Chapter 312: Deformed hair dryer hand, the difficulties of the poor
"Everyone, don't rush, don't push, fill out your medical records, and I will call your numbers one by one." Ji You was trying hard to maintain order.
She is a very qualified nurse.
The standard of a good woman is that she can be both a lady in the living room and a housewife in the kitchen.
An excellent nurse must not only be skilled in giving injections and changing dressings, but also be proficient in communicating with patients and maintaining order in the on-site clinic.
"Doctor Zhou, my son's left hand was injured. Please help take a look."
The young mother held her child in her arms with concern and was in the first position.
Look at this little boy, he is only two or three years old at most, his eyes are full of tears, and there are still traces of tears on his face. It seems that he has just cried.
After a physical examination, Zhou Can found that the little boy had a mild hematoma on his left wrist.
Moreover, his left hand seemed to be completely powerless and he didn't even dare to move.
"How did this happen?"
"In the morning, while having breakfast, he was rolling a hard-boiled egg on the dining table. As a result, he accidentally fell off the chair while chasing the egg."
It seems that little boys are more likely to fall and get injured because they are more naughty than girls.
You also need to be braver.
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 asking the parents, Zhou Can still didn't dare to be careless.
A broken hand is just a minor matter. Children's bones are very flexible, and generally the most serious injuries are dislocation or joint displacement. Fractures rarely occur.
Head injuries are the most dangerous.
The skulls of many children take one or two years to close, which is what we often call the fontanelle.
There is a gap on the head of a newborn baby, which is called the fontanelle. This is caused by the incomplete closure of the skull. It can be usually divided into the anterior fontanelle and the posterior fontanelle. The anterior fontanelle is usually located at the top of the head and is diamond-shaped.
The posterior fontanelle is close to the occipital region and is triangular in shape.
The surface of the fontanelle of a newborn baby only has the scalp, and the inside contains the meninges, cerebrospinal fluid and brain. If you gently place your hand on the fontanelle, you can clearly feel the beating.
If the fontanelle of a child is still not closed after the age of two, it is very likely that there is something wrong with the child's body, such as calcium deficiency or developmental delay. At this time, you must take the child to the hospital to see a doctor.
Zhou Can was still worried that the child had injured his head and might have intracranial hemorrhage or something.
After a careful examination of the boy's head, there were no obvious bruises or hematomas. When I touched him, the boy showed no signs of pain, so I guessed it was nothing serious.
"I'll apply for an X-ray first. You take him to get an X-ray. Be careful not to touch the injured part of his wrist. No one knows whether the bones inside are broken or not."
Zhou Can gave the instructions again, and the woman took the list and took the child for a check-up.
The second one was actually another child.
He is a little older than the previous little boy and is five years old.
"Doctor Zhou, we saw on TV that you are very good at treating children's hand diseases. Can you please see if you can cure my baby's hand?"
The family member was a young man who was no more than two years older than Zhou Can, estimated to be at most twenty-six or twenty-seven years old.
I didn’t expect that other people’s children are already able to help with cooking.
Zhou Can somewhat understood his parents' constant urging for him to get married. Seeing people of Zhou Can's age getting married and having children, his parents were naturally anxious.
“Hey, is this hand natural?”
Zhou Can found that the little boy was a little embarrassed and didn't dare to stretch out his hand.
The boy's father grabbed his hands and forced them onto the examination table. It was obvious that the boy's fingers could not be straightened and were hooked like chicken claws.
The thumb can be extended but not fully abducted.
This child's grip function will definitely be greatly affected.
"A few days after the child's attack, I discovered that his hands were different from those of ordinary people. His fingers could not be straightened and were slanted. Later, when he grew up, the problem became more serious when he used his hands to pick up things. I had many arguments with his mother because of this. Finally, she left when he was three years old and never came back."
When the man talked about this incident, he seemed particularly sad and full of regret.
"Doctor Zhou, if you can heal my son's hands, I can find a way to bring him back to find his mother."
Generally speaking, family members will not easily tell doctors about these family scandals.
The man may indeed feel regretful and have thought about how to get his wife back.
It would be easier to persuade the child to come back after curing his illness and then finding his mother.
"Children without mothers are 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 his hands were born disabled. If you can give him a warm and complete home, it will be of great benefit to his growth."
Zhou Can usually seldom interferes with his patients' family affairs.
This time is an exception.
Because children born with disabilities are more likely to have low self-esteem, are more fragile mentally, and need the combined care of both maternal and paternal love.
"You're right. I was too young before and didn't know how to cherish. When the child was born with disabled hands, I always blamed her. Now I feel really regretful. How could I blame her? I have looked for her in the past two years, but she has always refused to forgive me. So this time I made up my mind to take the child and cure his hands. Only in this way can she change her mind."
When the man told him about the plight of these families, the little boy just lowered his head, looked at the table, and said nothing.
This child seems particularly autistic.
It's really heartbreaking to watch.
"Don't be afraid, little boy. After your uncle examines you, he may be able to find a way to cure you!"
Zhou Can comforted the little boy.
I began to give him a serious physical examination.
While examining, ask family members for relevant medical history information.
"Does anyone in your family have this kind of hand and foot deformity?"
"No! My brothers and sisters, parents, grandparents and I are all normal."
"What about the child's mother's family line?"
"I asked her at that time, and her brothers and sisters, parents, grandparents, all of them have healthy limbs."
"Are you and your wife married as close relatives?"
"no."
"Did the mother take any medication when she was pregnant with this child?"
"We were very careful at that time. When we caught a cold, we would just boil some ginger and brown sugar water and didn't dare to take medicine."
Family history, consanguineous marriage, and drug harm caused by taking medicines during pregnancy can basically be ruled out.
"What kind of job was the child's mother doing at the time? Did she come into contact with radioactive or toxic substances?"
"She worked with me in a food factory, so she shouldn't have come into contact with these things."
"Okay, take the child to have a blood test and take an X-ray. I will then take a look at the condition of the child's hand bones. He may need surgery to correct this. If there are particularly serious problems with the joints, then I'm afraid surgery may not be possible. In short, as long as there is a glimmer of hope, I will do my best to help him with the treatment, so please rest assured."
Zhou Can also knew that this family was special.
Healing this child's hands not only opens a window of hope for a child whose life is so dark, but also saves the family.
…
About an hour later, the little boy who broke his wrist came back after taking the X-ray.
Zhou Can took the film and looked at it, and a smile immediately appeared on his face.
"Your son is very lucky. His wrist was only injured superficially, and no bones were broken."
"Really? That's great!"
The little boy's mother was as happy as if she had won five million in the lottery.
"Children have a strong ability to recover. Buy him a bottle of safflower oil or something like that, have him go home and rub it on himself, and he'll be fine in a few days." Zhou Can told the family.
"Thank you, thank you! Um, does the hospital have this medicine for sale? Your doctors are more professional and the medicine they prescribe will be better. Medicines in big hospitals are more reliable."
The little boy's mother trusts Zhou Can very much.
"Okay, I'll prescribe some medicine for him, and you can just pay for it and go to the pharmacy to get it. You can apply it several times a day, and keep an eye on the child and don't let him take it."
Zhou Can prescribed a bottle of the most commonly used blood-dissolving and blood-activating medicine for the child.
Topical medications are relatively safe.
The only thing to pay attention to is to prevent children from being greedy and licking it with their tongue.
After this child was treated, the child with deformed hands also came back after the examination.
I first looked at the blood test report, which was quite normal.
Let's look at the patient's hand X-ray.
My goodness, the patient's fingers were ulnarly deviated at the metacarpophalangeal joints and flexed at the metacarpophalangeal joints. The lateral X-ray of the left hand looked like a hook, and the lateral X-ray of the right hand looked even more terrifying, a bird's claw.
When both hands are positioned upright, the shape of the patient's hand bones is equally scary.
After Zhou Can looked at the X-ray, he re-examined the appearance of the patient's hands.
The patient's palm skin is short and tight. If surgery is performed, the skin may need to be stretched. The thumb is adducted and cannot be abducted, and the base of the thumb is narrow.
Try to bend it with a little force, but the skin at the base of the thumb may have poor elasticity due to maintaining this inward-adducted posture for a long time.
And the thumb joint is very stiff.
The patient's thenar eminence was affected and was obviously underdeveloped, and he looked like a severely malnourished, skinny fish.
A disease related to congenital hand deformity suddenly popped up in his mind.
Congenital hair dryer hand deformity.
This means that the hand will lean to the direction the wind blows. 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 medical journals Zhou Can had read, congenital hair-blowing hand deformity has three distinct characteristics.
That is, the metacarpophalangeal joint of the palm is ulnarly, the metacarpophalangeal joint is flexed, the thumb is adducted and the base of the thumb is retracted.
Ulnar deviation and flexion of the fingers at the metacarpophalangeal joint are most obvious in appearance, but in fact, thumb adduction and thumb retraction have the greatest impact on hand function.
As far as Zhou Can knows, in addition to the typical triad, this disease is also characterized by congenital vertical talus and short stature.
After carefully studying the patient's X-rays, Zhou Can tried hard to find the cause of the disease and possible surgical options.
Abnormal palmar aponeurosis, intermetacarpal ligaments, and interdigital ligaments are all causes of hand deformities.
At the same time, ulnar deviation of the fingers at the metacarpophalangeal joint should also be considered, and the imbalance of muscle strength between the normal flexor tendons and the abnormal extensor tendons will also aggravate the loss of finger flexion and extension ability.
Even the patient's left hand has wrist flexion, which will definitely affect and restrict the movement of the shoulder and elbow joints.
It is very difficult for patients to undergo surgical correction.
After all, Zhou Can only trained in orthopedics for three months, and spent the last month in the manual reduction room. It was not easy to perform the operation on this patient alone.
"Doctor Zhou, can my son's hand be cured?"
The child's father looked at Zhou Can with hopeful eyes.
For Zhou Can, it was just a case in his career, but for the patients and their families, the impact will last a lifetime.
"I can't guarantee that it can be cured, but after looking at the X-rays, I think I can try multiple surgeries to correct it, and I think I should be able to achieve satisfactory results."
Zhou Can thought for a while before answering the family's questions.
It is impossible to correct such severe hand deformity with one surgery.
Even after multiple surgeries, we can only try our best. No doctor dares to say that it can be cured.
"How much will the treatment cost?"
When the family members heard Zhou Can say that the disease could be cured, they immediately showed a hint of joy.
However, for the poor, they also need to consider the cost of treatment.
Every day, family members of different ages squat on the ground and cry with their heads in their hands in the corridors of the hospital's intensive care unit and outside the wards. The high cost of treatment is like a mountain, weighing them down and making them breathless.
On one side is the unbreakable family ties, and on the other side is the unbearable cost of medical treatment. This is the cruelest world of adults.
"The specific cost depends on the actual treatment, but based on your son's condition, a conservative estimate is that the treatment cost will be between 70,000 and 90,000 yuan." Zhou Can could only give a rough estimate.
Surgical treatment will result in very large cost fluctuations depending on the actual treatment situation, each person's physical condition, whether infection occurs, whether the operation is successful, etc.
The cost of treating a single hand deformity is approximately RMB 30,000 to 45,000.
If the hand bone correction or skin grafting is not effective, the cost of the operation will increase. If infection occurs, or bone collapse, ischemic necrosis, and other extreme conditions occur during osteotomy, the cost will rise exponentially.
"You need so much!" The family member's expression became a little timid.
"Because the surgery is not completed all at once, it will be divided into multiple stages. This time span will be relatively long. If you can raise about 70,000 yuan, I think you can start applying for the surgery. In theory, the earlier the correction of this congenital hand deformity, the better, and the cost will be relatively low. Postoperative rehabilitation and hand function training can achieve relatively satisfactory results."
Zhou Can's idea was simple. If the family could raise 70,000 yuan for the boy's surgery, and they really couldn't afford it at that time, it would be no problem for him to donate about 20,000 yuan.
It mainly depends on the attitude of the family members.
If the family members are not willing to work hard, Zhou Can will naturally not be the savior.
His principle in life is to only help those who can be helped.
People who just lie down, have a negative will, and only think of relying on others to save them are the kind of people that give the government a headache.
The family member thought about it for a minute or two, during which time he even took out a very old mobile phone as a calculator, calculating how much money he could raise.
Zhou Can saw clearly that the man first entered 53,000, which should be his deposit.
Then keep entering numbers one by one.
"Seventy thousand yuan is no problem. I calculated that I can get it together. But if it's not enough, I want to beg the hospital to let me owe it first. After working for a year and deducting the food expenses, I can save thirty or forty thousand. Then I can pay it back with interest."
The man said to Zhou Can sincerely.
"I will report your situation to the hospital and try to reduce the fees as much as possible. In addition, this is just a preliminary treatment plan and estimated costs. The specific surgical plan needs to be discussed with the orthopedic surgeon before it can be formulated. Do you live in this city?"
Zhou Can asked.
"Yes, I work in a food factory and live with my son in the company dormitory."
The man who answered like this probably does not have a house in the city.
"Wait a moment, I'll ask Director Zhang."
Zhou Can stood up and walked to Director Zhang Bihua's side, and briefly described the patient's condition in a low voice.
"Director Zhang, do you think it is possible to recommend that the child undergo corrective surgery at Tuya Hospital?" This was the main thing Zhou Can asked.
