Those years when I hung up and upgraded in the hospital

Chapter 87 Peer Communication (Please collect and read)

The reason why a major is called a major is that there are certain professional barriers.

The most basic professional barrier in sports medicine is the understanding and use of arthroscopic tools.

If compared to an ordinary and easy-to-understand description, the arthroscope is a tool similar to the various tools of a carpenter. You must first be able to use it, and then you can understand the diagnosis and treatment of professional diseases.

Further up, it is a question of professional depth.

Arthroscopic exploration is the most basic basic surgery in sports medicine. Although joint exploration is basic, it also has a certain depth and proficiency.

And this not only requires you to be able to use arthroscopy as a tool, but also requires you to have enough theoretical reserves to actively study part of the content in depth.

For example, the shoulder joint exploration technique performed by Fang Yun now is extremely detailed and has many angles.

"This is the glenohumeral ligament, and this is the labrum. If the labrum is damaged, shoulder joint instability will easily occur. But this patient did not. We diagnosed it before surgery..." Fang Yun's theoretical knowledge did not not bad.

It is not possible for ordinary people to get such a high score in the theoretical examination of surgery. This requires reading a lot of books.

During the four years that Fang Yun had been in the town, he had been working tirelessly and had not learned any professional operating skills, but his theoretical depth had already exceeded level 3.

"Let's check the attachment point of the joint capsule to the humeral head again. Look, it's right here. Then gently move the arthroscope back to check whether there is softening of the humeral head articular surface at the rear of the glenohumeral articular surface and wear of the posterior labrum of the shoulder joint. Or partially torn.”

"At this time, we will move the arthroscope back to the biceps tendon, and then we will start the examination of the tendon tissue." Fang Yun's speaking speed was neither urgent nor slow, and the operation was neither fast nor slow.

Now that he has started to undergo arthroscopic internal examination of the shoulder joint, Fang Yun no longer holds back and exerts himself to the maximum of what he can do, with a relatively complete explanation.

The technical depth of arthroscopic exploration is not very high, but when it really needs to go deep, the penetrability is still very strong.

If you use an arthroscope to explore the entire joint cavity, what you can see is quite exciting.

At this time, while Fang Yun was talking, he noticed that the expressions of Director Hu Jun, Chai Junye and others changed slightly, but Fang Yun did not stop.

There are several reasons. The first one is to fully demonstrate your abilities with the permission of others, not to show off, but to show your basic skills and heritage.

Second, if you want Director Hu Jun to fully and thoroughly recognize your arthroscopic operation ability, you must use a deeper cognitive theory to gain his trust.

His own arthroscopy experience is level 3. Hu Jun must have known from the beginning that what he was afraid of was that he had wasted his time in town for a long time and had worn away his theoretical reserves.

Then looking at the operating room, the anesthesiologist, circulating nurse and others stood up one after another at this moment and stood curiously in front of the arthroscope display screen. Although they might not be able to understand it, they still accepted Fang Yun's teachings seriously. and explanation.

"Director Hu, we only looked at the surface of the biceps tendon before, but if there is damage to the biceps tendon!"

"We can flex the elbow slightly to reduce the pull on the biceps. Then we explore the biceps tendon through the rotator cuff, both above and below."

Hu Jun heard the sound, pushed Chai Junye away, and actively helped Fang Yun get into the corresponding position. Fang Yun made a hole at the right moment where the operating hole was about to be punctured, and then used an arthroscopic probe to penetrate deep into the operating hole. “A portion of the biceps tendon is retracted into the joint using a probe through the anterior portal to determine whether synovitis is present and whether there is an incomplete tear in the more distal portion of the upper arm.”

"At this time, the arthroscope is rotated upward, aligned with the rotator cuff, and gently rotate the upper arm inward and outward to carefully check whether there is wear, partial tearing of the rotator cuff, or calcification at the insertion point of the rotator cuff at the tuberosity. Move the joint The scope is pushed medially along the tendon to check for synovitis, wear, or rupture.”

"Obviously, this patient's synovitis is relatively obvious, but wear and tear is not supported by the current evidence under direct vision."

"Let's look at the posterior part of the rotator cuff."

"Gently withdraw the arthroscope and observe the bare area behind the rotator cuff and humeral head. There is no articular cartilage coverage here, and there are normal small blood vessels entering under the rotator cuff. This is where it is."

"Let's open another anterior approach. This approach can be used as a later operation approach." Fang Yun was already in a completely autonomous state. When he spoke, he just asked Hu Jun's opinion.

This is going to be the second operating hole.

It is very normal for shoulder arthroscopy surgery to have two to four operating holes.

"Move the arthroscope to the anterior portal, and the probe can be placed at the posterior portal. Through the anterior portal, the posterior articular surface, posterior labrum, posterior recess and posterior joint capsule can be observed for hyperplasia, synovitis and shoulder joint instability. Wear or inflammatory changes.”

"Moving the arthroscope forward, you can look upward to see the rotator cuff, and looking downward toward the glenoid, you can see the biceps labral complex."

“By moving the arthroscope further forward and back toward the inferior recess, the humeral attachment of the glenohumeral ligament and its inferior glenoid attachment can be visualized.”

“The arthroscope is then rotated downward to observe the attachment of the anteroinferior glenohumeral ligament and the labrum of the joint capsule, as well as the middle glenohumeral ligament, subscapularis tendon, and subscapular recess.”

"Next, we need to explore the subacromial bursa, which can extend posteriorly from at least 2cm away from the front edge of the acromion to about the middle of the acromion. Place the posterior sleeve into the subacromial space..."

Fang Yun said as he finished the microscopic examination of the glenohumeral space.

However, Fang Yun did not continue with the subsequent operations. After exploring so many contents by himself, they were all related to the glenohumeral space. As for the subacromial space, which is the more classic and exciting part, Fang Yun felt that he could leave it to Hu Jun.

Reciprocity is a kind of friendship and a way of communicating with peers. I have already demonstrated solid basic skills and cognitive theory. If Director Hu Jun needs to discuss it together, then the other exploration of the gap under the shoulder will be left to him. A better opportunity to 'show off'.

"Director Hu, I wonder if there is an opportunity for you to take us together to learn how to detect the subacromial space?" Fang Yun did not finish his words.

But just this sentence has already resolved the embarrassing situation.

Hu Jun looked at Fang Yun, then at Fang Yun, and then said with a formal expression and tone: "Dr. Fang's techniques, theories, and investigation details are quite mature, so let's communicate with each other and learn from each other's strengths. "

"If there is any lack of detail, Dr. Fang must point out and correct it."

"No kidding." Hu Jun emphasized his tone.

(End of this chapter)