“Maintain traction. Don’t let up.”
Imagawa Ori frowned and increased the force in her hands.
Joint instability caused by a ruptured ligament truly wasn’t something that could be solved by manipulation alone.
But before the plaster set, she had to maintain this unstable reduction as best she could.
That required tremendous finger strength.
Kiryu Kazusuke looked at Imagawa Ori’s finger joints, pale from the exertion.
He adjusted the angle of traction slightly, placing the wrist in mild dorsiflexion.
At this angle, the tension of the surrounding intact ligaments and joint capsule could be used like a net to cradle the lunate, preventing it from slipping palmward again.
This was what “Joint Dislocation Reduction · Basic” had brought him.
It was different from a “Perfect” skill, the kind that allowed one to walk a tightrope on the edge of a cliff.
While applying traction, he was merely making use of the most fundamental principle of “ligamentous reduction,” allowing him to better coordinate with the surgeon’s pressure and serve as a stable base.
Imagawa Ori immediately sensed the change beneath her hands.
That force that had constantly seemed about to slip free suddenly vanished. The lunate was firmly seated in the lunate fossa of the radius.
She glanced at Kiryu Kazusuke in some surprise.
“Apply the cast.”
But Imagawa Ori wasted no words. Freeing one hand, she signaled for the nurse beside her to hand over the bandages.
With the two of them working together, the plaster cast was soon applied.
To maintain the reduction, the wrist joint was fixed in a position of mild dorsiflexion and ulnar deviation.
Mrs. Ando looked at her right hand, now wrapped in a thick plaster cast.
Although it looked cumbersome, the piercing pain from before, as well as that awkward sensation as if something inside the joint had shifted out of place, had indeed eased considerably.
Imagawa Ori asked with satisfaction, “How does it feel?”
“It seems… much more comfortable.” Mrs. Ando tried moving her shoulder. “It doesn’t hurt as much as just now.”
“That’s good.”
Imagawa Ori nodded, then turned to instruct the nurse.
“Take her to radiology. Repeat the X-ray.”
“This time, take comparative films of both wrist joints. Also add a clenched-fist stress view.”
……
Before reduction, an MRI was needed for confirmation, but afterward, an X-ray would be enough.
After all, a single MRI cost tens of thousands of yen, and the experience was hardly pleasant either. If Mrs. Ando ended up making a fuss, it would not be worth the loss.
Inside the radiology reading room.
The freshly developed X-ray films still carried the sour smell of developer solution as Imagawa Ori inserted them into the lightbox.
Good. The reduction was excellent.
The surrounding ligaments were still ruptured, but for palliative treatment, this was the limit.
On the lateral view, thanks to Kiryu Kazusuke’s control of the traction, the support of the plaster and the tension of the soft tissue had combined to restore the lunate to its anatomical reduction point.
Gilula’s three arcs had regained their continuity.
The capitate, lunate, and radius were aligned in a single line.
However, this did not mean Mrs. Ando could escape surgery.
When a bone broke, as long as it was aligned, it could grow back on its own through callus formation.
But her problem was the ligament.
Within a cavity filled with synovial fluid, coupled with retraction of the severed ends, a ligament could not possibly heal on its own.
When the plaster was removed, once it lost the forced restraint of external support, the lunate, with no ligament to hold it, would slip out again like a wild horse throwing off its reins.
At that point, the entire wrist joint would collapse.
It was like the main beam of a house—the ligament—had snapped, and they were temporarily propping up the roof with a wooden pole—the cast—to keep it from caving in.
After the New Year, once the materials were ready, they would still have to lift the roof and reconnect the main beam.
Otherwise, the moment the wooden pole was removed, the roof would collapse all the same.
“As expected of Dr. Imagawa.”
Beside her, Takigawa Takuhei offered a heartfelt word of praise.
This manual reduction had been done so standardly that no one could find fault with it.
“Dr. Imagawa really is amazing.”
Tanaka Kenji also leaned his face toward the lightbox, his eyes full of admiration.
Was this the strength of a specialist?
However…
Imagawa Ori said nothing. She simply stared at the fluoroscopic films on the lightbox.
In her heart, she knew that achieving a reduction to this degree was not entirely her own merit.
Kiryu Kazusuke.
He had adjusted the angle of traction, using an extremely subtle technique to employ the tension of the joint capsule and cradle the bone that wanted to slip out.
If the person responsible for traction at the time had been Takigawa Takuhei…
Then in all likelihood, they would only have achieved seventy percent reduction, and the remaining thirty percent would have depended on whether Mrs. Ando was someone blessed by the heavens.
“Let’s go.”
“Tanaka, go tell Mrs. Ando that the reduction was very successful.”
“Takigawa, prescribe her the best painkillers. Let her have a good New Year.”
“Kiryu, you can go back to the medical office.”
With a snap, Imagawa Ori turned off the reading light, pulled down the films, and no longer wanted to look at the foolish faces of Takigawa Takuhei and Tanaka Kenji.
Kiryu Kazusuke followed behind, both hands in his pockets.
After the group left radiology, they each went their separate ways.
In the corridor, people came and went. They were all patients and family members hurrying to see the doctor before the holiday.
When Kiryu Kazusuke reached the connecting corridor leading to the pharmacy department, he stopped.
At the corner of the corridor, a middle-aged man in a dark gray suit stood against the wall, holding several exquisite paper bags printed with the “Nakamori Pharmaceutical” logo.
A medical representative.
In this era, their power had not yet been restricted by the strict regulations that would come later.
They entered and exited professors’ offices as if no one could stop them.
Giving gifts, treating people to meals, arranging golf outings—even helping doctors pick up their children, wash their cars, or move house.
As long as they could get doctors to write a few more of their company’s drug names on prescriptions, they would do anything. Even pillow business was commonplace.
The middle-aged man seemed to sense someone looking at him and raised his head.
When he saw the words “Resident Physician” written on the name tag hanging on Kiryu Kazusuke’s chest, the smile on his face became somewhat stiff.
He gave a perfunctory nod, then lowered his head and continued pretending to arrange the gift boxes.
Kiryu Kazusuke did not particularly care.
Resident physicians had no prescription authority—or rather, their prescription authority was restricted.
In the eyes of medical representatives, residents were barren land with no development value. They could neither bring sales nor decide procurement lists.
Compared with them, those specialists, lecturers, and professors were the fat sheep in their eyes.
Kiryu Kazusuke’s gaze swept over the gift boxes.
Judging from the quality of the packaging, there were probably several boxes of beautifully wrapped high-end pastries inside, with a few department store gift cards or an envelope pressed underneath.
Although the bubble had burst, the profits in the medical industry were still astonishingly rich.
Drug prices were inflated, and kickbacks were rampant.
This was the medical circle of 1994.
Exchanges of benefits were laid out nakedly on the table. As long as the media did not catch anyone red-handed, everyone tacitly followed the rules.
As he passed the medical representative, Kiryu Kazusuke slowed his steps slightly.
Once he was closer, he glanced again at the gift bags.
Nakamori Pharmaceutical?
It seemed to be a second-tier pharmaceutical company mainly producing antibiotics and painkillers. Recently, it appeared to have launched a new nonsteroidal anti-inflammatory drug and was promoting it with all its might.
But that was not the important point.
Kiryu Kazusuke thought of that woman who had wanted to claw at Imagawa Ori—Nakamori Sachiko.
Able to afford a Maybach, wear jewelry worth millions, and even spend over ten million yen opening a champagne tower.
With that level of spending power, if she was the president of a large local pharmaceutical company in Gunma Prefecture… or the president’s wife?
Then it made sense.
If he could make the world line converge through her again and fleece a few hundred thousand yen, that would be nice.
Kiryu Kazusuke made up his mind. He would have to find an opportunity for a chance encounter.