Chapter 121 Do you call this Level II surgery? (Please subscribe!)
Zhou Cheng also saw An Ruo's dodge and smiled kindly at her, even though she didn't see it.
Zeng Yi also saw this series of actions and shrugged his eyelids, feeling a little funny.
As a student, he seemed to be a little scared by people from the Department of Orthopedics, but in fact, Zeng Yi still felt that the Department of Orthopedics was still one of the most benevolent departments among all surgeries.
Except for the occasional violence, it's actually quite clean. Isn't it much prettier than neurosurgery to turn over the brain, thoracic surgery to turn over the lungs, or general surgery to turn over the intestines?
…
Cai Dongfan washed his hands, dressed and walked into the operating room. After approaching the operating table, he faced Dou Chengpeng and asked: "Chief Dou, we are all ready, can we start?"
The medical department is a functional department. It is the superior management department of all disciplines and departments in the hospital, and it is also the management department of all doctors.
Therefore, it is another level of leadership besides the director.
It's just that the medical department doesn't care about clinical practice and doesn't walk in the arena of specialists. When it's time to scold, you can point your nose and scold, but when you want to be respectful, you still have to be polite.
Dou Chengpeng said confidently: "Let's get started. I'd like to see if our hospital can, for the first time for the first time, grant a level II surgical authority to residents in advance. This will also help improve the teaching strength of our hospital."
It will definitely help.”
Although the medical department does not care about teaching, the Eighth Hospital has been working in two general directions recently -
Special hospital.
Teaching hospital.
Each one is extremely tempting, and every hospital would very much like to put their brand in the hospital before they get the above two titles.
Teaching hospitals are also secretly divided into many levels, which are related to the medical schools they are affiliated with. It's just that the schools that the eight hospitals rely on to cooperate are a little different, but they have no choice...
Cai Dongfan nodded and said to Zhou Cheng to start.
After hearing this, Zhou Cheng took a deep breath, and in order to show his respect and respect for the event arranged by Zeng Yi, Director Wang Yongjin and others today, he took a few steps away from the operating table, and then walked to the reader again.
.
The ninth time before surgery, and the third time after entering the operating room, carefully observe the patient's imaging examination data.
This is an assessment for surgical authorization, not an ordinary surgery.
Zhou Cheng naturally had to pay enough attention to it.
When they saw Zhou Cheng walking out of the operating table again and going to the image reader, no one felt upset that he was putting on airs and wasting time. Instead, they all understood Zhou Cheng's nervousness at this moment and praised him for his stability.
.
Cai Dongfan whispered to Luo Yun: "Xiao Zhou seems to be such a mature and steady person since he entered the department, right?"
Luo Yun nodded, agreed with Cai Dongfan's statement, smiled, and said helplessly: "If he wasn't such a person, Director Cai, you must have noticed him long ago."
"On the contrary, I feel that his thinking is too tightly bound by today's secular rules."
"It's a bit pitiful, and it will also affect his future."
Zhou Cheng was so stable, from beginning to end, if someone hadn't asked him to come on stage to help, he would have looked on coldly, just like Yama in this world, without any energy.
Momentum is a characteristic of young people, and it is also one of the essential characteristics of young people with unlimited potential.
Dare to venture and dare to do something, this is what young people should have.
Cai Dongfan shook his head: "No, no, you are wrong, Luo Yun."
"You can't rely on Xiao Zhou's own experience. Instead, you have to consider the problem from Luo Yun's perspective. Before and now, he was just an ordinary person. He was not stable. If something happened, where would there be a teacher to help him?
endorsement?"
Luo Yun shook his head and stopped talking.
To be honest, he has never been a simple residential trainee, so he may not understand Zhou Cheng's current situation.
When Luo Yun graduated, the standardized training had not yet been promoted nationwide. At that time, he only had to follow his teacher and just manage the bed, and there were not so many things.
——
After Zhou Cheng carefully read the film and determined that the patient had only a simple fracture of the lower end of the fibula, without any other hidden injuries or other accompanying problems, he slowly exhaled and left.
Come to the stage.
Then he asked Cai Dongfan in a low voice: "Teacher Cai, should I start first?"
"Well, let's get started. Do you want to do some fluoroscopy first?" Cai Dongfan immediately started to go through the procedure, which is also the routine procedure of closed/open reduction and internal fixation of fibula fracture.
The surgical plan he prepared was both open reduction and closed reduction. He also discussed this with the patient. He mainly hoped that Zhou Cheng would not do anything difficult, and this small surgery, the simplest level II surgery, was performed on Zhou Cheng.
Used it for practice today.
So I put it on the first channel to give Zhou Cheng some confidence.
Moreover, even Du Yanjun can perform this surgery, and Cai Dongfan believes that Zhou Cheng can also do it.
Zhou Chengcheng took the initiative to answer the conversation: "Let's not do fluoroscopy for now, Teacher Cai."
"Two of you and Teacher Luo, one of you will help me fix the pelvis, and the other will fix the mid-thigh. I will perform a manual reduction first to see if I can reduce the existing fractures that are not displaced much."
In fact, it is quite difficult to simply perform manual reduction for a simple fibula fracture.
The tibia and fibula are parallel lower limb bones, and the tibia is very strong.
If the fibula is fractured, if the pain factor is not considered, it will not affect the patient's walking or any functions, because the length and hardness of the tibia are enough to support a person's normal walking.
It is precisely because of this, without the characteristics of plasticity and displacement, that it is quite difficult to reduce the fracture of the fibula.
But that's for ordinary people.
Zhou Cheng's understanding of the manual reduction of fractures is that it is a perfect redefinition, so naturally he does not find it difficult.
Closed reduction and Kirschner wire internal fixation is also one of the standard orthopedic level II surgeries and operations.
Luo Yun and Cai Dongfan nodded instantly.
After standing in their respective positions——
Zhou Cheng immediately started the reset operation.
Three-piece set of standard fracture reduction techniques.
Continuous traction——
Orthopedic displacement——
Keep the traction position temporarily fixed——
After continuing to pull with both hands for a while, Zhou Cheng gently pushed the patient's ankle joint toward the medial malleolus.
Then the left hand continued to exert force, and the right hand immediately and neatly reached the patient's fracture position, and began to palpate and stroke it up and down.
After wandering up and down for ten seconds, Zhou Cheng quickly turned around and shouted: "Sister Yan, the Kirschner needle is equipped with an electric drill, I will fix it temporarily!"
Liu Yan is a very professional orthopedic specialist nurse, otherwise Cai Dongfan would not call Liu Yan to the operating room every time he encounters a critical operation, either as a circuit nurse or as an instrument nurse——
Liu Yan quickly handed it over.
After Zhou Cheng took the Kirschner wire with the electric drill, he immediately aimed at the protrusion of the lower part of the fibula, which is also something that all of us ordinary people can feel, the bony protrusion on the outside of the ankle——
The lateral malleolus is formed by the swollen lower part of the fibula.
For Zhou Cheng's first K-wire, the needle insertion point was slightly outside the lateral malleolus, and the needle insertion direction was obliquely upward.
By crossing the fracture line diagonally in this way, the fixation effect can be achieved.
The principle can be naturally referred to the candied haws skewers -
"Da da da da da da!"
The Kirschner wire was very sharp and the battery of the electric drill was new, so the Kirschner wire was driven in quite smoothly and the fixation effect was achieved.
"Teacher Cai, Teacher Luo, okay, that's all."
After Zhou Cheng said something to Cai Dongfan and Luo Yun, he turned back and looked at the roving nurse: "Teacher roving, please push down the C-arm machine."
But for this tour, it had been prepared for a long time. It seemed that the patient had been informed of the operation process in advance, and a fluoroscopy would be performed before the operation started.
Although Zhou Cheng omitted this step, she was always ready behind the C-arm until she received other orders.
Today's surgery was special. Cai Dongfan thought of every detail and was thorough in every aspect.
Although Cai Dongfan's eyes are small, his mind is not small. Only by perfecting more details can he have more room for error.
When the circulating nurse started pushing the C-arm machine, Zeng Yi and others stood up naturally, including Dou Chengpeng.
Because of the detailed steps of the surgery, I wrote this article.
Zeng Yi shouted softly: "Ruoruo, the X-ray is done, get out of the isolation room."
——
After everyone calmed down for a while, they all came to the isolation room and closed the lead door.
The results came out immediately.
Cai Dongfan and Luo Yun looked normal, while Zeng Yi and Yan Haihan rubbed their eyes in disbelief.
Because they doubt whether their eyes are blind——
The path of the Kirschner wire after the TM fracture is fine, but what about the fracture line?
Wang Yongjin's eyes immediately flashed, and he, who had been immersed in clinical practice for forty or fifty years, kept looking up and down Zhou Cheng.
Zhou Chengcheng hurriedly said: "Teacher Cai, Teacher Luo, Sister Yan, just wait for me here for a while. I'll go in and put in another Kirschner needle. Then I'll take another picture. This will save some time."
After saying that, Zhou Chengcheng took the initiative to step on the sensor door of the lead door, then strode in wearing a sterile green surgical gown. When he got to the instrument nurse's table, he found the Kirschner wire himself and put it into the electric drill, using the lock.
Lock the drill.
The second crossed K-wire was quickly completed to achieve a more stable fixation.
The principle can be referred to the cut chicken legs at the barbecue stall. Cross-fixing them is stronger than running skewers in parallel!
When Cai Dongfan saw Zhou Cheng withdrawing the electric drill, he said to the circulating nurse: "Yali, call the department later to pick up the next patient."
"Ah?~" Nie Yali was stunned on the spot.
Because the stupid operation is a bit too difficult for her, there is probably no other girl willing to cooperate...
An Ruo was immediately like an ant on a hot pot, her little hands kept grabbing it.
He looked up at his teacher Zeng Yi, blinking his eyes as if asking for help innocently: Teacher, teacher.
It's coming, it's coming again, what should I do?
Didn't we say that the pace of the surgery won't be too fast?
At this moment, Zeng Yi still remembered what he had just said. Seeing that his student had a slight stress reaction, he immediately pinched his throat and coughed to remind her to pay attention to her image and not to lose her grace in front of outsiders.
It was impossible for An Ruo to do such a thing, but he kept cursing in his heart:
Orthopedics is toxic.
Orthopedics is the devil.
orthopedics--
The curse is the enemy of life.
Zhou Cheng walked out of the isolation room again, so Cai Dongfan stepped on the C-arm fluoroscopy for the second time.
The results are still great.
After Zhou Cheng looked at it, he breathed a sigh of relief and said, "Teacher Cai, Teacher Luo, I'm going to put on the plaster. You can get off the stage and rest."
The corners of Cai Dongfan and Luo Yun's mouths suddenly twitched.
Glancing at the timing panel in the operating room.
00:04:42!
Four minutes and forty-two seconds.
This is the total time it took Zhou Cheng to go back in and get the second Kirschner needle after two fluoroscopy procedures. In other words, Zhou Cheng’s own operation time may have been less than a minute!
Zhou Cheng walked in again.
Nie Yali still didn't react. How could this be the end?
When did the surgery begin?
Seeing that Nie Yali was still motionless, Zhou Cheng was already wandering in front of the operating table, as if he didn't know where to start the next operation.
After all, the C-arm machine is only covered with a sterile C-arm machine cover on the upper part, and other parts are still sterile.
Cai Dongfan reminded: "Yali, go push off the C-arm machine and prepare for the second surgery. Thank you for your hard work."
Nie Yali reacted immediately and ran into the operating room to help.
Then Cai Dongfan said to Luo Yun: "Luo Yun, please go in and help Xiao Zhou put on the plaster. I will step down first."
After saying that, he started to undress himself.
In fact, Cai Dongfan felt that this operation was too fast. He originally thought that Zhou Cheng had to inject two Kirschner needles, which would make the reduction slower than the previous method?
But, it seems that he is thinking too much.
When Cai Dongfan was taking off his clothes, he saw Zeng Yi's frown, and immediately smiled innocently and apologized to him: "Director Zeng, thank you for your hard work. Go and remove the anesthesia, and then work hard to inject the anesthesia for the next one."
Zeng Yi walked into the operating room calmly and said nothing.
Now in front of people from the medical department, even though he has ten thousand opinions and complaints in his heart, he dares not express a word.
If the surgery in the clinical department is done quickly, how can your anesthesiology department have any objections? During meetings on weekdays, what do you complain about when the surgery is done slowly?
An Ruo immediately turned into a diligent little ant, running around in the operating room, her mouth pouting under the mask.
It’s so hard for me——
…
When he saw Cai Dongfan taking off his clothes, Dou Chengpeng was completely stunned. He looked at Yan Haihan, Zeng Yi and Wang Yongjin. All three of them marked their own scores on the score sheet.
Suddenly he was a little anxious. He quickly asked: "Director Zeng, Director Wang, how should I grade this?"
"So many scoring details have not been made."
After Zeng Yi heard this, he quickly explained: "Director Dou, this, the surgery chosen by Xiao Zhou is a level II surgery of closed reduction and Kirschner wire internal fixation."
"This is not the plate and screw internal fixation we routinely perform, so the details of the surgery will be later."
Cai Dongfan was naturally very well prepared and wrote several scoring rules for surgical plans.
Dou Chengpeng's eyes suddenly widened.
Damn you guys are so naughty.
This is an assessment for surgical authorization, not a game of house, so why are you still playing multiple-choice questions?
Adults can either choose both or just one.
Are you still having fun during surgery?
Then I opened the back of the scoring rubric, and I immediately felt that people in orthopedics are even more naughty——
I saw that closed reduction and Kirschner wire internal fixation of fibula fracture, surgical procedures and scoring rules:
1. Use routine disinfection and draping, disinfect the upper limbs from the middle of the thigh to the entire lower limbs.
2. Preoperative C-arm fluoroscopy.
3. Manual reduction and internal fixation with K-wires.
4. C-arm fluoroscopy.
5. Plaster external fixation.
Even if Dou Chengpeng is not an orthopedic specialist, he can still understand it. When he writes these five points, he is just too damn good.
Disinfection drapes and C-arm fluoroscopy accounted for three of them.
The really useful ones are probably manual reduction, Kirschner wire internal fixation and plaster external fixation.
Do they also feel that the scoring rules are too rough?
Dou Chengpeng's expression changed for a while.
At this time, Wang Yongjin began to explain: "Chief Dou, the steps of the four-person manual reduction are simple, but in fact, it is the most difficult level II surgery among these surgeries."
"Basically, only a few hospitals dare to perform this kind of surgery on a regular basis, but they just can't grasp the degree of manual reduction."
As the senior director, Wang Yongjin has the most say, and Wang Yongjin does not mind giving his juniors a hand.
As he spoke, he pointed to the C-arm fluoroscopic display and explained to Dou Chengpeng: "Chief Dou, look, when we evaluate whether the reduction and fixation of a fracture is good or not, we mainly look at the degree of closure of the fracture line and the degree of reduction of the displacement."
"We can see that the previous lateral displacement has basically been restored."
After hearing this, Dou Chengpeng immediately asked: "Director Wang, is this just basic? What is better?"
Hear this.
Wang Yongjin, Zeng Yi, Yan Haihan and Cai Dongfan almost choked to death on their own saliva.
Wang Yongjin also shrugged his forehead, dug his ears with his hands, and said to Dou Chengpeng with some embarrassment: "I said basic, but actually I was just being polite."
"Although my surname is Wang, I am not a mother-in-law, nor do I sell melons."
Wang Yongjin and Dou Chengpeng were joking.
Wang Yongjin is the generation of teacher Dou Chengpeng, so he can joke with Dou Chengpeng casually.
Dou Chengpeng immediately fell silent, feeling secretly bitter in his heart, well, this exposed his unprofessionalism.
I secretly took a look at Director Zeng Yi and others, and felt that I might have been a bit ridiculous just now. Translated from modern words, it means the scene of social death.
It seems that we still need to say less and make fewer mistakes...
It's not certain that the work done by this little doctor will be very poor. A great director like Wang Yongjin Zengyi will definitely be able to find flaws.
In fact, Dou Chengpeng did nothing wrong. He just subconsciously asked Wang Yongjin how the operation was done and whether it could be better. But he didn't expect that Wang Yongjin couldn't answer it, and Zeng Yi and others also felt quite embarrassed.
It seems like maybe this is the ceiling.
…
Finally, the second operation started on time at 8:54.
The first operation time, when Cai Dongfan brought Zhou Cheng and others down, was 08:21!
The operation is over and the patient leaves the operating room at 08:27!
The anesthesiology department and the circulatory department completed the operation turnaround of picking up patients and anesthesia in twenty-seven minutes. They were already riding hot wheels in secret.
Little girl Anruo felt that the soles of her feet were a little warm, and her wrists were also a little warm.
This is the precursor signal for lactic acid accumulation during short-term overload exercise.
After the anesthesia, he leaned back against his teacher's chair to rest for a while, a little suspiciously. Zeng Yi stood up and came to the operating table to watch Zhou Cheng's operation.
Under the timing panel in the operating room, Wang Yongjin, Zeng Yi, Dou Chengpeng and Yan Haihan of the Fourth Middle School were sitting upright with writing boards in their hands, as if they were seriously evaluating the second surgery.
Yan Haihan, who knew the operation best, quickly explained: "Director Wang, Director Zeng, and Chief Dou, this second operation is a fracture of the lateral ankle. From the professional point of view of our orthopedics department, this operation is strictly
Open surgery.”
"The alternative to surgery is the second one, which is to put a locking plate on the outside."
"This time, these scoring rules will come in handy."
Wang Yongjin also said: "This surgery is a routine surgery in orthopedics. It is more routine than the previous one. It is now one of the very mature surgical methods."
Dou Chengpeng breathed a sigh of relief.
But because of the lessons learned just now.
He still turned around and then looked at the operation scoring details. There was no operation plan like the previous operation with only a few simple items, which made him breathe a little.
He replied calmly: "Well, in fact, it mainly depends on Director Wang, Director Zeng, and Director Yan, the four majors."
"I'm a layman."
Dou Chengpeng began to show weakness with lingering fear to avoid social death again.
After Zeng Yi watched Cai Dongfan and others, he did not expose his calf like the first one. Instead, he applied a sterile patch and then stepped back a few steps: "An Ruo, this time we must have an operation. You
Look, the sterile patches for the surgery are all done."
Zeng Yi knew that two consecutive anesthesia machines would consume a lot of physical energy for the anesthetist.
Being an anesthesiologist is a professional and technical job, but Zhou Cheng was forced to do physical work, which was very difficult for a female student like me.
An Ruo nodded, not daring to think about anything. She just stood up, gave up her seat to Zeng Yi, then sat on her small round stool, nodded and said, "Yeah."
Very well-behaved and very sensible.
Because she found that if she didn’t complain, she would actually feel much better, and complaining would not reduce her workload.
In fact, it means accepting your fate.
Cai Dongfan was not in the business of welcoming people, so he participated in the entire operation, including disinfection and draping.
Finally, everything is pending.
Cai Dongfan stood at the first assistant position and said to Wang Yongjin and others: "Director Wang, Chief Dou, we have started the operation."
Wang Yongjin and others had already seen Zhou Cheng lifting the round knife, so they quickly stood up.
Then they walked slowly one by one to the operating table.
Zeng Yi wiped his forehead with the back of his hand.
After all, you took the scalpel, unlike the first one, which said it was an operation, but didn't even lift the scalpel, but prepared it. Isn't this a waste of resources and an increase in the burden on the patient?
Of course, I just think so in my heart. I don’t know how many patients expect and desire such a ‘burden’!
The operation can be completed without using a knife, and it only costs a few dollars more for the scalpel, which cannot be done elsewhere.
Do you think he would be happy with it?
An Ruo also calmed down, patted her chest, took a long breath, and then began to rest.
"Start the operation!" Cai Dongfan immediately ordered Zhou Cheng when he saw Zeng Yi and others approaching.
Zhou Cheng was well prepared, and Luo Yun and Cai Dongfan had already exposed the patient's outer ankle, which was exactly the right direction and location for Zhou Cheng to operate.
However, after Zhou Cheng lifted the knife, he put the round knife down again, and then thought about the type of fracture for a while.
Zhou Cheng then shouted to Liu Yan, the traveling nurse: "Sister Yan, give me the Kirschner needle and the electric drill first."
Liu Yan was stunned when she heard this.
In this surgery, Cai Dongfan told her that she would need to make an incision first, then temporarily fix it with Kirschner wires, and then put a steel plate on it?
Liu Yan then looked at Cai Dongfan.
Cai Dongfan's little eyes rolled around: "Electric drill, with Kirschner wire."
On the side, Wang Yongjin also noticed a slight change in the surgical process, and hurriedly explained to Zeng Yi and others: "Xiao Zhou slightly changed the surgical strategy. He first used K-wires to temporarily fix it, and then followed the advancement of the K-wires.
Using needle points to make incisions can be more precise."
“It can also narrow the patient’s incision where the plate is placed.”
Wang Yongjin had previously performed surgery from the atlas to the toes, so his understanding of fractures of the lower limbs was far better than those like Zeng Yi, who had assigned the lower limbs to the Department of Orthopedics several years ago.
Dou Chengpeng took a look at Article 6 of the surgical procedure and discovered this as expected.
He immediately nodded secretly and said: "In order to reduce the length of the surgical incision for the patient, this is a good thing. But it will not affect the patient's recovery, right?"
Wang Yongjin shook his head: "No, and the inner ankle is also prominent. Even blind typing is quite troublesome."
"That's good, that's good."
Dou Chengpeng nodded hurriedly: "After all, quality is the priority."
Wang Yongjin said so, and Liu Yan could only temporarily hand the Kirschner needle to Zhou Cheng.
Zhou Cheng then inserted the Kirschner needle in one direction from the outside to the inside without much hesitation.
Immediately afterwards, Zhou Cheng said again: "Sister Yan, give me the other Kirschner needle!"
Liu Yan was not suspicious and handed over the Kirschner needle.
But this behavior made Cai Dongfan a little confused. Why are you giving so many Kirschner needles?
The more Kirschner wires, the better.
"Zhou Cheng, the fracture of the medial malleolus is too large, and the fixation effect of Kirschner wire is not accurate." Cai Dongfan reminded hurriedly.
"I know, Teacher Cai." Zhou Cheng was now in the chief surgeon's position, so he naturally knew this.
However, he already has his own surgical plan.
Level II surgery, fixation of the medial malleolus.
As he spoke, Zhou Cheng formed another K-wire at a certain angle with the first K-wire and inserted the K-wire.
After doing this, Zhou Chengcai said: "Sharp knife!"
Cai Dongfan was not suspicious, but slowly breathed a sigh of relief.
Fortunately, Zhou Cheng did not shout: Tour teacher, push down the C-arm machine, otherwise, he would really hit someone on the operating table.
Liu Yan handed over the sharp knife.
Zhou Cheng took the sharp knife, and then made a 0.6cm incision at the insertion point of the first Kirschner needle, which penetrated directly into the bone end.
Cai Dongfan frowned immediately after reading it, and Luo Yun reminded: "It is better to use a sharp knife to slowly peel it inside."
"There are no nerves or blood vessels at the protrusion of the lateral ankle, Teacher Luo." Zhou Cheng replied.
He pulled out the sharp knife, and then made a second parallel incision where the second Kirschner needle was inserted.
Seeing this, Cai Dongfan's expression immediately changed!
Everyone is stupid.
What are you doing?
The principle of surgery is that if one incision can solve the problem, a second incision should never be made.
You can even extend it further up and down without making parallel incisions. Parallel incisions are only used for tension-reducing suturing.
But now?
Cai Dongfan's scalp was slightly numb.
Zhou Cheng has been killed, and it is impossible to turn back. Cai Dongfan cannot be on this to demolish Zhou Cheng. He is just secretly thinking about how to deal with it, and how to explain to Dou Chengpeng how to open this door later.
The mouth is good.
Luo Yun was also startled, his gluteal muscles pinched with tension, and his hands twitched slightly, but he did not speak.
Yan Haihan inadvertently said: "Uh."
Wang Yongjin and Zeng Yi immediately glanced at Yan Haihan and each pinched their throats.
Uh-huh.
It was as if a group of people had pharyngitis at the same time.
Tell him to shut up.
Dou Chengpeng doesn't understand professional skills, so don't discredit your own people.
Only then did Yan Haihan react and said nothing.
Zhou Cheng dropped the sharp knife and saw Cai Dongfan constantly giving him looks that almost burst out of fire, asking him what on earth he was doing.
But when Zhou Cheng returned the sharp knife to Liu Yan, he gently patted Cai Dongfan's hand and whispered: "Teacher Cai, don't worry, I have confidence in my heart."
"Sister Yan, give me two headless compression screws, one 5.5 and one 4.5!"
After hearing Zhou Cheng's words, everyone's brains were shut down.
Only Luo Yun suddenly looked up at Zhou Cheng in shock, as if he understood Zhou Cheng's intention.
The headless compression screw is a single fixation screw used for posterior malleolus fractures. It has a very strong fixing force. It is also feasible if two are used to fix the lateral malleolus.
What Zhou Cheng needs to do is to make the incision as small as possible and minimize the trauma...
But he is also too courageous!!!
Liu Yan handed the headless compression screw to Zhou Cheng, but found that the eyes of Cai Dongfan, Zeng Yi and others were a little strange.
But he didn't stop her, and he didn't mean to take over the operation, so he had to listen to the surgeon first.
After Zhou Cheng took the screw, he applied pressure and began to tighten it inside.
This tightening process is neither fast nor slow, it is a laborious task.
…
While Zhou Cheng was doing all this, Luo Yun appeared in Cai Dongfan's ear and whispered: "Director Cai, what Xiao Zhou is doing now is to use headless compression screws to fix the medial malleolus. This can be repeated indefinitely.
The incision was reduced.”
"This method is currently at the forefront of small-incision surgery in trauma surgery."
"The Magic City and Kyoto have already started doing this."
Cai Dongfan immediately felt as if he was struck by lightning.
Looking at Zhou Cheng, he continued to stuff the screws in with a calm expression. He suddenly felt as if Zhou Cheng had driven a nail into his heart, constantly squeezing his coronary arteries, and he felt as if he was squeezing.
.
Cai Dongfan was not stupid and naturally understood what Luo Yun said.
But the word "frontier" made his scalp numb.
I was yelling in my heart, Zhou Cheng, Zhou Cheng, don't fucking hurt me, I gave you a military order in front of Zeng Yi, cutting-edge surgery?
You call this Level II surgery?
…
Luo Yun then took a few steps back, called Zeng Yi, Wang Yongjin and others aside, and explained again: "Director Wang, what Zhou Cheng is doing this week is a small incision for fractures that has great potential and is at the forefront of trauma surgery.
Reduction and internal fixation.”
"His procedures and choices are correct. Many doctors have performed reduction of posterior malleolus fractures under closed conditions."
It was okay if Luo Yun didn't say anything. Once he explained it clearly, Wang Yongjin and the four others became confused.
You look at me, I look at yours.
Then, Dou Chengpeng turned over the scoring rules prepared for him by the orthopedics department and asked: "Then how to score this?"
"Isn't it written on this?"
"Director Wang, then I will follow your lead in scoring?"
Dou Chengpeng's words made Wang Yongjin's eyes and upper body tremble slightly.
After pondering for five seconds, Wang Yongjin tilted his head slightly and said apologetically to Dou Chengpeng: "Here, Chief Dou, I can't give you a score. I don't know this kind of technique either."
Dou Chengpeng looked at Zeng Yi and Yan Haihan.
Zeng Yi and Yan Haihan could only bite the bullet and follow Teacher Wang Yongjin, standing closely behind Teacher Wang Yongjin.
Shaking his head: "Neither can we."
Dou Chengpeng suddenly felt a little sad.
Damn it, you guys from the Department of Orthopedics don’t know how to grade, so what are you going to say about today’s surgery authorization?
Three minutes later.
After Zhou Cheng inserted a total of two headless compression screws, he let out a long sigh of relief.
My palms feel a little hot.
Sure enough, it is girls who like to spin. Men do not feel pleasure when they spin and rub.
Said: "Sister Yali, please push the C-arm machine. Let's do it."
In fact, Nie Yali knew that there might be something wrong with the operation when Wang Yongjin and others were whispering, and Cai Dongfan and Luo Yun did not speak or be polite, so she was very nervous and at a loss, paying full attention to the progress of the operation.
Nie Yali looked at Cai Dongfan.
Cai Dongfan was extremely helpless at this moment. He glanced at Zhou Cheng with complicated eyes, wondering why Zhou Cheng was so troubled and wanted to do such a stupid thing today. It was a bit unreasonable.
But now that the matter has come to this, we can only take a photo first to see the situation.
Then he nodded and said in a dry voice: "Let's go through it first."
The sound and look are like a landlubber who doesn't understand water gets into the water, quacking, quacking, quacking.
Hear this.
The groundhog - An Ruo immediately sat up straight, eyes wide open, innocent and cute, as if waiting to be beaten to death.
What happened again?
Didn't Zhou Cheng take a knife?
Why do you need perspective again?
Could it be?
An Ruo looked at the timing panel of the operation, which showed the time progress.
00:08:08!
He looked at Zhou Cheng with complicated eyes and secretly spat.
Can't you hold on a little longer?
Immediately afterwards, I saw everyone walking silently towards the isolation room. However, whether it was Cai Dongfan or Luo Yun, including Wang Yongjin, Zeng Yi and others, there was no such laughter as during the previous operation.
Their faces were quite heavy.
I was secretly happy.
Could it be that some mishap or mishap caused the operation to take longer?
so good?
But when this idea floated out, An Ruo herself was startled, and she quickly clasped her hands and whispered a few times.
Then he secretly explained: I didn’t mean it this way, I definitely didn’t mean it this way…
Wang Yongjin and others naturally felt worried.
An operation that was difficult to understand appeared in front of him, and it was such a critical moment. This Zhou Cheng was simply too reckless.
If something unexpected happened, you wouldn't even know how you died.
Are you still showing off your skills at this time?
However, when everything was prepared and the C-arm fluoroscopy results came out, the expressions of Wang Yongjin, Zeng Yi and others suddenly changed again in shock.
This fracture line and displacement?
Could it be that the normal imaging of the patient in the previous unit was copied, and the patient's ankle in this unit was photoshopped?
However, the previous one was on the left leg, and this time on the right ankle, the direction is different.
Wang Yongjin hurriedly greeted him and said, "Yali, Cai Dongfan, please go in quickly and take a lateral radiograph to take a look."
The tone was a little anxious.
Zeng Yi also patted Cai Dongfan on the shoulder in a hurry.
Small incision and internal fixation.
Trauma, minimally invasive!
Even if Zeng Yi is a fool, he still knows how influential it is. There is no systematic surgery in this area yet. If it can be done so well, then in the future, during academic exchanges.
The Eighth Hospital will definitely no longer be a mere spectator, it will blind the eyes of everyone in the province.
Zeng Yi suddenly felt enlightened.
If Zhou Cheng knew Zeng Yi's thoughts, he would definitely say, Director Zeng, you have a small business...
But no, this kind of small incision open reduction and internal fixation, it took Zhou Cheng a lot of time to achieve the perfect level. If even Wang Yongjin and others can't be shocked, then it is really in vain.
And if he was just arrogant in the province, it would be a shame that he had been simulating it for so long. In the simulating copy, he had already abandoned his wife and children...
Two minutes later, the lateral radiograph came out.
Zhou Changchang breathed a long sigh of relief, leaving Cai Dongfan and others to continue to gape in the isolation room. He called Nie Yali and went to complete the finishing work of suturing.
Until Zhou Cheng finished suturing, no one from Zeng Yi and others came out of the isolation room——
After a full minute, Nie Yali went to call An Ruo who was in a daze. Then An Ruo walked back to the operating room from the isolation room with complicated eyes. After wandering desperately between Zhou Cheng and the operating room timing panel for a while,
Accepted.
When I meet this devil, I am no longer the teacher's beloved disciple, nor is I the chief disciple in the department, but a senior sister with a high status in the world, let alone the eldest daughter who is loved by everyone in the family. I am a tool of hardship.
people.
Tool people are never tired.
I went to withdraw the anesthesia, An Ruo screamed mentally, and walked in a hurry...
After another half minute, Luo Yun walked in again and waved to Zhou Cheng: "Zhou Cheng, after the suturing is done, come over here. I have something to do with you."
After Zhou Chengfang finished applying the last bow of the plaster, he hurriedly walked to the isolation room.
On the C-arm fluoroscopy panel, Wang Yongjin was still pointing at the examination results, judging from a very professional perspective whether the results of the surgery were good or not.
Although he can't do it himself, he can understand the surgical process and ideas, but he still understands the strength and ability to evaluate whether the surgery is good or not.
Seeing Zhou Cheng come in, Cai Dongfan pulled him in front of him.
Wang Yongjin glanced at Zhou Cheng and asked with a particularly amiable smile: "Xiao Zhou, how did you think of using headless compression screws to fix it like this instead of using steel plates?"
Zhou Cheng scratched his head: "Director Wang, fracture of the lateral malleolus, small incision, temporary fixation with K-wires, screw fixation, and external plaster fixation are considered level II surgeries, right?"
"Plate and screw internal fixation of lateral malleolus fractures, strictly speaking, should be considered a level III surgery, right?"
"It's an intra-articular fracture after all!"
It's okay if Zhou Cheng didn't explain it, but when he explained it like this, Wang Yongjin was so frightened that he fell back a little, and was quickly supported by Zeng Yi and Zeng Yi.
Wang Yongjin looked at Zhou Cheng, his mouth under the mask was squirming, and he was speechless.
I screamed in my heart, it turns out that this is how you define level II surgery.