My medical skills add experience

Chapter 312 Hairy hands are deformed, it is not easy for the poor

"Everyone, don't be in a hurry, don't squeeze, fill out the medical records, and I will call you one by one." Ji You was trying to maintain order.

She is a very qualified nurse.

The standard of a good woman is to be able to go to the hall and go to the kitchen.

An excellent nurse must not only be proficient in the operation of injections and dressings, but also communicate with patients and maintain the order of the on-site clinic.

"Doctor Zhou, my son's left hand has been injured, please help."

The young mother holds the child distressedly and takes the first place.

Look at this little boy, who is only two or three years old at most, with teary eyes and wet tears on his face.It seems that I have just cried not long ago.

After a physical examination, Zhou Can found that a mild hematoma had occurred on the boy's left wrist.

Moreover, his left hand seemed to have no strength at all, and he dared not even move it.

"How did this happen?"

"During breakfast in the morning, he rolled a hard-boiled egg on the dining table for fun. As a result, he accidentally fell off the chair while chasing the egg."

The ones who are prone to falls seem to be little boys, because boys are more naughty than girls.

Courage is also greater.

The probability of getting into trouble is naturally much higher.

"You didn't hit your head, did you?"

"Probably not! I was eating with my head down, and when I heard the noise, he had already fallen to the ground."

After Zhou Can asked the parents, he still didn't dare to be careless.

Injury to the hand is only a trivial matter. Children's bones are very flexible, and generally dislocations, joint displacements and the like are the most common.Fractures rarely occur.

Head injuries are the most dangerous.

Many children's skulls need to be one or two years old to close, which is what we often call the brine door.

There is a gap in the head of a newborn baby, which is called a lomen.This is caused by the incomplete growth of the brain and skull. It can usually be divided into an anterior and a posterior halo. Generally, the anterior halo is located on the top of the head and is in the shape of a rhombus.

The posterior brine door is close to the occipital and is triangular in shape.

The surface of the newborn's blotch is only the scalp, and the inside contains meninges, cerebrospinal fluid and brain. If you gently place your hand on the blotch, you can clearly feel the beating sensation.

If the child is over two years old and the halogen door is still not closed, it is likely that the child has a physical problem.For example, calcium deficiency, or developmental delay, etc., at this time, you must take your child to the hospital to see a doctor.

Zhou Can was still worried that the child's head would be injured, because he was afraid of intracranial hemorrhage.

The little boy was carefully checked, and there were no obvious bruises or hematomas on the head.When touched, the little boy did not show any pain, so it is estimated that there is nothing serious.

"I'll apply for an X-ray examination first, and you take him to take a picture. Be careful not to touch the injured part of his wrist as much as possible. Because no one knows whether the bones inside are broken or not."

Zhou Can told her again, and the woman took the list and took the child for an examination.

The second one turned out to be another child.

A little older than the previous little boy, it was a five-year-old boy.

"Doctor Zhou, we saw on TV that you are very good at treating children's hand diseases. Please see if my doll's hands can be cured?"

The family member is a young man not more than two years older than Zhou Can, estimated to be 26 or seven years old at most.

Unexpectedly, the children of the family can already make soy sauce.

Zhou Can somewhat understood the feelings of his parents who kept urging him to get married.When the parents watched people who were about Zhou Can's age get married and have children one by one, they were naturally anxious.

"Yo, is this hand born?"

Zhou Can found that the little boy was a little embarrassed and did not dare to stretch out his hand.

The father who was still a little boy grabbed his hand and put it on the examination table.It can be clearly seen that the fingers of the child's hands cannot be straightened, and they are hooked like chicken feet.

The thumb can be extended, but not fully abducted.

The child's grasping function will definitely be greatly affected.

"A few days after the child got his hands, I found that his hands were different from ordinary people's hands. The fingers could not be straightened, and the fingers were slanted. Later, when he grew up, the problem became more serious when holding things with his hands. Because of this I quarreled with his mother many times about it, and finally he left when he was three years old and never came back."

When the man talked about this incident, he looked very sad and full of regret.

"Doctor Zhou, if you can cure my son's hands, I can find a way to bring him back to his mother."

Under normal circumstances, family members will not easily tell the doctor about these family scandals.

The man may indeed regret it and think about how to get his wife back.

It is easier to persuade the child to come back after curing the child's illness and then going to the child's mother.

"The child without a mother is the most pitiful! Regardless of whether the child's hands can be cured, you should find the child's mother. The child is innocent, and it is very unfortunate that the hands are born with disabilities. If you can give him a warm and complete It will be of great benefit to the growth of children.”

Zhou Can seldom takes care of patients' family affairs.

This time is an exception.

Because children born with such disabilities are more prone to low self-esteem, more fragile in heart, and need the joint care of mother's love and father's love more.

"You're right. I was too young to cherish it. I always blamed her for being born with disabled hands. Now that I think about it, I regret it. How can I blame her? I haven't looked for it in the past two years. She, it's just that she has been unwilling to forgive me. So, this time, I made up my mind to take the child to heal my hands, only in this way can she change her mind."

When the man told about the situation of these families, the little boy just lowered his head, looked at the table, and did not speak.

The child seemed particularly autistic.

It's very distressing to watch.

"Little friend, don't be afraid. After uncle examines you, maybe he can find a way to help you heal!"

Zhou Can comforted the little boy.

Started to give him a serious physical examination.

While checking, ask family members for relevant medical history information.

"Do any members of your family have such deformities of hands and feet?"

"No! My siblings, parents, grandparents, and I are all normal."

"Where is the child's mother's line?",

"I asked her at that time, her brothers and sisters, parents, grandparents, are also able-bodied."

"Are you and your wife consanguineous?"

"No."

"Did the child's mother take any medicines when she was pregnant with this child?"

"We were very careful at that time. When we caught a cold, we just boiled some ginger and brown sugar water by ourselves, and didn't dare to take medicine."

Family genetic history, marriage of close relatives, and drug harm caused by taking medicine during pregnancy can basically be ruled out.

"What kind of work did the child's mother do at that time? Did she come into contact with radioactive or toxic substances?"

"She and I work in a food factory, so there should be no contact with these things."

"Okay, take the child for a blood test and take an X-ray, and then I'll look at the bones of the child's hand. He probably needs surgery to correct it. If the joint has a particularly serious problem, I'm afraid there is no way Surgery. In short, as long as there is a glimmer of hope, I will do my best to help him heal, please rest assured."

Zhou Can also knows that this family is very special.

Healing the child's hands not only opened a window of hope for a child whose life was in darkness, but also saved the family.

……

About an hour later, the little boy who broke his wrist came back after taking the photo.

Zhou Can took a look at the film, and a smile appeared on his face.

"Your son is very lucky, the wrist is only a skin trauma, and no bones are injured."

"Really! That's great!"

The little boy's mother is as happy as if she won 500 million in the lottery.

"The child's recovery ability is very strong. Buy him a bottle of safflower oil and other medicines, rub it at home, and he will be fine in a few days." Zhou Can said to his family.

"Thank you, thank you! Well, do the hospitals have this kind of medicine? Your doctors are more professional, and the medicines you prescribe will be better. The medicines in big hospitals are more secure."

The little boy's mother trusted Zhou Can very much.

"That's fine, I'll prescribe some medicine for him, and you can just pay the fee and go to the pharmacy to get it. You can wipe it several times a day, and watch the child carefully so that he doesn't get it in his mouth."

Zhou Can prescribed a bottle of the most commonly used medicine for removing stasis and promoting blood circulation for the child.

For external use, it is relatively safe.

The only thing to pay attention to is to prevent children from being greedy and licking with their tongues.

After the treatment of this child, the child with deformed hands also came back after the examination.

First looked at the blood test report, very normal.

Look at the X-ray of the patient's hand.

Good guy, I saw that the metacarpophalangeal joints of the patient's fingers were ulnar deviation, and the metacarpophalangeal joints were flexed.The X-ray picture of the left hand looks like a hook, and the right hand looks even more terrifying, a proper bird claw.

With both hands in the right position, the shape of the patient's hand bones is also scary.

After Zhou Can finished reading the X-rays, he re-examined the shape of the patient's hands.

I saw that the skin on the palm side of the patient was short and tight.If surgical correction is done, it may be necessary to stretch the skin.The thumb is adducted, unable to abduct, and the tiger's mouth is narrow.

Try to break it with a little force, and you may maintain this adducted posture for a long time. The extensibility of the tiger's mouth skin is extremely poor.

And the thumb joint is very stiff.

The patient's thenar is affected and visibly stunted, giving it the appearance of a severely malnourished lean fish.

The name of a disease related to congenital deformities of the hands could not help appearing in his mind.

Congenital hand deformity.

It means that the wind is blowing that way, and the hand is tilted to that side.The disease was first officially discovered and named in France in 1897.The French have always been romantic, even when naming diseases.

According to the records of medical journals that Zhou Can has read, congenital hand deformity has three notable features.

That is, the ulnar deviation of the metacarpophalangeal joints of the palm, the flexion of the metacarpophalangeal joints, and the adduction of the thumb accompanied by contraction of the tiger's mouth.

Ulnar deviation and flexion of the fingers at the metacarpophalangeal joints are most obvious in appearance, but in fact, thumb adduction and twitching have the greatest impact on hand function.

As far as Zhou Can knows, in addition to the typical triad, the disease also has the characteristics of congenital vertical talus and short stature.

After careful study of the patient's X-rays, Zhou Can worked hard to find the cause of the disease and possible surgical options.

Abnormalities of the Dupuytren's fascia, metacarpal ligament, and interdigital web ligament are all causes of hand deformities.

At the same time, the ulnar deviation of the fingers at the metacarpophalangeal joints, as well as the muscle strength imbalance between the normal flexor tendons and abnormal extensor tendons, will also exacerbate the loss of flexion and extension of the fingers.

Even the patient's left hand has already flexed the wrist joint, which will definitely affect and limit the movement of the shoulder and elbow joints.

Surgical correction is very difficult for patients.

After all, Zhou Can only had three months of regular training in orthopedic surgery, and spent the last month in the manipulation reduction room.It is not easy to preside over the operation of this patient alone.

"Doctor Zhou, can my son's hand still be cured?"

The child's father looked at Zhou Can expectantly.

For Zhou Can, it is just a case in his career, but for patients and their families, it affects his whole life.

"I can't guarantee that it will be cured, but after seeing the film, I think I can try multiple surgical corrections, and I should be able to achieve a satisfactory therapeutic effect."

Zhou Can thought for a while before answering the family's question.

With such a serious hand deformity, it is impossible to correct it in one operation.

Even with multiple operations, we can only try our best, and no doctor dares to say that it will be cured.

"How much will the treatment cost?"

When the family members heard Zhou Can say that it can be cured, they immediately showed a gleam of joy.

However, for the poor, there is also the issue of treatment costs that need to be considered.

In the corridors of the intensive care department of the hospital and outside the wards, family members of different ages squatted on the ground with their heads in their arms and cried every day.Because of the high cost of treatment, they are like a mountain, overwhelming them.

On the one hand, there is the constant family affection, and on the other hand, the unaffordable medical expenses. This is the cruelest world for adults.

"The specific cost depends on the actual treatment, but according to your son's condition, it is conservatively estimated that the treatment cost will be [-] to [-]." Zhou Can can only give a rough estimate.

Surgical treatment will have very large cost fluctuations according to the actual treatment situation, as well as each person's physique, whether there is infection, whether the operation is successful, etc.

The treatment price for a single hand deformity is about [-] to [-].

If the effect of correcting hand bones or skin grafting is not satisfactory, the cost of surgery will increase.Infection, or bone collapse, avascular necrosis and other extreme cases during osteotomy orthopedic surgery, the cost will increase exponentially.

"It's so much!" The expressions on the faces of the family members became a little nonchalant.

"Because the operation is not completed all at once, it will be divided into multiple stages. The time span will be relatively long. If you can raise about 7 yuan, I think you can start applying for the operation. This kind of congenital hand deformity correction , Theoretically speaking, the sooner the treatment is more beneficial, the cost will be lower, and postoperative rehabilitation and hand function training can achieve satisfactory results.”

Zhou Can's idea was simple. If the family members could raise 7 yuan for the operation on the little boy, they would really have no money to spend at that time. It would be no problem for him to donate around [-] yuan.

It mainly depends on the attitude of the family.

If the family members are not willing to work hard, Zhou Can will naturally not be the savior.

His code of conduct is to only help those who can be helped.

Blindly lying flat, passive-willed, and only thinking of relying on others to save him, that kind of person would even give the government a headache.

The family member thought about it for a minute or two, during which time he even took out an old mobile phone as a calculator, calculating how much money he could scrape together.

Zhou Can could see clearly that the man first entered 53000, which should be his deposit.

Then keep inputting numbers one by one to add in.

"7 yuan is no problem. I calculated it, and I can make it all together. But if it is not enough at that time, I want to ask the hospital to let me owe it first. I can save [-] to [-] yuan by working part-time for a year to get rid of food and expenses. At that time, I can try to repay it together with the interest."

The man said sincerely to Zhou Can.

"I will report your situation to the hospital, and try to reduce the expenses that can be reduced. In addition, it is only the preliminary treatment plan and estimated cost that I told you. The specific operation plan needs to be discussed with the orthopedic surgeon. Make it first. Do you live in this city?"

Zhou Can asked.

"Yes, I work in a food factory, so I live in the dormitory with my son."

The man answered this way, most likely he did not have housing in the city.

"Wait a minute, I'll ask Director Zhang."

Zhou Can stood up and walked to Director Zhang Bihua, and briefly explained the patient's condition in a low voice.

"Director Zhang, do you think that the child's corrective surgery can be recommended to Tuya Hospital?" Zhou Can mainly asked about this matter.

(End of this chapter)