Practicing Medical Skills in a Small Clinic-Chapter 103 - 101: Unlimited Opportunities for Bone Palpation, Hands-On Teaching (Part 2)

Chapter 103: Chapter 101: Unlimited Opportunities for Bone Palpation, Hands-On Teaching (Part 2)

"Xiaoli, take a look at the hip joint X-ray."

The patient had numerous scans taken, not only X-rays but also a CT scan.

The absence of an MRI request probably means the doctor was conscientious, not applying for one.

After all, MRIs are a very valuable medical resource.

In larger hospitals, MRI scans are often prioritized for patients who truly need them.

Such as undiagnosable tumors, or diseases with unknown causes, and so on.

Beside him, Dr. Chen looked at Doctor Xu with a resentful gaze as he handed the hip joint film to Li Jingsheng. It felt like the difference between one’s own child and someone else’s.

Li Jingsheng examined the film carefully.

"Remember the skeletal positioning of the dislocated hip joint in the film, then examine the patient’s hip joint."

Doctor Xu discreetly offered Li Jingsheng an invaluable opportunity to practice the Bone Touching Skill.

Beside him, Dr. Chen was thoroughly envious.

For heaven’s sake, what’s the background of this newcomer, Dr. Li? Could he be a relative of Doctor Xu?

He had never seen Doctor Xu be so caring towards any junior doctor before.

After reviewing the film, Li Jingsheng squatted down and began recalling the essentials of the Bone Touching Skill.

Light first, then heavy; distant first, then near...

He began carefully palpating the patient’s bones.

Due to the special position of the hip joint, the area has a thick layer of fat and a rich muscle group, making it difficult to feel the bone.

"Ouch! Ouch... It hurts, it hurts..."

The patient let out cries of pain.

This time, it sounded much more vigorous than before.

What an actor!

The family members watching from the side showed pained expressions, and their eyes were filled with anger.

"If you don’t want surgery, you’ll have to endure this. Accepting manual Bone Setting here not only costs less but also allows for a quicker recovery with minimal side effects. Surgery would be far more painful than this."

Doctor Xu calmly assisted by speaking for Li Jingsheng.

Upon hearing this, the family’s expressions visibly relaxed.

The patient also gritted their teeth and endured, no longer being so ’fragile’.

Their hip joint was dislocated, and experiencing pain during palpation was inevitable. Li Jingsheng was, after all, a novice, having only just learned the theory of Bone Touching Skill and not even reaching entry-level.

This injured patient was unfortunate to end up in his hands.

No wonder many patients fear encountering interns and trainee nurses practicing on them when visiting the hospital.

Of course, neither an intern doctor nor a trainee nurse would tell the patient and family, "I’m just starting my internship and need to test my clinical skills on you."

If they did, no family member would agree.

After a round of bone palpation, Li Jingsheng gradually gained some insights.

He correlated the X-ray imagery stored in his mind with the actual bone position felt through palpation, then slowly summarized and corrected discrepancies.

He palpated for a good seven or eight minutes, and several layers of cold sweat appeared on the patient’s forehead from the pain.

The family members’ patience was also nearing its limit.

Li Jingsheng, knowing when to stop, finished honing his Bone Touching Skill and stood up.

"No fractures detected, the patient’s muscles are tense, before repositioning, we should consider relaxing the muscle groups around the hip joint."

Doctor Xu nodded slightly after hearing this.

"Oh, the muscles are quite tense? Let me check."

With that, he proceeded to examine himself.

Compared to Li Jingsheng’s inexperienced handling, he was much more adept.

He spent less than ten seconds examining before standing up and telling the family, "Before repositioning with Bone Setting, anesthesia might be necessary, as the pain and anxiety have left the muscles very tense, making it impossible to operate."

"Sure, sure, as long as you can reposition my brother’s hip manually, using anesthesia is no problem at all."

The family nodded in agreement readily.

"Anesthesia is great. It won’t be painful during manual repositioning."

"The technique here is truly amazing; two other hospitals insisted surgery was necessary for repositioning."

The family members discussed animatedly.

The driver responsible stood silently by the side, fully cooperating with the patient’s treatment.

In addition to blocking nerve conduction so the patient doesn’t feel pain, anesthesia also serves to relax muscles.

The hip joint is in a very special location, located at the junction of the trunk and lower limbs.

This area cannot be locally anesthetized.

Unlike the arm, which can directly undergo brachial plexus anesthesia.

Manual repositioning of the hip joint typically uses general or epidural anesthesia.

Doctor Xu had already asked the nurse to call the anesthesiologist over.

It’s worth noting that epidural anesthesia is not the same as spinal anesthesia. The former is commonly used, while the latter is less.

Because spinal anesthesia could potentially damage the spinal nerves.

It might even cause local infection.

Due to its stronger side effects, doctors, adhering to the principle of avoiding harm, rarely use spinal anesthesia.

The anesthesiologist arrived quickly and set up for the anesthesia.

"Come, lift the patient onto the treatment bed."

Doctor Xu instructed Li Jingsheng and Dr. Chen to lift the patient onto the treatment bed together.

This treatment bed is reinforced and exceedingly sturdy.

It’s slightly higher than a regular hospital bed.

This is presumably to facilitate the Bone Setting operation.

Epidural anesthesia is relatively safer compared to general anesthesia and is somewhat more convenient to administer.

The anesthesiologist and nurse methodically and cautiously proceeded with the operation.

After a successful puncture, they administered a small test dose first.

Then they patiently waited and closely monitored the patient.

After a good ten-plus minutes, confirming the patient had no signs of lumbar numbness, they then administered a full dose of anesthesia.

Li Jingsheng watched their operation with envy.

The seemingly simple puncture actually harbored great risks and demanded a high level of technical skill.