Hermes' surgery is scheduled for next week and needs to be discussed in the afternoon.
This surgery is a big one. Most of the tibia must be amputated and discarded. Except for the proximal and distal healthy parts, all the infected bone tissue in the middle must be amputated.
Then use the Ilizalov technique and use external fixators to extend the healthy bone tissue at both ends, extending from the two ends to the middle, and finally meeting them.
In order to complete the task of bone lengthening, an external fixator must be installed on the calf. There are screws on the external fixator. When the screw is turned, the external fixator will move with the bone tissue.
The lengthening begins two weeks after the operation, and the length is one millimeter every day. Hermès needs to be lengthened by more than 30 centimeters, which takes about a year.
This is just an ideal state. If osteogenesis abnormalities occur during the process, the extension needs to be stopped.
Yang Ping finished Luo Xiaohu's surgery in the morning and had nothing to do in the afternoon, so he slept in the duty room, entered the system space, read books for a long time, dissected dozens of experimental subjects, and trained his ability to compose pictures.
We also spent 5,000 points to purchase 500 cases of external fixators for specialized surgery training.
Director Tian returned to the ward from the first floor. He had translated Tan Boyun's opening speech into English and handed it to Zhang Lin.
Zhang Lin's posters have almost been revised. He sat in front of the computer and went through them one by one, several times.
"Is this really a Japanese doctor? Are you sure the pictures weren't stolen?" Xiaowu sat next to Zhang Lin, still struggling with this issue.
Zhang Lin ignored him, and Xiao Wu remembered that Director Tian was familiar with the guests attending the conference, had also been to Japan, and had extensive knowledge. He asked whether he was right, and pointed to the photo on the computer: "Is this really a Japanese doctor?" p>
Director Tian smiled and said: "Really, she is a guest attending the meeting. Fujiwara, a doctor at the Affiliated Hospital of the University of Tokyo School of Medicine, is very good at sports medicine."
"Have you met her in person?" Fatty Liang was also very interested.
"I met her in person when I was a visiting scholar there." Director Tian did meet her.
"Am I that beautiful in person?" Xiao Wu still didn't believe the photo.
Director Tian smiled: "I am more beautiful than this. Do you know how tall she is?"
"How much?" Zhang Lin asked, because the information provided did not include height.
"One meter seventy-eight!" Director Tian reported the number.
"So high? As tall as me! Only Song Zimo can hold it down, and senior brother can barely hold it down!" Zhang Lin was surprised.
Director Tian said so much and became impatient: "Let me say, pour a glass of water, don't say you did it."
Xiao Wu immediately offered a glass of water with a smiling face, and then Director Tian continued: "This is nothing, what will surprise you more is what her part-time job is, do you want to know?"
What? Everyone is very interested. This is interesting, could it be--
What an island country! It always makes people think about it. Who hasn’t been young? Two letters have popped up in someone’s mind.
Director Tian took a sip of water: "Fat man, take out your weight loss meal replacement and give it to me. It requires energy to talk. There is a serious lack of ATP."
The fat man took out a few chocolate balls from the bag and handed them over. Director Tian peeled one open and threw it into his mouth.
Everyone watched him eat eagerly, waiting for him to tell him what his part-time job was?
Director Tian took a sip of water and said: "She is a part-time model, a Japanese supermodel, top ten in the World Elite Model Competition, and has participated in the Victoria's Secret Show in Paris."
"If you bring someone like this here, don't hold the academic conference, let's just watch her catwalk." Fatty Liang said.
Zhang Lin sneered: "Fat man, do you think everyone is as vulgar as you? Be more elegant."
Director Tian continued: "She is a rising star in Japan's sports medicine world. Her brother is good at orthopedics and trauma. She probably came out with his brother this time. Although situations like her are rare, they do exist. Norio Ohga, Chairman of the Board of Directors of Sony Japan
, is also the conductor of the Tokyo Philharmonic Orchestra; Hedy Lamarr, the inventor of CDMA telecommunications technology in the United States, is a generation of Hollywood movie stars and the first female star to appear naked in the world; Bohr, everyone knows? Bohr's law, high
After high school, he is not only a physicist, a Nobel Prize winner, but also the goalkeeper of the Danish national football team; let me tell you, several gold medal winners in the history of the Olympic Games have a serious career as a doctor! Invite me to dinner if you have time
, I will tell you slowly."
Director Tian is knowledgeable and eloquent.
"Great guy!" Fatty Liang shook his head helplessly.
"Fat man, so are you, an anesthesiologist and part-time chairman of the Sanbo Food Association." Zhang Lin said seriously.
Fatty Liang was not angry, but said afterward: "A good man is brave enough to be brave. To tell you the truth, when I was in college, I actually formed the school's society - the Food Association. I was the first president of the association, and I did everything I could.
Pay the price, look at my current figure, it’s the price.”
The fat man gestured to his waistline.
"Master!" Zhang Lin Xiaowu gave the fat man a thumbs up.
"Look, this is a photo of her Victoria's Secret Fashion Show in Paris!" Zhang Lin searched for the photo of the Japanese female doctor on the Internet.
"Wow!" Xiaowu and Fatty stretched their necks very long.
"Keep your distance and don't spray nosebleeds on me." Zhang Lin ducked sideways.
"This is not a photo retoucher. She is so beautiful. These legs can knock down 90% of the men in the world!" The fat man swallowed.
Fujiwara's photo, on the catwalk, wearing a windbreaker, short shorts, and sunglasses, shining brightly on the T stage.
Suddenly, Director Tian stopped speaking and coughed several times.
An unknown person slapped Zhang Lin on the shoulder. Zhang Lin immediately switched the screen without thinking, "Well, this patient is indeed troublesome."
"Well, it's very troublesome!" Xiao Wu touched his chin.
"It's quite troublesome!" Fatty Liang also nodded and frowned.
A group of drama queens, drama queens who were delayed by studying medicine.
"You guys performed well today. Are you looking at Wang Changxin's medical records?" Professor Zhang Zongshun walked in from the door.
Wang Changxin is the name of Hermès, and his name is so wealthy.
"Well, let's get familiar with it in advance!" Zhang Lin stood up with a sense of gain.
I don’t know whose damn paw touched the computer keyboard and actually brought up Fujiwara’s picture.
Professor Zhang looked through the gap between their bodies: "What is this?"
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Zhang Lin turned around and saw that the picture actually popped up and said calmly: "Screen saver, screen saver pattern."
"Oh!" Professor Zhang stopped pursuing it.
"Where's Yang Ping?"
"Study in the duty room!"
Actually sleeping in the duty room.
"Where is Song Zimo?"
"Practice arthroscopy in the laboratory!"
I am indeed practicing arthroscopy.
"Is everyone here? Let's discuss Wang Changxin's medical records later." Professor Zhang nodded slightly.
"Director Han is in the administration building and hasn't come back yet." Director Tian moved a chair for Professor Zhang to sit on.
"It's okay. Please prepare first. Wait, Director Han. This case discussion was raised a few days ago. Have you all read the book?"
"I've seen it!" Xiaowu Zhang Lin said in unison.
Everyone went to the classroom to wait for Director Han. Director Tian called and Director Han was on his way back. Not long after, Director Han came back.
The discussion started, Xiao Wu’s patient, Xiao Wu finished reporting the medical records.
"Xiaowu, you guys have studied the medical records and read the book in advance. Please share your views on this case." Director Tian presided over.
Xiao Wu looked at the screen: "There is no problem with the diagnosis of this patient. He has chronic osteomyelitis of the right tibia. The imaging examination and bacterial culture all support it. The best way is to completely remove the infected bone tissue of the tibia and then use an external fixator to lengthen the tibia.
, the defective part was temporarily filled with calcium sulfate containing vancomycin."
Yang Ping told them, and he felt a little worried.
"The length of the tibia must be at least thirty centimeters. This length is very rare. Will there be any neurovascular complications? Zhang Lin, tell me." Director Tian asked.
"Well, this, that -" Zhang Lin scratched his head.
Song Zimo took over and said: "This is different from the extension of abnormally shortened limbs. There is no need to consider the extension limit of nerves and blood vessels, because it is only extending the bone tissue, and the blood vessels and nerves do not need to be extended. Theoretically, it can be extended as long as it is.
There are limits."
Song Zimo has solid knowledge and was once known as the problem solver for the director's ward rounds.
"There are two options for extension instruments, external fixators and intramedullary nails. Of these two, external fixators are more suitable for this patient. Two sets of fixation pins can be placed on both the retained proximal and distal tibia. The external fixator is installed
No problem." Director Tian added.
Most people only know that external fixators can be extended, but they don’t know that there is a special intramedullary nail that can also be extended.
"What do you think of Yang Ping?" Professor Zhang asked by name. Yang Ping's speech was never very positive.
Yang Ping calmed down and said: "Everyone has explained in detail, there is not much to say. When inserting the needle, be careful to choose the intermuscular space to insert the needle, so that during the extension period, there will be the least interference with muscle strength training."
Song Zimo looked over and penetrated through the muscle space. It was easy to say, but it was difficult to complete completely. Everything seemed simple to him.
Director Han collected everyone's opinions and made a teaching summary, with the finishing touch: "Ilizarov's stretch tissue regeneration theory: biological tissue is slowly pulled to produce a certain tension, which can stimulate tissue regeneration and active growth. Its growth method is similar to
Fetal tissue is the same cell division. To put it simply, slow and continuous traction is used to return the tissue to the state where it can grow during the fetal period. This technology is subversive to the traditional compression fracture healing theory."
Yang Ping admired these pioneers of medical theories very much. These people had big brains and rich imaginations.
Professor Zhang would like to talk about the origin of this theory: "Ilizalov was a rural doctor in Siberia, the former Soviet Union in the 1950s and 1960s. This technology came about from an accident. His original purpose of designing the external fixator was to treat
A patient with a fracture promotes fracture healing by tightening the screws on the external fixator every day to tightly pressurize the broken end. Once he was going on vacation and asked the nurse to adjust the screws on the external fixator every day. This nurse
He was very serious and strictly followed his doctor's instructions, except that he turned the screw in the opposite direction. When Ilizalov came back, the patient's fractured ends were separated, but he found that even if the fractured ends were separated, callus had grown.
Inspired by this phenomenon, he devoted a lot of time and energy to research, and finally proposed the tensile stress law, which is the theory of stretch biological tissue regeneration. Later, the Soviet Union invested a lot of manpower and material resources in research and improvement of this theory, and only then did it have the current mature theory.
This theory is fully qualified to win the Nobel Prize, but it was naturally unable to win the prize due to the Cold War between the United States and the Soviet Union. Our country began to develop this technology in the 1980s. There was a time when this technology was abused to increase the height of normal people, causing many complications.
, skin necrosis, muscle loss, bone non-healing, nerve damage, etc. In October 2006, the Ministry of Health ordered that bone fracture heightening be prohibited from being used in "medical beauty projects", that is, it cannot be used to increase the height of normal people, and can only be used to increase the height of normal people.
Bone defects and unequal limb lengths caused by congenital malformations, trauma, infection, tumors, etc., as well as limb deformities caused by diseases."
Discussion can not only make the patient's diagnosis and treatment plan clearer and complete, but also be a good opportunity for young doctors to learn. Through clinical case study and accumulation of experience, a typical case can master the knowledge of a type of disease.
After such a discussion, everyone has a basic understanding of the magical Ilizarov technology.
When the meeting ended, Yang Ping received a WeChat message from Su Nanchen, asking Yang Ping to go to the attached clinic for a consultation.
