Chapter 180 Difficult Osteophytes, Introduction to Extraskeletal Diagnosis

If you sit on a hot chair that someone else has just sat on, there is a certain risk of infection if the other person carries an infectious virus.

Although human skin has a very strong barrier capability, caution is always the best.

"Here, you won't dislike the ones I've used, right?"

She took out a water mat from the drawer, first put a newspaper on the chair, and then spread the water mat on Li Jingsheng.

It's actually a cute pink color with cartoon patterns painted on it.

"You really know how to enjoy it!"

Li Jingsheng sat on the water cushion, which was cool and soft, and very comfortable.

"Hehe, who doesn't know how to enjoy it? How is your orthopedic surgery diagnosis level? Help me take a look at this case."

She smiled and invited him to watch a medical case on the computer.

Li Jingsheng moved his chair over and got very close to her. She had no intention of avoiding him, but her pretty face was slightly red.

After all, she was in the office, and it was the first time she sat so close to a member of the opposite sex, so she felt a little embarrassed.

The medical history is not complicated.

This patient was injured in a car accident more than a year ago, resulting in a fracture of the radius of his right hand with a certain degree of defect and dislocation of the distal radioulnar joint. He then chose to undergo surgical treatment at the Second Hospital.

Checking the past medical records, the last operation was open reduction, ulnar head transplantation, and internal fixation with steel plates and screws.

After the operation, the patient's bone injury healed fairly well.

However, patients often report pain on one side of the wrist joint, especially when moving the wrist.

The result of the re-examination at that time was that there was osteophyte formation on the ulnar stump.

However, it can be seen from the film that the size of the osteophytes is very small and the density is also very low. The attending doctor recommended that the patient be observed for a period of time before further treatment.

Osteophytes and bone spurs are common after joint injuries.

It is usually caused by repeated friction and stimulation.

It will cause a certain degree of pain to the patient, but generally will not affect the patient's joint movement function.

Moreover, some patients gradually recover after a certain period of adaptation.

In the case of this patient, observation is completely advisable.

Unexpectedly, as time passed, the man's pain not only did not reduce, but gradually worsened. Now the patient's forearm can hardly rotate, and the pain is also excruciating when reaching for things.

I had no choice but to come for treatment again.

After X-ray examination, it was found that the patient's ulnar stump osteophytes had increased many times, and the density was close to normal bone.

Repeatedly comparing the patient's pre-operative, one-year post-operative, and post-operative radiographs, as well as the current radiographs, it can be seen that the patient's ulnar stump osteophytes have grown particularly rapidly. Its length and thickness are already close to the ulna.

The entire body is conical, and a medullary cavity can be seen forming.

The fracture site of the distal radius had healed that year.

"The patient's pain must be caused by osteophytes. Wouldn't it be enough to simply remove them through surgery?"

Li Jingsheng's extra-orthopedic skills are average, but fortunately his basic knowledge of orthopedic surgery is fairly solid.

In addition, his general surgical diagnosis has reached a proficient level, which is somewhat helpful for his extraskeletal diagnosis ability.

"The difficult thing now is not how to deal with the osteophytes, but that after the osteophytes are removed, as long as the patient's right hand moves, because the stump bone is unstable, a slightly larger swing will irritate the surrounding tissue and cause pain. In this way, it will also cause pain.

New osteophytes will regenerate."

This is what Ou Qinglan is worried about.

"I checked the information and found that regeneration of stump osteophytes is almost a necessary complication of this kind of surgery and there is no way to avoid it."

Tissue hyperplasia really gives doctors a headache.

Needless to say, scar hyperplasia is more difficult to eliminate than cancer tumors.

Bone hyperplasia is also very difficult to deal with.

It is easy to relapse after treatment.

Clinical breast hyperplasia is even more frightening to lesbians, who are afraid that it will directly turn into cancer after 4A.

"Didn't you ask your superior doctor for advice?"

"Dr. Ruan said he wanted to exercise my clinical thinking and let me think on my own."

The Dr. Ruan she was talking about must be the sharp-mouthed and monkey-cheeked Dr. Ruan Xiaoqin.

This man was thirty-seven or eighteen years old, so at least he was an attending physician.

He has some status within the department.

Ruan Xiaoqin was not seen today.

"Isn't the patient scheduled for surgery yet?"

"No. The surgical plan has not been determined yet. We will discuss it this afternoon."

She shook her head.

"Are you in Professor Wu's group?"

"right!"

"Isn't your group only studying bone cement treatment?"

"Who said that! Bone cement treatment is a special treatment project that Professor Wu specializes in. Our group mainly treats bone trauma cases. We also have a little dabbling in joints."

I see.

Think about it, there are only a few patients treated with bone cement every year.

If a hospital had such a large group of doctors and only treated a few orthopedic patients a year who were willing to receive bone cement treatment, it would probably go out of business long ago.

It is impossible for the hospital leaders to agree.

Bone trauma is a big deal, and there are still quite a lot of patients.

"It's okay, I'll check the information for you."

Li Jingsheng had nothing to do anyway, so he took out his mobile phone and searched online for relevant literature on osteophyte treatment.

There are quite a few studies on this aspect, but there is not much relevant treatment experience.

Even fewer are useful.

No wonder Ou Qinglan feels distressed.

Fortunately, Li Jingsheng's English reading skills were passable, so he entered an international medical exchange forum and began to read related posts.

Because the registration threshold for this forum is very high, only doctors with certain achievements in the surgical field can become registered members.

He can only browse page by page as a tourist.

Visitors cannot post, reply, or search, but they can view some surgical discussion threads open to the public.

In order to help his girlfriend, he also worked hard.

When he opened a clinic, he often delved into some surgical clinical knowledge, and finally discovered this website. He felt that the posts there were of high quality, and most of the people who posted them were top leaders in surgery-related fields.

He has kept this website ever since.

Unfortunately, because of my low status, I didn’t have any decent honors or certifications, so after I submitted my registration application, it was always under review.

The forum announcement states that in order to ensure the quality of this medical forum, a higher threshold is set for registered members.

And even if you successfully register as a member, you can't irrigate them wantonly.

If there are serious errors in posts or replies, points will be deducted. If a certain number of points is accumulated, the membership will be cancelled.

After Li Jingsheng searched for it on his mobile phone, his hard work paid off and he finally found an authoritative statement on the formation of osteophytes on stumps.

"The stump often has osteophyte regeneration, and when it is large in size, it is often due to subperiosteal osteogenesis."

In this way, the regeneration of osteophytes is closely related to the stimulation of the periosteum.

In order to verify whether this netizen's view was correct, he quit the forum and started frantically searching for information on periosteum and osteophytes.

After multiple verifications, it is basically certain that the views expressed by that netizen are accurate.

After checking this step, Li Jingsheng already had some confidence in his mind.

He noticed that his level of orthopedic surgery seemed to have improved, and he subconsciously checked the attribute panel.

There is actually a new medical skill in the diagnostic skill column.

Introduction to Orthopedic Surgery0/10.

He was particularly surprised that he was able to elevate orthopedic surgery diagnosis to an entry-level level at this critical moment.

It has been three days since he joined the orthopedic surgery department. Although he has been messing around in the surgical clinic, if he can improve his orthopedic surgery diagnosis level, it will greatly improve his abilities in many aspects.

It is even more crucial to improve his status in orthopedic surgery.
To be continued...