The news spread quickly, and the entire orthopedics department knew that Yang Ping was going to perform a 3,000-piece comminuted fracture of the lower end of the humerus, using only steel wires and needles.
Including spine, joint, and sports medicine, many young doctors, graduate students, and interns inquire about the operation time in advance.
Zhang Lin, the fifth child, had already said: "One seat, one meal! No bargaining." He even went to the head nurse to get the registered textbooks.
They also took away the ink pad that Corey signed, saying that it would be written in black and white by then.
"Old man Zhang will be here by then. He must be sitting in the middle of the front row. I'll put a layer of glue on his chair." Zhang Lin has a lot of clever ideas.
"I've been called to the operating room three times, but you're still applying glue here." Yao Ling, the head nurse, took the medical record and patted him gently.
The head nurse still has a relatively high prestige in the department, and is equivalent to the housekeeper in the department.
Everyone has found the people who will take over the surgery, rolled up their sleeves, and prepared to take a closer look. Anyway, there are many people in the department, and there are a lot of graduate students waiting in line for the surgery. Allocating manpower couldn't be easier.
Song Zimo, Zhang Lin, Fang Yan, and several other groups, including Director Ouyang and Director Bai, also came, and more than a dozen people from the spine, joint, and sports medicine departments also came.
Everyone wants to see how this 3,000-yuan surgery is performed. The key is to use wire Kirschner wires, which is impossible.
After classes were handed in on Thursday, everyone was afraid of not being able to get a seat, so they sat in the demonstration classroom next to the main operating room early in the morning, barely holding a box of popcorn.
Wearing hand-washing clothes and wearing masks, everyone greets each other. They are all orthopedic surgeons, and we can see each other without looking up. We may have worked together during the previous rotation.
Doctors who have just graduated usually first do rotations in the surgical or internal medicine departments. They stay in one department for three months to become fully familiar with the knowledge of surgery or internal medicine, and by the way, they get to know their colleagues in each department.
Some interns had no seats, so they stood in the back, and those with whom they were close squeezed into a chair. The front row was automatically reserved for Mr. Zhang and the director. The director may or may not come. p>
But when Old Man Zhang heard that he was coming, his assistant had already given the word.
"Professor Zhang, hello!" Dr. Peng on the other side of the spine saw Zhang Lin and greeted him immediately.
Everyone's hearts jumped in fright, thinking that Professor Zhang Zongshun had arrived.
Zhang Lin immediately shook hands: "Nice to meet you, Professor Peng, come in person?"
These young doctors tease each other in private and call each other professor and director.
Next door, Song Zimo was disinfecting, Xiao Wu raised his hand, Director Tian was sitting aside, equipment nurse Su Yixuan was arranging the equipment, Yang Ping had already put on surgical clothes and was standing aside waiting.
Director Tian is relatively stable and has solid skills. He is the kind of person who is usually inconspicuous but can come in handy at any time.
When they saw the pair of reading glasses wrapped with tape, everyone didn't dare to say anything, and their bodies shrunk by half. He was really here.
Professor Zhang Zongshun, guided by his assistant, came in and sat in the middle seat. Zhang Lin quickly informed Director Han, and soon Director Han also showed up.
It's just an operation, so it won't delay anything. Other operations can be pushed forward, so Director Han also arranged the time.
Director Han shook hands with old man Zhang: "Professor Zhang, why are you here in person? We can just send the video over and give you a grade."
"Let's take a look. Didn't you say that Kirschner wire can't be used for this kind of fracture? I just want to see how you can get to the imperial capital if you don't have money to buy a plane ticket?" Mr. Zhang always speaks in such a spicy and humorous way.
Director Han accompanied him: "Quickly, find a cushion for Mr. Zhang to lean on."
A student brought a silicone posture cushion over. Mr. Zhang was not polite and put it on the back of his waist: "Young man, if you dare to go on stage, get one extra point."
"Young people are inexperienced, and their basic skills are not as solid as the doctors at Zhang's time." Director Han said.
"Don't be humble for him. I'm afraid this kid is a bit fierce. It's hard to estimate the weight without squeezing it out. His clavicle is broken, and not everyone can get it out with those Kirschner needles. Besides, it's really not possible.
"Aren't you the one who has the whole story?" Mr. Zhang said slowly.
Director Han knew in his heart that Mr. Zhang knew what was going on. He wanted to test Yang Ping, but if it didn't work, the two of them could give him the truth. The purpose of Mr. Zhang coming to the operating room was to give him the truth.
"When the show starts later, just pretend that the old man doesn't exist and just do your best -" Tian Yuan cheered to Yang Ping.
"Side-lying position is a good choice of body position." Old Man Zhang said.
Prepare for operation and check before operation.
The knife was slapped on the palm of Yang Ping's hand. He held the pen in a standard way, opening and closing the knife in place. The skin was cut in one go, neither deep nor shallow. When I changed the electric knife, the blood hadn't come out yet, and the electric knife had already cut it.
Click on it, tap it gently, and the bleeding point will be completely eliminated. Continue to use the knife to incise the deep fascia.
The olecranon osteotomy approach is the most convenient for exposure. With a micro-electric saw, use a beautiful V shape to open the olecranon upward and expose the entire lower end of the humerus articular surface.
The suction device removes the accumulated blood, and the broken bones inside are exposed. There are some with cartilage, some without cartilage, coronal plane, sagittal plane, cross section, all kinds of shapes, a mess.
"How to do this?" It's worse than the x-rays show.
Everyone looked at the video on the screen clearly, and they were all confused. Originally, they wanted to see how to do it, but it was impossible to do the operation like this.
There is a special word to describe this: a bag bone!
A bag of bones!
The broken bones are like stones, and the outer skin and soft tissues are like a bag.
The piecing together of these bone fragments is extremely difficult and can be said to be impossible.
If it is an extra-articular fracture, it is easier to deal with and there is no need to put it back together. Intra-articular fractures are different. Any unevenness will wear out the joint. Once worn, there will be long-term pain and mobility impairment. Intra-articular fractures require
Anatomical reduction means what it was like originally and what you want to put it back together.
If you can't fight back, you'll be a little bit worse and you'll be left with arthritis; if you're a little bit worse, you'll be disabled.
After a lot of training in the system, Yang Ping summarized the rules. There is a certain method for this kind of bone assembly. The order of reset and the distribution of Kirschner wires are the most important. The whole step is like solving a Rubik's Cube, there must be a scientific order.
, it’s not something you can mess around with.
Something that seems simple requires a lot of effort.
If an empty eggshell is broken, someone can restore it with bare hands. Believe it or not, Yang Ping believes it anyway.
The fractures are in such a mess that no large pieces can be found that reflect the original appearance. Even the largest bone fragments cannot be seen where they came from.
It's like a house that completely collapsed and turned into a pile of rotten bricks. Can you still tell where the bricks are?
Director Han frowned, but Old Man Zhang remained silent.
The most powerful ghost eye can identify the few leaves it has seen among thousands of the same leaves.
A lot of training gave Yang Ping a sharp eye. He carefully held the bones and identified them one by one. If the bones had soft tissue attached, no matter how many, they were absolutely protected.
The vascular forceps are like clamping egg shells, the strength is extremely controlled, and they are stable without breaking.
After all the bone fragments have been identified, I already know where each one should be, and the order in which to build the restoration is gradually taking shape in my mind.
If you can't find the scientific order, one piece will be put back up, but the other piece will fall off; this piece is in good place, but it blocks the reset of the other piece; as soon as this piece is placed, that piece will be missed again, and it still cannot be done.
to recovery.
"Cut the other end of the K-wire to a sharp point and prepare five of these."
Xiao Wu did as he was told. A normal K-wire has only one end that is pointed and the other end that is flat. Now the other end needs to be cut into a beveled tip.
"He really wants to reset, how can he reset?"
"This is difficult to make even with steel plates."
"Didn't do CT."
"He wouldn't dare to go on stage even if he was beaten to death by CT scan."
"I'm embarrassed now. How can I get off the stage?"
Everyone discussed carefully. They originally wanted to see surgery, but how to deal with the situation now? There is absolutely no way to do it. The so-called most serious treatment is actually simpler. It is possible to open or close it.
Some people were very disappointed and came to observe and learn with enthusiasm, but the result was like this.
Old man Zhang leaned against the silicone pad, took off his glasses, and wiped them.
After rinsing the surgical field, the Kirschner wires have been cut and loaded into the power drill.
The first bone fragment is moved up, and the Kirschner wire is firmly set at the proximal end of the humerus, allowing the Kirschner wire to penetrate the bone on the opposite side and the skin, and the bone fragments are aligned and sutured tightly.
Director Han secretly praised him for his good eyesight. He did not even try to align this part, and just reset it in one go.
Use the key to unscrew the clamping head of the electric drill and withdraw it; in turn, clamp the exposed other end and slowly withdraw it until only a little bit of the flat bone surface of the tip is exposed.
The second piece comes up, still using the original Kirschner wire, but in the opposite direction, and going back; the third piece, facing the proximal end of the humerus, has a Kirschner wire diagonally from the opposite side, 60 degrees from the first Kirschner wire.
Cross each other, put the fourth piece in the middle, and put them on together.
I don’t know why the fourth piece is placed in the middle. Can’t you tell it’s in the middle?
Everyone is confused, let alone the fourth piece, among the pieces that have been nailed on now, I can’t tell where they are from, and they still feel messy.
The fifth piece was inserted through a gap by the Kirschner needle just now.
Just like the recovery of a Rubik's Cube, each step is related to other steps and must be done according to the established method, otherwise it will not be recovered. Similarly, before recovery, what others see is also messy. Why is the red here in this step and the blue in that step?
Why is the color there?
After working on it for a long time, it's still messy. It's a mess.
Won't we just stick it out with a steel needle and call it a day? Everyone is worried.
Song Zimo was worried that Yang Ping had been a little uneasy recently and would undergo such an operation.
But looking at his serious look, he seems to be confident and not just fooling around.
Is it really possible to put these bone fragments back together intact?
You can't be so awesome.
When the sixth piece was embedded, the two Kirschner needles were pushed back and both passed through the sixth piece; the seventh piece was pasted on the gap just now, and a new gap appeared. The ninth piece just filled this gap, and the third piece
A Kirschner wire was inserted, not only through these two pieces, but also through other bone pieces.
The steel needle penetrates the bone block, and it is in place every time. Even the small and thin bone block, which is not allowed to be penetrated a second time, is safely passed through.
Song Zimo had already seen the clues and felt an indescribable feeling in his heart.
The lateral condyle has been formed, and the first layer of the Rubik's Cube has been assembled. The tenth, eleventh, and twelfth pieces are embedded in an oblique shape, and the position of each piece is precise. The fourth thin Kirschner wire is fixed once and just passes through the most
Strong leather part.
The medial condyle part has begun to take shape, and the second layer of the Rubik's Cube has been put together.
The thirteenth piece is attached, the fourth one is pushed forward, passes through this piece, and the fifth K-wire is inserted, not only through this piece, but also through several other pieces.
The shape of the medial condyle is fully displayed, and the joint surface is successfully assembled, smooth and without defects.
The smooth joint surface is formed without any gaps or steps.
At this point, the third layer of the Rubik's Cube has been successfully restored.
Wow! There were small exclamations from the audience.
Those who felt bored began to cheer up; those who were about to leave early gave up their thoughts and focused their eyes on the screen. Some began to regret that they did not look at the details of the reset just now, wasting precious learning opportunities.
A standard tension band is bundled with steel wire on each side, and an oblique tension band is placed on each side to form a three-dimensional triangle shape, just like the steel frame structure of a building.
Tighten the wire, cut it, and process the tail. Cut the Kirschner wire and bend it to process the tail.
Just like solving a Rubik's Cube, I can't understand the process, but the ending is clear.
It was really restored. Kirschner wires and steel wires formed a wonderful three-dimensional stable structure.
Move your elbow joint, it will be very stable.
Such an outrageous operation!
Only then did everyone understand that the order in which the bone pieces were put together and how to apply Kirschner needles were all planned. Only in this way can we achieve the best balance, lock each other, and finally form a whole. One step was messed up, and one was missing.
, cannot be completed.
I can’t accept it!
Wonderful! It was also the first time that Song Zimo saw someone using steel wires and Kirschner needles like this.
This is not surgery. This is building a miniature self-stable building using bone blocks, steel needles and wires.
"Second Han, this kid under your command is not an easy one. Take good care of him." Old Man Zhang stood up.
"Why, Mr. Zhang, don't you finish reading?" Director Han said.
"The prostate is not up to par, I can't hold it in any longer." Mr. Zhang stood up.
