The access is open, the operation is only half done, continue.
For top experts, the difficulty of this surgery lies in the approach and subsequent reduction and fixation. Dr. Zhong should also be able to complete it. The difference is only in speed and quality.
When the reduction and fixation of the anterior acetabular fracture began, the surgeon was not skilled, but was extremely skilled, making the originally difficult operation seem extremely simple and easy.
Then the iliac wing fracture, sacrum fracture, sacroiliac joint dislocation, pubic bone fracture, and finally the pubic symphysis.
Numerous resets and fixations, one after another, are smooth and clear, and there is no stagnation even for a few minutes.
Even when dealing with sacral fractures and sacroiliac joint dislocations, the troublesome presacral venous plexus bleeding can be handled very easily. The precision of double-click electrocoagulation is very high, like a moving target shooter, every point is accurate.
The steel plates are horizontal, vertical, and oblique, all of which are well attached and can firmly fix fractures and dislocations.
The whole process is pleasing to the eye and very ornamental. If an operation has a certain degree of ornamental value, it is no longer as simple as completing the operation, but a comprehensive expression of superb surgical techniques, speed, fluency, rhythm, and details.
Perfect and so on.
Dr. Zhong's forehead was covered with sweat. In order to prevent the sweat from falling off and contaminating the surgical area, the circulating nurse reminded him several times. Only then did he hear it and turned around to ask the nurse to wipe away the sweat.
The fractures that needed to be dealt with in the anterior approach have been successfully completed.
"We need to do a posterior approach later when we turn over." Song Zimo reminded that there was still a posterior acetabular fracture that had not been performed. He was afraid that the operation would go too smoothly and Yang Ping would forget about it.
"It's done once, and you don't have to turn over anymore," Yang Ping said.
"Knife!"
The incision was lengthened, its course changed, and the ilioinguinal approach evolved into the pararectus abdominis approach. The surgeon's use of the incision was creative.
Pararectus abdominis incision, a new approach that has appeared in recent years, can complete the anterior and posterior acetabulum fractures through a single approach, without turning over to complete the posterior acetabulum fracture from the posterior approach. But for complex and difficult-to-recover posterior acetabulum fractures
Fracture, this approach is still very difficult to complete the fracture of the front and back of the acetabulum at the same time.
At that time, Director Tian was in Shipo. It was with this in mind that he gave up the single approach and adopted the classic combined anterior-posterior approach.
"Pararectus abdominis approach?" Tan Boyun saw the surgeon's intention at a glance.
At this time, he still dared to use the pararectus abdominis approach. He was too courageous. Tan Boyun straightened up.
The pelvic cavity has serious adhesions. At this time, it is much safer and easier to end the front battle quickly, change positions, re-sterilize and spread the drapes, and treat posterior acetabular fractures from the back, because it seems that this adhesion is caused by pelvic tuberculosis.
It will obviously affect the structure of the back road.
Boy! What a bold artist! Director Tian also adjusted his posture.
However, Yang Ping's level was clearly understood when Shi Po helped deal with the retracted death artery, so he didn't have much to worry about.
The usual sharp knife and double-stroke electrocoagulation are advanced layer by layer, quickly and rhythmically. The nerves and blood vessels are exposed and retracted, the peritoneal-wrapped intestines are pushed open, and the gaps are separated. Adhesion is not an obstacle at all under the sharp knife and double-stroke electrocoagulation.
The bloodless operation is carried out to the end.
Before Tan Boyun had time to evaluate, he had already fractured the posterior part of the acetabulum and began to reduce and fix it.
In the flexing space, the difficult-to-recover posterior acetabulum fracture was easily reduced. The steel plate template went in and came out, and it was already shaped. Su Yixuan handed over the steel plate and bender prepared by Su Yixuan.
Song Zimo immediately clamped the steel plate, and Yang Ping restored the steel plate with a few movements. After comparing it with the template, it was exactly the same; at the same speed, he bent another steel plate.
Put the steel plate in, drill holes and tighten the screws, see through!
Dr. Zhong was still in a daze, but Zhang Lin had already pushed the C-arm machine, and everyone avoided it.
Complete the fluoroscopy and return to the operating room.
The fluoroscopic image on the screen, the front position, exit position, entrance position, several fluoroscopic angles, the fracture was perfectly reduced, and the position of the plate and screw was very satisfactory.
There was no popping sound when moving the hip joint, and the screw did not accidentally enter the joint cavity.
It’s not the same magnitude. Dr. Zhong has forgotten the shame he felt before and started focusing on perfect surgery.
The back of my hand that was beaten by Yang Ping is still a little painful. The condescending feeling of superiority I felt when I first came here has been completely extinguished.
He has some technical status in Appendix 2. It is no problem for him to follow Director Tan, not to mention walking sideways but also taking a few steps diagonally.
Those who can handle complex pelvic fractures in the Department of Traumatology and Orthopedics are those who can stand on their own in large hospitals.
It’s too painful. I’ve done so many pelvic surgeries, but I’ve never encountered such a weird one. This pelvic surgery is full of scars and adhesions. It’s like boiled noodles that turn into dough after being left for a few days. Where can I separate a piece of it?
Noodles one by one.
But they just separated the noodles one by one.
Hey! Fortune! It’s all fortune!
If it hadn't been for bad luck, I would have received admiration stronger than the equatorial sunlight.
Dr. Zhong lamented that times are bad but good things never fade away. His head was buzzing, as if he was wearing a mask, and it was blurry.
During the fluoroscopy just now, Zhang Lin called out twice before he heard it and followed everyone out to avoid the rays.
"Perfect!"
"Call it done!"
The circulating nurse began to count the gauze and instruments and calculate the amount of bleeding.
Song Zimo said: "Brother, thank you for your hard work. You can go down and rest. Doctor Zhong and I are talking about this. Doctor Zhong, are you okay?"
"No problem, no problem." Dr. Zhong immediately returned to the operating table. Now his whole body is like a top, reaching wherever it hits.
Yang Ping began to take off his surgical gown and gloves, and Xiao Wu also went to the operating table to help.
"You should take a rest!" Su Yixuan said, her eyes mixed with love, admiration and gratitude.
"Are you okay?" Yang Ping pointed to her hand.
Su Yixuan shook her head, very sweet.
Rinse, place a drainage tube, and suture in layers.
The operation is over.
"Big brother is so awesome"
"Yeah, look, the doctor in Appendix 2 has lost his temper."
"I can do this surgery and still look so beautiful, I worship you!"
There is a little excitement next door. As long as everyone is not too stupid, they can all feel the significance of this operation.
Dignity! It’s not just the dignity of a certain person, but the dignity of a team.
Now, dignity is strongly maintained!
"Ding dong! The mission was successfully completed: the battle of dignity, a super difficult pelvic surgery, the operation was perfect, the team's dignity was successfully maintained, and the reward is 10,000 points."
"This kind of pelvis can be operated with almost no blood from beginning to end, which is amazing." Dr. Jin said.
Director Ouyang said: "The two people's surgical skills are not at the same level. Xiao Yang's surgery is really excellent!"
Director Bai had a smile on his face: "Our young people in Sanbo are still stable."
"Director Tan?" Director Han stopped tapping his thigh.
Tan Boyun did not respond.
"Director Tan?" Director Han's voice was slightly louder.
"Oh!" Tan Boyun came back to his senses.
Is the operation over? It was so fast.
There is really nothing to complain about about this surgery.
Tan Boyun said awkwardly: "Director Han has so many powerful generals. One farm is already great, and there is such a young powerful general who will be formidable. It's amazing, it's incredible. We, the Second Division, all feel inferior to us."
"Brother Tan, please don't praise me. Brother Tan will be Director Han's number one general from now on." Tian Yuan came up.
"Where is it!" Director Tan's neck was burning.
"In the future, the Department of Microtrauma Orthopedics will have to rely on Director Tan to lead it to a higher level." Director Han patted Tan Boyun on the shoulder.
"Under the leadership of Director Han, we will do our best." Tan Boyun suddenly felt a little shorter.
Tan Boyun was in Annex 2, and he had always had trouble getting along with the chief director, and he was always dissatisfied. This time he was transferred to Sanbo. To be honest, he coveted the director of the orthopedic department. This time, it was better. He was totally beaten by this surgery and couldn't find him.
North, I am completely convinced, and I no longer have any desire to covet him. I just want to sit down and secure my position as the director of the Department of Microtrauma and Orthopedics, and make some achievements while I am still in my prime.
"Tian Yuan, please accompany Director Tan for a walk and familiarize yourself with the operating room. I'll take a step back beforehand."
Director Han stood up, followed by Tan Boyun and Tian Yuan.
Director Han made a gesture of invitation: "Director Tan, please!"
Tan Boyun immediately bowed and said: "Director Han first, Director Han first."
Director Han held his hand: "Okay, you guys go around and get together again in the evening. Dean Xia will host a banquet in person."
"You're busy, let's talk in the evening!" Tan Boyun's sharp edge completely dropped in front of Director Han.
Director Han strode out, Tian Yuan said: "Director Tan, let's go around and get familiar with the operating room here."
"Well! Director Tian, please." Tan Boyun also felt a little more humble towards Director Tian.
Dr. Zhong also came out and saw Director Tan: "Director!" with a look of shame on his face.
Director Tan patted him on the shoulder: "Let's walk around with Director Tian and take a look at the operating room."
