In Cheng Liquan's office, Su Nanchen and Cheng Liquan stood in front of the reading lamp.
"Master Su, what should I do? I didn't look carefully at that time, so I fell into this trap." Boss Cheng's face turned red.
Su Nanchen was very calm: "Don't worry. If you stopped at the edge of the pit and haven't fallen yet, it's not because you are not careful. Not many people have experience with this kind of case. It's too special."
Boss Cheng gave himself a small slap in the face: "Young Master Su, it's all my fault for being impatient. If I had listened to you and stopped treating patients like this for the time being, nothing would have happened."
"It's useless to talk about it now! Let's wait for him to come over tomorrow and we'll study it together. The surgery hasn't been done yet, so why are you afraid? The worst thing is not to do it." Su Nanchen comforted him, and blaming others afterwards would not help.
Surgery is something that cannot be done without force. If it doesn't work, then give in. If you don't give in before the operation, you will suffer the consequences after the surgery. Even if you give in, you won't have a chance.
When Su Nanchen came here last time, he was in a hurry and did not see the patient or study the patient's imaging data. This time he came here specially and found that this patient was too special. The intercondylar fossa was severely deformed, filled with bone hyperplasia, and the posterior part of the tibial plateau was partially defective.
The defect happened to be the original tibial insertion point of the rear fork, and the patellofemoral joint was still underdeveloped, so we urgently performed a three-dimensional CT reconstruction of the knee joint.
Su Nanchen and Boss Cheng frowned as they looked at the three-dimensional CT reconstruction in front of them. Quadruple reconstruction was already extremely difficult, and with this special situation, the difficulty of the operation doubled.
This surgery, on the basis of quadruple reconstruction, also requires intercondylar notch shaping. This intercondylar notch shaping is not easy to do. It does not just restore it, but requires the surgeon to design a shape of the intercondylar notch to meet the needs of the surgery.
Otherwise, the operation will fail and cause bad consequences.
If it were not for a doctor with experience in multi-ligament reconstruction of the knee joint, he would not be aware of such negative consequences. Fortunately, Su Nanchen had experience in this area, otherwise he would have stepped on a thunderbolt.
"I checked later and found that this patient was seen in Yunjian. They said the schedule was too tight. In fact, this was not the case. They contacted Professor Ye. After seeing the patient's imaging data, Professor Ye thought it was too difficult, especially
This intercondylar notch formation couldn't be done, so I declined. They brought this patient to me and deliberately harmed me. It was too dirty." Cheng Liquan regretted it, with sweat on his face. Su Nanchen saved him this time.
,If it weren't for Su Nanchen, he would not know the serious consequences of the matter.
"Those people are so vicious! They dug a hole for me to jump into. I almost jumped, and the sign was damaged in just one operation." Cheng Liquan was a little scared.
"The operation will definitely not be possible. No matter how powerful the person I hired for you is, he will not be able to complete this kind of operation. However, I will pick him up tomorrow and study it together. I have made an appointment with him." Su Nanchen thought this case was too serious.
Specially, Yang Ping must be invited to come over. Even if the operation is not performed, it is still necessary to see the patient and study it.
"It's up to you. I'll pay for your friend's surgery as usual, and I won't embarrass you, Mr. Su." Boss Cheng wiped his sweat.
Su Nanchen didn't speak, and was still watching the film on the film reader. No matter how powerful Yang Ping's surgery was, it would be impossible to complete this kind of surgery.
This intercondylar notch formation cannot be performed at all. If done conventionally, it will definitely cause patellar joint instability and render the reconstructed rear fork useless. This is why Professor Ye does not dare to do it.
If you want to do it, you need to design a software, build a model, use 3D simulation technology to reconstruct the intercondylar fossa on the computer, and finally design an intercondylar fossa through constant simulation and trial and error. Use 3D printing or virtual reality technology, and the doctor will take photos.
It needs to be formed according to the designed mold. Even so, the surgeon needs to have strong spatial imagination ability to barely make a qualified intercondylar fossa.
---
Su Nanchen sent the patient information to Yang Ping's email. Yang Ping was playing ball and did not see Su Nanchen's information.
"Ding dong! Mission: I'm just starting out. I went to an outside hospital to perform a multi-ligament reconstruction of the knee joint. The surgical level was perfect. The reward is 40,000 points. The deadline for the mission is: within twenty-four hours!"
While I was playing ball, the system released a task. It was strange that my five-link reconstruction did not release a single task. This four-link reconstruction actually released a single task, with a reward score of 20,000 points. Is this four-link reconstruction more difficult than the five-link reconstruction?<
/p>
Now the system is very good at selecting tasks, and the reward points are also high. It doesn't bother to deal with operations that are not particularly difficult. High difficulty, high reward, this seems to be the current principle of the system.
After playing, Yang Ping took a rough look at the patient information on his mobile phone during the break. Sure enough, this quadruple-link reconstruction was more difficult and a higher level than the last five-link reconstruction.
When he was free in the evening, Yang Ping began to study this case in detail.
It is actually a hidden five-joint, more complicated than the five-joint I made a few days ago. Why? Because on the basis of the four-joint, intercondylar notch molding is also required.
The five-unit surgery I did was a four-unit surgery plus habitual dislocation of the patellofemoral joint. This is a four-unit surgery with the addition of intercondylar notch shaping. The previous anterior cruciate ligament reconstruction I did had intercondylar notch shaping. p>
However, the formation of this intercondylar notch is more difficult than before. In the past, patients could just follow the mirror image of the intercondylar notch on the healthy side.
This is not possible. In this case, the entire intercondylar notch is severely deformed, the posterior tibial plateau is still partially defective, and the patellofemoral joint has dysplasia. Quadruple injury plus these three factors make it worse.
The patellofemoral joint dysplasia means that this patient's previous intercondylar notch was abnormal. As for what happened, who knows; the posterior tibial plateau defect means that when reconstructing the rear fork, the formed intercondylar notch must be considered when rebuilding the rear fork.
The insertion point of the femur is not in the normal position, and the shaping must take care of this. Therefore, an extremely special intercondylar notch needs to be formed.
If we follow the previous method and use a mirror image to form the intercondylar notch based on the normal intercondylar notch on the opposite side, the operation will definitely fail, which will lead to loss of function of the reconstructed posterior fork and instability of the patellofemoral joint.
Originally, the patient could barely walk now, but it is possible that after the operation, the patellofemoral joint became unstable and frequently lateral dislocated, making it difficult to walk. He could walk without the operation, but he could not walk after the operation. Can the patient accept this? p>
For this surgery, you have to conceive the shape of the intercondylar notch yourself. There is no template for this shape. It must meet several conditions at the same time. It must provide the best tunnel entry point for the ligaments without causing patellofemoral joint disorder and ligament damage.
Impact, this difficulty is not recovery from beginning to end, but a reconstruction process, which is equivalent to designing an intercondylar fossa with strict parameter requirements. If there is a slight mistake, the operation will collapse.
We can only rely on the brain's composition ability. The core of the super training plan is to cultivate the brain's composition ability. This kind of composition is not a simple static composition, but a dynamic, connected and logical composition.
Yang Ping's brain composition ability is constantly improving. This time he constructed the static graphics very easily. It was formed once and did not make many additions. However, the construction of dynamic images was still very difficult. He repeated it many times and constantly revised, supplemented and strengthened it.
Only then can the picture be made.
The pattern changes in my mind, sometimes it needs to move, sometimes it needs to switch, one intercondylar notch appears one after another, and then the ligament is implanted in the ideal position, but it doesn't work! Then continue to modify the intercondylar notch, implant the ligament again, and repeat it many times
, after several sets of ligaments were implanted, optimal function and balance could be achieved; however, there was impact again during flexion and extension, so we continued to modify it until the impact completely disappeared; patellofemoral joint instability reappeared, so we gritted our teeth and continued to make modifications, trial and error.
When I finally solved this problem, my forehead was covered with sweat, my clothes were almost soaked, and my brain power was consumed too much. Fortunately, I was able to find the most suitable shape of the intercondylar fossa through composition.
Yang Ping checked the final shape of the intercondylar fossa several times and found that there was no problem, so he remembered it in his mind and prepared it for tomorrow's surgery.
"This patient's intercondylar fossa needs to be formed, and it is extremely difficult to form. Come and have a look tomorrow!" Su Nanchen's message.
"I have read the information. It is indeed difficult, but the problem is not big." Yang Ping replied.
---
This guy, the problem with this kind of surgery is not big. He is really amazing at the surgery, but he still didn’t read the imaging data carefully.
Su Nanchen arrived at Sanbo Hospital on time at 8:30 on Sunday morning. At about 9 o'clock, Yang Ping had already arrived at Liquan Hospital.
In order to show his attention, Boss Cheng stood at the door of the hospital. Su Nanchen appeared with Yang Ping in his field of vision. He took a closer look and realized, no, how could a person who was more powerful than Professor Ye be so young? No matter how blind he was, he could still see this person's personality.
Approximate age, isn't this just in your twenties? What is the concept of being in your twenties? It's just a small doctor at most. What kind of method did Su Nanchen play this time?
Boss Cheng then thought about it. Su Nanchen always kept his word in everything he said and did. There was no need to worry about this problem at all. The person he invited must be a master. It's a pity. It would have been better if the patient had been an ordinary quadruple reconstruction. Today's surgery is
It was done, filling the gap in Liquan Hospital, and indicating that there is no technical gap between Liquan and Yunjian. But this patient - the operation cannot be performed, what a pity! Boss Cheng sighed, feeling unwilling.
As a businessman, Boss Cheng is shrewd and tactful. He didn't show any thoughts on his face, not even his insinuations. He stretched out his hand from afar.
"Yang Ping from Sanbo, Dr. Yang!" Su Nanchen introduced.
"Hello, Dr. Yang, nice to meet you, Cheng Liquan -" Boss Cheng was warm and friendly, making people feel like old friends at first sight. He immediately handed over his business card respectfully with both hands and bowed slightly.
Yang Ping took the business card: "Boss Cheng, I have been a famous name for a long time. Who in the medical circle doesn't know Boss Cheng's name?"
He is famous, but this is the first time Yang Ping knows Cheng Liquan’s name.
The three of them chatted while walking. This sports medicine center is really good. The decoration was designed by professionals. Even the slope of the stairs, the width of the steps, the height of the handrails, and the color matching are all very particular.
High-end is not only technology, but also an experience.
This man is in his twenties, but his behavior, words and deeds are not frivolous or unstable at all. Instead, he shows a strong sense of calmness and self-confidence. Chaoshan people are good at doing business, and businessmen are good at observing people and things. Boss Cheng
Observing from the secret, this friend Su Nanchen is really a master in terms of temperament.
A beautiful nurse leads the way. The slim-fitting nurse uniform outlines her slim and graceful figure. Her professional smile makes people feel very comfortable. This hospital is run with great care.
Yang Ping had heard a lot about these specialized hospitals, and was a little biased, but Su Nanchen's friend opened one, so it shouldn't be too wild.
Intuitively, this hospital is quite formal, and Boss Cheng kept introducing his hospital all the way.
"First come to my office to sit down and take a rest!" Boss Cheng said.
Yang Ping waved his hand: "No, let's take a look at the film first and then look at the patient later."
When everyone arrived at the doctor's office, the reading lamp was already covered with films. Yang Ping walked to the lamp and looked at the patient's films carefully.
Everyone gathered around. Two doctors and several master's students were trained by Boss Cheng. They are the backbone of the hospital. Nowadays, it is not optimistic for doctors and masters to find jobs, especially in G city. It is difficult for better public hospitals to gain a foothold. Some can only
Secondly, go to some private hospitals, either large comprehensive private hospitals, which are very few, or small and sophisticated specialized hospitals like this.
Yang Ping narrowed his eyes slightly and scanned the film with his sharp gaze.
Boss Cheng held his breath. He still hoped that this operation could be performed, although the hope was slim. Although this was an operation that Professor Ye had given up on, and Professor Ye was unwilling to do it, who else in the country could do it? Speaking of this type of surgery,
In terms of surgery, others are at most the same level as Professor Ye.
Seeing that Yang Ping didn't speak, just staring at the film on the reading light, Su Nanchen and Boss Cheng didn't dare to speak, so they just waited quietly. Originally, it was not good to call someone over for this kind of surgery.
After Yang Ping read it, he said: "Let's go and see the patient."
Boss Cheng asked the doctor to lead the way and took Yang Ping to the ward to see patients. The wards here are all suites and are very luxuriously decorated.
Yang Pingzai inquired about the medical history and carefully examined the patient. He had sufficient information and felt confident.
Back to the doctor's office.
"How is it?" Su Nanchen asked.
Boss Cheng waited eagerly for the results.
"Send the patient!" Yang Ping said lightly.
Sending patients? Is this possible?
Su Nanchen was not sure whether what he said was true or not. He could do this surgery. This guy was really crazy.
