despite being hit, Lu Cheng still smiled obsequiously and said honestly, "Thank you for your guidance, Teacher Tong, but I wasn't just fooling around."

Chen Song put down his water glass and poured Tong Yuan'an a cup of tea. Feeling it wasn't flavorful enough, he asked the waiter to bring him a pot of extra green tea, which he had to pay for himself.

"Go on," Tong Yuan'an said, his hands behind his back, intently watching Lu Cheng's expression.

"Teacher Tong, let me not talk about the general situation, but just talk about the shoulder dislocation I treated."

"First, through physical examination, I can suspect her diagnosis of anterior shoulder dislocation. Then, through physical examination, I can determine the position and distance of the humeral head displacement to determine the subtype."

"Afterwards, I reviewed the X-rays, clearly saw the position of the humeral head, ruled out a fracture, and graded the injury. I could see that the joint capsule was not dislocated, and the space of the acromioclavicular joint was narrowed. It was not a grade II injury, but still a grade I injury."

"Non-secondary injuries are generally not accompanied by rotator cuff or ligament injuries in sports medicine, because the grading can be used to infer the force encountered at the time of injury."

"The diagnosis is clear: shoulder dislocation, with a clear classification; it is the simplest type of anterior inferior dislocation."

"The degree of dislocation is clearly defined, indicating a second-degree dislocation."

"The treatment methods are also quite standard. You can choose the hand-pulling and foot-cushioning method, the suspension method, and the Kocher reduction method. Among them, the Kocher reduction method has a relatively high success rate. If you master it, you can expect good treatment results."

"So I proceeded with it." Lu Cheng logically and theoretically organized and analyzed the entire treatment process.

Chen Song and Tong Yuan'an may not understand the specific classifications and degrees of joint dislocations, but they are certainly familiar with this analytical method.

Of course, Tong Yuan'an, who had a more solid theoretical foundation, pressed further: "Then why did you choose the Kocher reduction method instead of the 'external rotation-adduction method, Milch reduction method'?"

After listening, Lu Cheng carefully considered his words before organizing his thoughts: "Teacher Tong, the Milch repositioning method is indeed very good!"

"Reduction can be completed with zero traction and only gravity assistance, and the risk of fracture is lower than that of the Kocher method, only one percent."

"Most importantly, this reduction method carries a lower risk of nerve damage than the Kocher external rotation reduction method."

"It is less strenuous and less risky, but it is more suitable for patients with strong muscles. The only drawback is that it takes longer than the Kocher method."

Lu Cheng remembered the precise reset time: the average reset time for the Kocher method was about five minutes, while the reset time for the Milch method was about 7-12 minutes.

"This patient is a girl, and because she was in a dislocation, she was constantly frowning. It is highly likely that she has a low pain threshold and is very afraid of pain."

"Although it's only a difference of 2-7 minutes, it's enough to bring her a more painful experience."

“Therefore, I chose the Kocher external rotation reduction method instead of the Milch reduction method,” Lu Cheng replied.

Tong Yuan'an composed himself, his eyes calm, as if deep in thought.

Hearing this, Chen Song looked at Tong Yuan'an and said, "So, Xiao Lu is really one of the more professional doctors in your orthopedics department. Judging from the theoretical level he is describing, he is no worse than a regular doctoral student."

Tong Yuan'an didn't refute, and patted the front of his thigh with his big fat hands: "Alright, you have the ability, the ideas, the theoretical support, the theoretical backing, the confidence, the orthopedic experience, and the professional title."

"Indeed, all risks were minimized. We had a plan in mind and didn't just rush in blindly."

Tong Yuan'an tapped the table again and praised, "It's just that you've studied a bit too broadly, not quite as pure as you could be." "Otherwise, with your current skill level, you should be able to perform quite a few surgeries that are unique to your specialty."

Tong Yuan'an thought Lu Cheng was a fearless newborn calf who was deliberately going head-to-head with the orthopedics department, but in reality, Lu Cheng had made many thorough preparations, he just lacked an opportunity.

Looking at it now, the orthopedic surgeons have made this incision for Lu Cheng, and it won't be easy to close it again later.

In today's medical system, the classification of diseases is no longer so specific!
The chief physician is responsible for the procedure, and surgeries should not be performed outside the physician's level.

Tong Yuan'an mainly didn't expect Lu Cheng's theoretical level to have reached the point of systematization. Otherwise, he wouldn't have slapped Lu Cheng's hand.

Thinking of this, Tong Yuan'an scratched his scalp with his chubby hand, his expression conflicted, and said, "Little Lu, I guess my research project has to be abandoned halfway through."

"After your confirmation, one thing is certain: it is useful and can surpass Professor Tajima's suturing technique, but it is only comparable. However, Professor Tajima developed it first, giving him an advantage."

"After I went back, I consulted my teachers, and it really is difficult to solve. There's no way to improve it. We have to admit defeat."

“Sigh…” Tong Yuan’an sighed.

Then, Tong Yuan'an explained, "It would be too improper for your emergency department to carry out other hand surgery procedures, and limb replantation is too far removed from your current situation."

"Skin flap suturing is possible, but Peng Kun's current skill level is barely enough to treat skin defects. He is an orthopedic specialist, do you understand what I mean?"

Lu Cheng nodded, admitting defeat: "Teacher Tong, the two techniques you taught me are both very useful, and I have already benefited greatly from them!"

"It's because I haven't accumulated enough experience; I can't even get started in the field of limb replantation..."

Tong Yuanan said, "However, you can have ligament resection and reconstruction surgery for finger and palm deformities. But this is an elective procedure, and your emergency department won't encounter it."

"My suggestion is that you could choose to transfer back to orthopedics..."

Chen Song tapped the table: "Tong Yuan'an, you're still saying these things now. Do you really not care about the emergency patients in Long County?"

"You said it yourself, deformities are elective diseases, while spleen rupture, cholecystitis, and bile duct stones are truly life-threatening emergency diseases."

"Lu Cheng's spleen-preserving and gallbladder-preserving surgeries are already quite advanced. Do you want him to go back to your orthopedics department and work with you on deformities?"

"Are you just going to disregard the spleen and gallbladder to save patients a little money?"

“Saving money is more important. If the spleen needs to be removed, then the gallbladder should be removed too. Anyway, they’re not your orthopedic patients, right? Out of sight, out of mind.” Chen Song said in a particularly formal and sarcastic tone.

Tong Yuan'an said helplessly, "That's not what I meant..."

Chen Song said indignantly, "Isn't that the end of it? If you really care, you should teach him the basics of suturing so that Xiao Lu can look forward to doing limb replantation, something that orthopedic surgeons won't be able to do for the next ten years. That's the right way."

"What kind of twisted timing is this?"

Chen Song was still paving the way for Lu Cheng, hoping that Lu Cheng could participate in the provincial-level skills competition through Tong Yuan'an.

The National Microsurgery Skills Competition is in December. The province will select people to participate, and the preliminary activities usually start in October, which is about two months away.

(End of this chapter)