Coming out of Old Man Zhang's single ward, Yang Ping went to the office to look for Xiao Wu. Xiao Wu was not there. Zhang Lin was writing medical records and preparing to sign the informed consent form. Although Professor Zhang was from this hospital, the process could not be saved.
Song Zimo was watching the CT reconstruction on the electronic reading screen. He leaned back in his chair and was very lost in thought. He watched for a while and then stopped to draw something on the paper.
Yang Ping did not disturb him, but just glanced at the medical drawing on the paper! This guy can do medical drawing, and his drawing is very good, even better than the drawings in some surgical works.
Yang Ping went to the duty room, where Xiao Wu was installing some software on a tablet computer. Yang Ping was surprised: "How did you know that Professor Zhang wanted to watch the live broadcast of his surgery?"
Xiao Wu said: "Who doesn't know Professor Zhang? I prepared it in advance. If I come to the operating room and bring it up, I won't have time to prepare."
Yang Ping said: "You guessed it right. Professor Zhang really told me to prepare a tablet and connect it to the video system in the operating room. He wants to watch the live broadcast while operating."
"I have downloaded the connecting app from the video system website and just checked with the operating room. There is a long dedicated data cable. Then I will fix the tablet on the head frame and he can watch it while lying down," Xiao Wu said.
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Yang Ping had a little accident. The kid was clueless and said that he was really delayed by studying medicine. Yang Ping found a bed and lay down: "I will rest for a while and call me when old man Zhang takes him to the operating room."
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"Let's have something to eat. I ordered several takeaways and they will be delivered right away." Xiao Wu said while working on the computer.
Yang Ping lay down to rest and entered the library of the system space. The time here needs to be paid with points, and each point corresponds to a small time.
There is no way to bring the film into space, so I can only draw pictures in space from memory, and then study the reset of each bone block, focusing on how to form bony support.
The system is extremely convenient for accessing information. As long as it is published publicly, it can be found, and it will be translated into Chinese no matter what language it is. Yang Ping has accessed a large amount of information on this aspect, especially on intertrochanteric fractures of the femur. Each paper is word for word.
Reading, anyway, I have accumulated more than 14,000 points in my hand now, so I can concentrate my resources to complete the task.
After getting the theory clear, Yang Ping went to the mall and found a hip fracture surgical training package among the densely packed training packages. It cost 4,000 cents and bought another 500 cases, including many closures of intertrochanteric fractures.
Surgery for reduction and internal fixation of PFNA.
PFNA is the abbreviation of proximal femoral anti-rotation intramedullary nail, which is currently the best fixation device for such fractures in the elderly. Hip fractures in the elderly - acetabulum fractures, femoral neck fractures, and intertrochanteric fractures are known as "death"
"Fracture", "the last fracture in life", the mortality rate within two months of conservative treatment at home is as high as 68%-70%; the survival rate after one year is 50%, that is, 100 people, 50 will die, and these 50
Most of them are treated conservatively. Therefore, if you can operate as much as possible, the fracture is not fatal, but the complications caused by bed rest are fatal: deep vein thrombosis, lung infection, bedsores, urinary tract infection, etc.
Professor Zhang has been engaged in orthopedics all his life and deeply understands the powerful relationship between them, so he urgently wants emergency surgery without waiting for a moment.
I performed another 500 surgeries in the system, almost all kinds of comminuted fractures. After I checked the stability, I thought about improvements.
I also spent 3,000 points on reading the book, and I still have 7,000 points left. I bought the fractured femoral shaft and tibia and fibula, and spent another 6,000 points, and I only have 1,000 points left.
Complete the entire training package without delay.
The 4-hour water fasting and 8-hour fasting time had come. Professor Zhang was pushed to the operating room for surgery, and the head nurse of the operating room followed him personally.
Yang Ping and others followed the flat car into the elevator. There were too many people, and there was a flat car in the elevator, so they couldn't squeeze in. They had to let Zhang Lin follow, and everyone took the elevator next to them to the operating room.
When changing clothes, Tian Yuan said: "Dr. Yang, you are very proud. This old man's prostate has not been surgically removed for several years. Now he has an intertrochanteric fracture. I have named you for emergency surgery. If this spreads out, I will call you in the cafeteria tomorrow."
You don’t even have to queue up for a meal, no one dares to stop you.”
Yang Ping put on a mask and said with a smile: "This has to be done. This is the last fracture in my life. The name is not for nothing. The old man understands it very well."
After changing clothes, we went to the operating room. Perhaps the requirements for the operation were too high, or perhaps the old man had a special status. Everyone sat in the demonstration classroom next to him early. There were twice as many people as last time, and there were people from other departments.
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Dean Xia came with several hospital leaders. No matter how busy he was, he had to find time to come. In fact, while Yang Ping was resting, Dean Xia went to the ward to see Professor Zhang, but Yang Ping didn't know. For combined spinal and epidural anesthesia, the director of the anesthesia department performed the anesthesia himself. However, because he had not administered anesthesia in person for a long time, he was afraid of being unskilled, so he was on hand to provide guidance, and it was Fatty Liang who actually performed the operation.
"Xiao Yang, Mr. Zhang will leave it to you." Dean Xia patted Yang Ping on the shoulder. He knew Yang Ping's level well. Needless to say, the five-dan replantation last time was the person appointed by Professor Zhang himself.
That could still be wrong.
At that time, Dean Xia learned that Mr. Zhang had suffered a fracture and wanted to keep Director Han, but Mr. Zhang refused to agree. He wanted to arrange for him to live in the Overseas Chinese Building, but he still refused. Dean Xia had no choice but to follow him. Mr. Zhang
Whoever decides what he decides, even eighteen cows can’t hold him back.
After the anesthesia was completed, Zhang Lin and Song Zimo were positioned, and Zhang Lin and Song Zimo put on the traction frame. Xiaowu connected the tablet to the video system, adjusted it, and fixed it on the anesthesia head frame, so that Mr. Zhang could watch the live broadcast of the operation while lying down.
Several cameras have also been adjusted, one facing the screen of the C-arm moving X-ray machine, one facing the surgical area, and one facing the surgeon.
"This surgery shouldn't be difficult, just use PFNA and it can be done in half an hour."
"Old man Zhang will walk with a heavy load tomorrow."
"No way? This fracture is broken into several pieces. How can I walk with weight after the operation?"
"I don't know, just listen to what Zhang Lin said."
"This guy is very powerful. He was the one who replanted the severed limb last time."
"The Department of Traumatology and Orthopedics is really good now. Director Han is a great figure. Tian Yuan seems to be very good too. Song Zimo is a genius. Now this guy is even better than Song Zimo. Director Han is planning to build Orthopedics into a national brand.
We’re going to work harder.”
"Yes, Director Han is going to apply for the Institute of Orthopedics now. It seems to be cooperating with Fudan. Didn't you see that he didn't come tonight? He went to Shanghai."
"Oh, then the development of our orthopedics department will be great."
The operation hadn't started yet, and everyone started talking about it.
Dr. Jin came in with a Bluetooth headset on his ear. Last time he was operating, he didn't see Yang Ping undergoing a comminuted fracture of the lower end of the humerus. This time he must come and take a look.
Dean Xia exchanged a few words with Professor Zhang, but it was not easy to stay for long. There were already many things to do, and besides, having a big dean standing here put pressure on the doctor. He knew what was going on and left in time.
"Xiao Yang, it's okay for our Xiao Su to specially prepare a table for you. If you have any comments, please feel free to ask." The head nurse in the operating room is also in her forties, and she is vigorous and vigorous.
Yang Ping was sitting in the corner, and Su Yixuan had already washed her hands and was about to put on surgical gown.
Yang Ping said: "Nurse Su is really excellent, and we cooperate very well."
The head nurse said: "That's good. Xiao Su will be left to you from now on. You can't bully her. She is a kind and smart girl. She has received orthopedic nurse training in Shanghai, Hong Kong and Japan.
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While chatting here, the tow frame has been installed over there.
Traction reduction: This kind of fracture is reduced by traction first, then sterilized and draped, and surgery is performed.
Traction and reduction play a very important role, accounting for almost half of the cases. Without good reduction, the following operations will be difficult to perform or even impossible to complete.
Song Zimo instructed Xiao Wu Zhang Lin to adjust the angle and strength of the traction. Yang Ping went over to take a look and readjusted it himself. He changed the adduction position to the abduction position, and he also re-tightened the adjustment rod.
After adjusting it and being satisfied, say: "Okay! That's it, see through."
"Brother, this is the exhibition booth!" Zhang Lin reminded, he thought Yang Ping had made a mistake.
During surgery, it is common for the assistant to promptly remind the surgeon if there is a problem.
Yang Ping said clearly: "Yes, the outreach booth."
How to insert an intramedullary nail in the abduction position? Xiao Wu is also confused.
The people next door also started talking about it.
"Isn't this kind of surgery an adduction position? How do you abduct it? How do you insert nails after abduction?"
"Yeah, have you forgotten?"
"Song Zimo didn't even remind me."
"What are you worrying about? Just focus on it."
A graduate student was responsible for controlling the C-arm X-ray machine. He skillfully pushed the machine in, adjusted the position and angle, and everyone went out. He controlled the machine with a remote control from outside.
The doors and walls of the orthopedic operating room are covered with lead protection to avoid daily exposure to excessive radiation. After taking the X-ray, everyone went in again. The lateral position was completely restored and we were satisfied.
Another anteroposterior X-ray shows that the fracture still has a certain angle on the anteroposterior film. The angle is still very large and the reduction is not complete. This kind of surgery is absolutely not possible if the fracture is not well reduced and has an angulation. Let’s wait for this angulation.
This will cause the intramedullary nail to be unable to be inserted, and the surgery will be awkward and difficult to advance.
"It's not restored yet, we need to reset it again." Zhang Lin said while looking at the screen.
Xiaowu was about to adjust, but Yang Ping stopped him: "That's it, no more adjustment."
Xiaowu came back in confusion, and Song Zimo was about to persuade Yang Ping: "This reset won't work, but-". But after thinking for a moment, and looking at Cheng Jiao on the screen, he suddenly remembered something: "Brother, you are indeed
Senior brother, you can’t accept it.”
"What's wrong?" Xiaowu and Zhang Lin looked confused.
Song Zimo smiled and said: "You guys are in the audience, my senior brother and I are enough. Watch carefully. Today our senior brother will perform another unique trick for you to see clearly."
Yang Ping had already gone out to wash his hands. Song Zimo quickly chased after him: "Hey! Wait for me."
"Do you have any comments?" Yang Ping stood in front of the sink, the sensor faucet began to water, and he began to wash his hands.
"You are really getting more and more incomprehensible. Do you really want to try minimally invasive surgery and anatomically reset those broken bones, including the ones inserted into the muscles? Will you really be able to walk on the ground tomorrow?" Song Zimo caught up. p>
"What do you think? He said, if you can't do it, just give me a zero." Yang Ping brushed his hands.
"I found out that Mr. Zhang is a god. How did he know you could do it?" Song Zimo said.
"Don't you call him a god? Does a god need a reason to do things?" Yang Ping choked Song Zimo with one sentence.
