Anyway, it’s not the first time that Xu Zhiliang has criticized him. Zhang Lin has long been used to it.
The two of them are from the same medical team. Zhang Lin usually likes to pretend to be the boss and handles graduate students, trainees, interns, and even doctors who come from outside for further training.
But Xu Zhiliang had him under control. When Xu Zhiliang took him for ward rounds, he was basically sweating profusely and trembling.
Xiaowu has never seen this kind of disease and can't tell anything.
Song Zimo and Xu Zhiliang are well-read and read various journals every day. Although they are unfamiliar with this case, they can at least have a preliminary understanding.
"I have read the literature about this. The first case appeared in 1800, and then there were a few sporadic cases. In the cases recorded in the literature, although the knee joint was recurved, there was no anatomical inversion. Those cases were all
Various reasons lead to ligament laxity, and the knee joint evolves into excessive forward bending. Finally, both the patellofemoral joint and tibiofemoral joint are dislocated or subluxed, and the knee joint becomes stiff in a deformed position of recurvature. This knee joint is different, its recurvature
It’s not that the ligaments are loose, but it’s completely anatomically reversed. You see, the patella is actually at the back.”
"Is this an atavism? The knees of mammals, such as dogs, point backwards." Zhang Lin asked again. He did not give up and wanted to show off because he had recently read Professor Qin Sihe's article and tried to imitate Professor Qin.
Use a higher perspective and look at some issues in orthopedics from the perspective of human evolution.
Teacher Zhang is awesome!
As soon as such high-end remarks came out, the graduate students and graduate students nearby cast admiring glances.
When Zhang Lin saw everyone's reactions, he immediately sat up straight, very scholarly.
It seems that if you want to show off, you still need to read more books. The failure rate of showing off without education is too high, and even if you succeed, the grade will not be high.
Xu Zhiliang took over: "Does your dog's knees face backward? The knees of mammals are the same as those of humans. They also face forward, with the patella in the front. In this case, the patella is in the back. How can it be atavistic? Strictly speaking, this kind of
The case is more appropriately called anteroposterior anatomical inversion deformity of the knee joint."
Zhang Lin failed to show off again, but there was nothing he could do. This was a case discussion, and everyone expressed their opinions. Dogs’ knee joints face backwards. He also learned this knowledge on the Internet. It seems that this knowledge on the Internet is too unreliable.
, I will read more academic journals in the future.
Song Zimo enlarged the picture and looked at it again: "Lao Xu's suggestion is very good and fits the timing of this disease. When writing the paper, we can name this disease as knee joint anteroposterior anatomical inversion deformity syndrome. You
It seems that the hip joint is also severely underdeveloped and in a state of deformity and dislocation. The ankle joint and foot are also inverted, professor! You don’t want her to stand up through surgery, do you?"
Song Zimo looked at Yang Ping and felt that he was a demigod, with his mind full of crazy ideas and always able to realize them.
Now Song Zimo really hopes that Yang Ping can lead a postdoc in the future and he can become a postdoc with him.
Let's talk about surgery. Many seemingly impossible surgeries were completed in his hands as surely as an expert.
Let's talk about scientific research. Spinal external fixators are used to treat scoliosis. This guy managed such a complex thing in one step and succeeded.
Now we are preparing to work on the subject of stem cell culture of muscle. If this subject is completed, it will be Nobel Prize-level.
Song Zimo had no doubt at this time that this guy could really do it.
Song Zimo gets excited just thinking about studying with such a person.
"After this patient came, we treated the whole process as a new subject. If we handle this case well, no matter how difficult the lower limb orthopedic surgery is in the future, it will not be a problem. This case uses almost all the knowledge of lower limb anatomy and physiological mechanics, and there is no step.
If treated well, the postoperative effect will be very poor. If the postoperative effect is too poor, it will be counterproductive. Originally, someone else could still crawl, but as a result, they could neither walk nor crawl after the operation, and ended up in a wheelchair." Yang Ping hopes that the team will pay attention to this case.
Since you are a professor, you should look like a professor.
Xiaowu smiled and said: "If the operation is not done well, not only will I not be able to regain a new life, but I will also ruin my current circus job."
That’s true!
"I contacted Ruixing's laboratory to conduct computer 3D modeling, then simulated osteotomy and soft tissue balance adjustment to find the best line of force, and then designed hip and knee prostheses. Xiao Wu was responsible for the reception of patients.
At work, Zhang Lin is responsible for collecting treatment, and Lao Xu is responsible for checking information, and the relevant knowledge is compiled into a booklet for everyone to learn." Song Zimo divided the labor for everyone on the spot.
After discussing the case, Yang Ping led everyone in ward rounds.
One patient named Yang Ping for surgery, saying that he knew Yang Ping, and held a small note written by Yang Ping in his hand.
Yang Ping felt strange when he had ever written a small note to someone.
During ward rounds, I saw this patient.
Yang Ping has a good memory and recognized this young man in his twenties at a glance.
When I went to the countryside in Nanqiao County, I saw a patient at a free clinic whose lower limbs were unequal in length. He fell from a tree when he was a child. Without formal treatment, he asked the rural osteopath to spit a few mouthfuls of cold water on his legs and then pull them hard.
After a few clicks, it turned out that the left leg was five centimeters shorter than the right leg, and the left ankle and left foot were also deformed, and I walked with a limp.
When the young man saw Yang Ping, he immediately got up from the bed and held Yang Ping's hand: "Doctor Yang, I finally found you. Do you still remember me?"
"Why don't you remember, you are from Nanqiao County?" Yang Ping immediately remembered him.
This guy also said at the time that today's medical men can be transformed into women, so his legs should be transformed.
"You have such a good memory. I thought you forgot things and didn't remember me. Look, Dr. Yang, I have always carried the note you wrote to me."
The young man carefully took out a notebook with a note in it.
Yang Ping took it and saw that the note was actually plasticized and well-preserved. It had the address, phone number and name written by Yang Ping himself.
"It's hard to find doctors in big hospitals, so I didn't dare to throw away this note until I saved enough money, so I dared to come to you." The young man took the small note that Yang Ping returned to him and put it back carefully.<
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"Dr. Yang, to tell you the truth, I want to walk normally and find a better wife." The young man did not hide anything, and revealed the ultimate purpose of his operation.
Because of these legs, it is a bit difficult to find a better wife.
Yang Ping chatted with him for a few words. The young man's family was poor and he had few relatives and friends. He had not graduated from junior high school and went out to work, moving bricks on the construction site.
He has a relatively clear life goal. He worked bricks and mortar for a few years, saved some money, and went to a chef school to learn how to be a chef. Later, he became a chef and his income was much higher.
The young man is very high-spirited, and he has standards in mind when looking for a wife, and he doesn't want just anyone.
"What do you mean by a good wife?" Xiao Wu joked with him.
The young man said seriously: "At least a junior high school diploma, a decent person, a clean history, good health, a height of more than 1.6 meters, a good figure, and good looks. I am also a skilled person, so I must not be casual about marrying a wife.
, you have to be selective, women should be careful when marrying, and I should be careful when seeking a wife, and men and women are equal."
This guy has a lot of theories, including equality between men and women. His world view and outlook on life are quite correct.
This standard is neither high nor low.
If this leg is not cured, it will be really difficult to achieve the goal.
The young man's name was Fang Faquan, and he had completed the admission examination. Song Zimo showed Yang Ping the full-length films of his lower limbs. Yang Ping took a closer look and found that there was an old fracture of the left tibia and fibula. There should have been shortening and overlap at the time, and later malformation healed.
He was already 12 or 13 years old when he was injured, and there was not much room for fracture and reshaping, so the tibia and fibula became varus and shortened, which affected the whole body. In order to compensate, problems also occurred in the hip joints, ankle joints and feet.
, the pelvis is tilted and the spine is scoliosis.
This kind of orthopedic surgery is relatively difficult because it has to consider restoring function as much as possible.
Three levels of surgery: resection, repair and reconstruction.
Reconstruction is the highest level, and it is also very difficult.
A small operation, once it involves functional reconstruction, the difficulty will naturally increase.
If you do not master the relevant core knowledge of surgery, the surgery may look very beautiful, but it will not achieve the desired function.
Just like a small factory can copy the appearance and interior of a Porsche, it can be exactly the same, or even more beautiful than a Porsche, but it just can't produce its core technologies, such as engines and power, etc.
Therefore, reconstructive surgery most tests the skill of a doctor.
"The purpose of your surgery is to get a good wife?" Yang Ping asked him.
Fang Faquan didn't hide it: "Yes, Dr. Yang, if it weren't for this, I wouldn't have bothered. Although I'm swaying, I'm used to it, and it won't affect my current work."
"The goal is clear and good. There are two methods. One is relatively cheap and simple, and the other is relatively expensive and complicated. Of course, the risk of the latter one is also high. The former solution is to shorten the normal long leg by five centimeters, and then shorten the left leg.
Orthopedics. The latter method is to straighten the left leg and lengthen it by five centimeters at the same time. Which one do you choose?" Yang Ping simply told him the surgical plan.
Fang Faquan did not hesitate: "The elongated kind. If the long legs are shortened, I am only 1.55 meters tall. If the short legs are lengthened, I can be 1.7 meters tall. I asked Dr. Zhang about the cost. My money
Enough."
"The risk of the latter is higher!" Yang Ping added.
Fang Faquan said: "Don't be afraid. At worst, you will still be lame, and the lameness will be more serious at the end. What can you do without risk? There are people in the kitchen who cut vegetables and cut off their fingers. Not long ago, an aunt who was washing dishes broke her bones while walking.
Doctor Yang, you help me pull, it’s best to pull both sides at the same time. I have read the introduction of your department, there is a patient who has a leg stretched by 30 centimeters, you help me pull it to 1.8 meters."
The more Fang Faquan talked, the more excited he became.
Yang Ping felt that this kid was really high-spirited: "Your condition is different from others. It will be good for you to walk normally after correction. Don't think about the height of 1.8 meters."
This young man's words made everyone laugh.
He not only has his own opinions, but also has his own outlook on life.
