Practicing Medical Skills in a Small Clinic

Chapter 339 - 180: Troublesome Bone Spurs and an Introduction to Orthopedic Diagnosis

If you sit on a warm chair that someone else just sat on, and that person carries some infectious virus, there’s a certain risk of infection.

Although the human skin has a strong barrier capability, it’s better to be cautious.

"Here, you wouldn’t mind using something I used, would you?"

She took a water cushion from the drawer, laid a newspaper on the chair first, and then placed the water cushion for Li Jingsheng.

Surprisingly, it was a cute pink color with cartoon designs on it.

"You really know how to enjoy yourself!"

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

"Hehe, who doesn’t know how to enjoy? How’s your level of orthopedic diagnosis? Help me look at this case."

She smiled and invited him to look at a medical case on the computer together.

Li Jingsheng moved his chair a little closer, sitting very near to her. She didn’t show any signs of avoiding, just her pretty face slightly blushed.

After all, it was in the office, and it was her first time sitting so close to the opposite sex, she felt a bit embarrassed.

The medical history wasn’t too complicated.

This patient suffered a fracture of the right radial bone with some deficiency and distal radioulnar joint dislocation over a year ago due to a car accident. Then, they chose to undergo surgery at the second hospital.

Reviewing the past medical records, the last surgery involved open reduction, ulnar head transplantation, and internal fixation with a plate and screws.

Postoperatively, the patient’s bone healing was relatively good.

However, the patient reported frequent pain on one side of the wrist, especially apparent when moving the wrist.

The results from the follow-up showed ossicles forming at the ulnar stump.

However, from the images, it can be seen that the ossicles are very small in size and have low density. The attending doctor suggested that the patient observe it for a while before taking further action.

It is quite common for ossicles or bone spurs to form after joint injuries.

It’s generally caused by repeated friction and stimulation leading to proliferation.

It can cause the patient a certain degree of pain, but generally doesn’t affect the joint’s functional movement.

Moreover, some patients gradually adapt and settle over time.

For this patient’s situation, suggesting observation is entirely appropriate.

Unexpectedly, as time passed, the man’s pain didn’t lessen but gradually worsened. Now the patient’s forearm can hardly rotate, and it is immensely painful to reach out and grab things.

With no other option, he had to seek consultation again.

After X-ray examination, it was found that the ossicle at the distal ulnar stump had enlarged several times, and its density was close to normal bone.

Repetitive comparisons of the preoperative images, the one-year postoperative follow-up images, and the current ones showed that the growth of the ossicle at the ulnar stump was particularly prominent. Its length and thickness were approaching that of the ulna.

The whole ossicle appeared conical, and a medullary cavity had formed.

The fracture site at the radial distal end from back then had healed.

"The patient’s pain is certainly caused by the ossicle. Can’t we just surgically remove it?"

Li Jingsheng’s level in orthopedics was average, but thankfully his basic knowledge in orthopedics was quite solid.

Moreover, his general surgery diagnosis had reached the Master Level, which somewhat aided his diagnostic ability in orthopedics.

"The issue now isn’t how to handle the ossicle, but that after removal, as soon as the patient moves their right hand, the unstable stump bone, with larger swings, will irritate the surrounding tissue and cause pain. Consequently, it may regenerate the ossicle again."

Ou Qinglan was concerned about this.

"I’ve researched material, and ossicle regeneration at the stump is almost a common complication of such surgeries, unavoidable."

Indeed, tissue proliferation gives doctors headaches.

Scar proliferation is a whole other story, even harder to eradicate than cancerous tumors.

Bone proliferation is equally troublesome.

Even after being cured, it’s easy for it to recur.

Mammary gland proliferation in clinics, especially, is feared by women, worried it would turn malignant after 4A.

"Haven’t you consulted a senior doctor?"

"Doctor Ruan said it was to train my clinical reasoning, letting me think on my own."

The Dr. Ruan she’s talking about is definitely that skinny face Ruan Xiaoqin.

This person is thirty-seven or eight years old, at least an attending physician.

Considered to have some standing in the department.

Today, Ruan Xiaoqin was nowhere to be seen.

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

"No. The surgical plan hasn’t been finalized; there’s a discussion planned for this afternoon."

She shook her head.

"Are you in Professor Wu’s group?"

"Yes!"

"Isn’t your group only researching bone cement treatment?"

"Who said!? Bone cement treatment is a specialized project Professor Wu focuses on, our group mostly deals with bone trauma cases. We also dabble a bit in joint matters."

So that’s the case.

That makes sense. There aren’t many patients accepting bone cement treatment annually.

If the hospital maintained such a large team of doctors only to treat a few patients willing to undergo bone cement treatment yearly, it would likely have gone bankrupt long ago.

The hospital leadership wouldn’t agree to that either.

Bone trauma is a significant category, with quite a few patients.

"No worries, I’ll help you search the data."

Li Jingsheng, since he was idle anyway, immediately took out his phone to search online for relevant literature on ossicle treatment.

There is quite a bit of research on this topic, though not much practical treatment experience.

Useful information is even scarcer.

No wonder Ou Qinglan felt troubled.

Fortunately, Li Jingsheng’s English reading ability was adequate. He accessed an international medical exchange forum to look up related posts.

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