In fact, the case discussion started at two o'clock, and the case discussion at the Sports Medicine Center started at about three o'clock.
This patient with Achilles tendon laxity has won the Olympic gold medal in the women's 5,000 meters, and is still in his golden age for sports, so Appendix 1 pays special attention to it.
If this patient's surgery is successfully performed, the sports medicine specialty of Appendix 1 will be able to reach the top of the industry pyramid like spine surgery.
After seeing the patients, Su Nanchen took Yang Ping to the conference room on the 20th floor, where weekly orthopedic case discussions were held.
There were two vacant seats in the second row of the conference room, and Su Nanchen took Yang Ping to sit down.
Sure enough, it was a grand occasion. Sitting in the first row were the directors of the various specialties of the Orthopedic Center, all of whom were doctoral supervisors and experts receiving special government subsidies. Several of them were nationally renowned big-shot figures.
For example, the director of the Spine Center, Professor Zou, is the leader in scoliosis correction in the country. He used to follow Professor Su. After Professor Su became the dean, he paid less attention to clinical work and focused on scientific research and administrative work. The Spine Center
Most of the surgeries are performed by Professor Zou. The first editor-in-chief of "Scoliosis Surgery" is Professor Su, and the second editor-in-chief is him.
Professor Huang, director of the Orthopedic Trauma Center, is also a nationally renowned professor and one of the main translators of "Principles of Internal Fixation of AO Fractures".
Professor Guan Sheng of the Sports Medicine Center, the favorite student of the sports medicine boss of the Imperial Capital Third Hospital, was hired by Su Qingyun and made sports medicine flourish in a few years.
When ordinary doctors sit in this venue, they will definitely feel a sense of shock and oppression. But Yang Ping does not. He is very calm. After all, he is a person who has worked hard in the system space.
He sat calmly and calmly, and Su Nanchen secretly observed that this calmness and calmness were definitely not something ordinary people could have, and he admired him even more.
The hierarchical system of doctors is clearly reflected here. Even if there is space in the first row, no one who does not meet his status will sit on it.
The second row is for the professors who lead the team, all of whom are chief physicians or deputy chief physicians; the third row is for other deputy chief physicians, and the fourth row is for outstanding figures among the younger generation.
Starting from the fifth row, you can sit freely, but they are still divided into camps spontaneously. For example, doctors and attending doctors are in the front, masters and residents are in the back, and those in advanced training and regular training are in the back. No one goes there stupidly.
It’s hard to squeeze in front.
Sitting in the second row is Chen Ge, the leading professor of sports medicine. This guy is also a character. He likes to compete with Su Nanchen. He is Guan Sheng’s doctor. He stayed in the attached first school after graduation. He is arrogant and competitive.
He is very competitive, but has always been suppressed by Su Nanchen.
He saw Su Nanchen leading a stranger in, and glanced sideways.
Chen Ge knew that Su Nanchen had invited a doctor from another hospital for consultation, and he had been wondering who it was that he was actually invited by Su Nanchen for consultation, and now he saw the real person.
I thought he was some kind of professor, but looking at his appearance, he was only in his twenties. A young doctor came to the Annex for consultation. It was interesting. Chen Ge touched his chin and sneered in his heart.
Su Qingyun looked back and saw that Yang Ping was already sitting with Su Nanchen. He looked as steady as a rock and secretly admired him in his heart.
The case discussion was very intense, and everyone was red-faced. Although the voices were loud, the speakers were never noisy or made personal attacks. They were well-founded and purely academic arguments, and academic issues were solved in an academic way.
Everyone has the right to speak, and will not bear any consequences for speaking! Doctors have grades, and speaking is not graded. This is the rule set by Su Qingyun. The free academic atmosphere is also one of the magic weapons for the rapid development of Affiliated Orthopedics.
Normal case discussions are usually internal discussions within each department. Cases discussed at the orthopedic center level are either difficult, high-risk, or some new surgical procedures, or they are patients with powerful positions and a certain social influence. Yang Ping also listened. One of the scoliosis patients was almost doubled over, with his nose almost touching his toes. He was going to undergo orthopedic surgery to straighten his spine.
Finally, it was the Sports Medicine Center’s turn. The Sports Medicine Center brought out two cases for discussion, one with an unstable knee joint and one with Achilles tendon laxity.
This knee joint is unstable, a professional football player, a well-known star, the knee joint is dislocated, resulting in the rupture of the anterior cruciate ligament, posterior cruciate ligament, posterolateral structure, and posteromedial structure. They all need to be reconstructed, and four structures need to be reconstructed, among which
There are several structures that need to be reconstructed for the posteromedial and posterolateral structures, making them look like matryoshka dolls. You can imagine the complexity.
The surgery is very complicated. The reconstruction in this case is the top surgery for knee sports injuries. There are only six hospitals in the country that can perform this surgery, and only a handful of doctors can do it.
Most surgeries in sports medicine are not life-saving. The goal is directly aimed at function. The most important thing is the quality of the surgery. It does not solve the problem of whether or not, but solves the problem of quality. Just like plastic surgery, the goal is directly aimed at appearance. The results are clear at a glance.
"What do you think of this case?" Su Nanchen whispered.
"There are too many structures to rebuild. Static balance, dynamic balance, near-term balance, and long-term balance must all be grasped." Yang Ping also lowered his voice.
"If you do it, will it be performed in separate operations or in one operation?" Su Nanchen wanted to test his tone.
"Once! Only in this way can we achieve true balance." Yang Ping replied without thinking.
Once? You have to balance it. This kind of difficulty is very difficult, and Su Nanchen is ashamed.
The second case was a female long-distance runner with Achilles tendon laxity. Dr. He took the stage to report the medical records. The attending doctor was on hand to help and make supplements at any time. The image data were marked with eye-catching dates and displayed on a huge high-definition screen.
"This patient is a professional athlete. The Achilles tendon problem is related to sports performance and future career. We plan to shorten the Achilles tendon, so we use classic surgery to cut the Achilles tendon in a Z shape or transversely, and then perform shortening sutures.
This solves the problem of laxity, but leads to a new problem. After the Achilles tendon is cut and re-anastomized, there will be some scars. Even if there are few, there will still be scars. A small amount of scar healing will also reduce the strength and endurance of the Achilles tendon. The patient has been to the UK
The treatment plan given by the doctor is the same, so please discuss it and see if there is a better plan?"
After the medical record report was completed, Su Nanchen, as the professor leading the group, pointed out the purpose of the discussion.
"As for suturing the Achilles tendon, any orthopedic resident can suture it skillfully. How much we shorten it is the core of the problem. If it is too much, it will cause tension in the Achilles tendon; if it is too little, the Achilles tendon will still be loose. As for scar healing, it cannot be avoided.
The operation is performed under a microscope, and a sharp knife is used to quickly cut the Achilles tendon, and the sutures are as neat as possible to reduce scar healing." Chen Ge spoke very positively.
"Then how to judge how much to shorten?" asked Guan Sheng, director of the Sports Medicine Center.
Chen Ge proudly said: "How much does the tension of the tendon increase for every millimeter of shortening? I am doing animal experiments and the data is being compiled."
"Orangutans crawl on four legs, while humans walk upright. The thickness of the Achilles tendon fiber structure of orangutans is also different from that of humans. It is difficult to apply animal experimental data to the human body." Another professor who leads a sports medicine group objected.
"Why is it necessary to conduct animal experiments? Can't we look for reliable data directly from the healthy side?" A postdoctoral fellow at the station put forward his own opinion.
"During the operation, the skin of the unaffected side is directly incised, the Achilles tendon is exposed, and the tension is measured in the same posture. Then this data is applied to the affected side and shortened step by step until the tension matches the data on the unaffected side!" the postdoc continued to explain.
He was nestled in the fourth row, with a slovenly look, one button of his white coat was buttoned off, a bottle of milk in his hand, and the straw had been chewed to pieces.
Drinking milk and eating is allowed as long as you don't make too much noise, because in the afternoon case discussions, many doctors may have just performed operations and have not eaten lunch.
"The tension adjustment everyone talks about is static, and the patient's running is dynamic. We must analyze the patient's movement status. After all, the patient's Achilles tendon and triceps have relative slippage. Is it still according to the previous standards?
To determine the tension? This data must be obtained from dynamics." Su Nanchen also expressed his own opinion.
There was a heated exchange of words, and the discussion continued. Voices expressed their opinions one after another, coming from different directions. The competition was all about real talent and knowledge. The speakers were foaming at the mouth, and the listeners were engrossed. No one was looking at their mobile phones.
Not a single phone ring.
"Everyone's speeches were very lively, and their opinions were actually relatively unified. The difficulty in performing Achilles tendon shortening through surgery is the distance of shortening. This data must be accurate, otherwise the operation will fail, and the patient's sports performance may even be worse than before the operation. Everyone
Many methods have just been proposed, such as animal experiments, healthy side reference, and motion state analysis. Then our next step is to find out the precise length of shortening. Professor Su, do you think it is okay?"
Professor Su stood up and said: "Everyone's opinions are very good, and they have put forward their own unique opinions, which shows that everyone is thinking seriously. This is what academic discussions should be, free and equal dialogue! Today, for this patient, we are fortunate to have Sanbo
Consultation with Dr. Yang Ping from the hospital. Dr. Yang has unique experience in sports medicine. What good advice does Dr. Yang have?"
Professor Su applauded, and everyone else applauded too. Everyone knows about Sanbo Hospital, and everyone knows about several major hospitals in the same city.
But who is Dr. Yang Ping’s background? I don’t know him! I’ve never heard of him! He was actually invited to Annex 1 for consultation?
Su Nanchen stood up: "Dr. Yang, please!"
If you have stage fright in this kind of situation, you will dampen Su Nanchen's enthusiasm and let down the high expectations of others.
Yang Ping remained calm as always, stood up and greeted everyone.
"Xiao Yang, go to the podium and talk about your views." Professor Su encouraged.
"Who is he? This awesome man appears from nowhere!" Everyone looked around, hoping that someone knew him and could give him a reply.
Several people who had just checked the room with him said: "Dr. Su's classmate, this guy is really awesome!"
One of them was very honest. He had already taken out his notebook and was about to take notes: "Brother, please take notes carefully. I just went to see this patient during a ward round with him. He gave a lecture. After listening to it, I suspected that I had a fake doctorate."<
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The person who asked the question also took out his notebook and took out a pen.
"Young Master Su's classmates studying in the United States?"
"Ninety percent yes!"
Yang Ping was unusually calm, walked to the podium, and bowed slightly to everyone.