Yang Yifeng went to the ward with the intention of studying and collecting case materials. He really had no other thoughts in his heart.
When writing a novel, the character material and story material are equally important.
The characters are the soul and the story is the flesh and blood.
They all come from life and are higher than life.
If you can thoroughly understand some things in reality and then infiltrate them into the story, there will be an indescribable chemical reaction...
certainly!
In addition to showing a learning mentality, Yang Yifeng also wanted to know what the hell happened to Zhang Zhengquan who had been connoting the several surgeries he had performed.
Yang Yifeng has always believed this. When a person truly understands an industry, he will be more afraid.
Especially in the field of medicine, the more you learn about it, the more difficult and scary you feel.
Except for a few careless people, it is said that those who do not know are fearless, and those who are ignorant are not guilty...
Fracture is first and foremost a disease.
Treatment requires treatment.
Treatment There are treatment options.
Divided into conservative treatment and surgical treatment.
Conservative treatment is - no treatment or manual reduction + plaster external fixation.
Surgical treatment is - surgical open reduction with steel plate or intramedullary nail internal fixation + plaster external fixation.
There is no distinction between high and low treatment methods. It does not mean that surgery is more advanced than manual reduction, or that manual reduction is more advanced than surgery.
In fact, any of the several treatment methods are parallel, but it depends on which one is suitable for you to choose.
However, treatment results vary.
There are more objective evaluation criteria for the results of treatment -
The quality of the treatment is determined by the quality of the surgical team.
This can be seen, and you can't hide it even if you want to in front of knowledgeable colleagues.
If it is just to pursue the speed of treatment, or to show off the number of patients treated, this is an extremely shameful thing.
Whether a doctor is high or not, as far as surgical treatment is concerned, is definitely not determined by the speed and number of operations——
The first patient Yang Yifeng saw was the special fracture patient he had participated in. This morning he reviewed the postoperative plain X-ray.
Because he has participated in the entire operation, he does not need to perform a physical examination on the patient. He knows what the patient's condition is.
The recheck results after reset were satisfactory.
It barely meets the standards for conservative treatment, and there is nothing special to see.
If the remaining patients were like this, it would really be meaningless.
The treatment process of conservative treatment is fast.
However, if you simply pursue the speed of treatment and ignore the quality of treatment, then it is completely a matter of neglecting the last thing——
You cannot do surgery just to complete the surgery or for the volume of surgery.
Then he looked at the second patient and communicated carefully with the patient's family. After getting consent, he also took the initiative to hand the film to Yang Yifeng and looked at him eagerly——
He immediately asked with great anticipation: "Doctor, was our operation successful? How was it?"
Patients cannot be required to know much about medicine, because their evaluation and understanding of surgery are based on success and failure, but doctors cannot simply look at the performance of the surgery.
Yang Yifeng took a quick glance and realized that this patient was a patient who had undergone PFNA, and his eyes immediately became critical.
Did you see the only patient who underwent surgical intervention so quickly?
He stretched out his hand and said, "I'll watch the movie first and then talk to you."
"Hey, okay! Okay."
At the same time, as a very professional orthopedic surgeon, Yang Yifeng began to conduct a very professional evaluation of the effects of the surgery from the perspective of imaging examinations.
This is a plain radiograph of the pelvis + anteroposterior and lateral radiographs of the femur.
The first thing to do is to check whether the intramedullary nail is in the bone marrow and whether it has poked out.
If it is found that the intramedullary nail has poked out, there is no need to comment, just go into the uterus as early as possible to avoid causing greater medical accidents.
Postoperative intramedullary nail is in place!
This is what you can see at first glance, whether it is inside the medullary cavity.
Let’s look at fixation again.
If the internal fixation device is loose, then the operation is completely meaningless. It just inserts a foreign body into the patient's body without any therapeutic effect——
Several locking nails penetrated the bone cortex.
Connected to the femur.
Fixation relies on connections and spirals...
Well fixed!
Quite good, Yang Yifeng nodded slightly.
Then we need to look at the fit between the intramedullary nail and the medullary cavity.
It's like ants and birds teasing an elephant. One of them gives you his body, but the other one doesn't realize it yet...
The choice of intramedullary nail model is very important!
This requires proper assessment during reaming.
can be seen.
The intramedullary nail fits perfectly into the medullary cavity!
In this way, the evaluation of the internal fixation device has come to an end, and the next step is to look at the fracture itself.
The imaging evaluation after a fracture is to look at the alignment of the fracture lines!
Huh?
TM’s fracture line?
Yang Yifeng shrank his pupils and pushed up his glasses at the same time. His eyes were so wide that stars were about to appear in front of his eyes.
A faint fracture line finally appeared in front of him.
Oh, but I finally found you.
This tiny fracture line!
Simply.
Good-looking and ugly.
I hate it but I also like it——
After finding it, Yang Yifeng immediately took off his glasses.
He blinked his eyes to relieve the tiredness of his eyes which had just been trying hard to see.
I almost thought I was blind.
He was almost blind.
Put your glasses back on and continue your objective assessment.
Anatomical reduction——
This is definitely an extremely rigorous anatomical reduction!
Yang Yifeng still had some reservations about using extreme and unnecessary.
Yang Yifeng was a little shocked in his heart——
Ordinary open reduction and internal fixation of fractures!
From a scientific point of view, perfect fracture alignment cannot be achieved.
Rigorous anatomical reduction actually only exists in theory.
Unless it is a particularly special fracture!
Basically, all fractures should have some bad alignment after surgery!
This is the difference in surgical quality when different orthopedic surgeons perform internal fracture fixation in the same way.
Of course, if there are a few fractures that are poorly aligned or have a displacement of less than 3 mm, this does not harm Daya, and the patient can recover extremely well.
Except for taking it out to review and compare with peers, neither patients nor ordinary doctors can see any difference.
Fractures have relatively strong plasticity during the healing process.
but?
Rigorous anatomical reduction is still the pursuit of all orthopedic surgeons when treating fractures.
Anatomical reduction in the clinical sense should actually be called a functional reduction close to anatomical reduction——
It cannot be called complete anatomical reduction.
However, the postoperative plain radiograph results of this patient showed an anatomical reduction of excellent quality!
If we evaluate it from the postoperative plain films, the quality of this surgery is very high!
Yang Yifeng turned to look at the patient and asked: "Are you still in pain? Aao (another name for grandma)?"
The old man shook his head and said with a smile: "I had some pain last night, but it's gone now. With this..."
Her expression was very soothing, and she raised her hand to the analgesic pump she brought back from the anesthesiology department.
"I would like to thank you doctors even more. Before the surgery, the pain was really unbearable. It all depends on your doctors." Lao Yao expressed her gratitude very sincerely.
Yang Yifeng nodded and said, "This is what we should do. Shall I take a look at your pre-operative film?"
The patient's family members immediately took the initiative to help Yang Yifeng look under the mattress and found it quickly.
When Yang Yifeng took a look, his scalp was slightly numb.
He held two films in his left and right hands, which became messy under the air-conditioning wind.
My brain shut down immediately.
???
Are these two films fucking related?
PS: I am revising the manuscript, and the next chapter will be released soon. It is just for quality, and on the basis of quality, I will pursue quantity. I have also made fine adjustments to what has been published before.
Book friends who want to read can do so, but it will not affect subsequent reading!