godfather of surgery

Chapter 49 The Strongest Patient Arrives

After the examination, the old man was pushed to the trauma orthopaedic ward, and Director Xiong personally went to the window to go through the hospitalization procedures.

Hearing that Professor Zhang arrived, the ward was like a dark cloud. From the interns to the professors leading the group, as long as they were still in the ward and did not leave work, they all panicked.

Everyone stopped what they were doing. The first thing to do was to check the buttons of the white coats. If there were any missing buttons, find the head nurse.

"What do you usually do? At this time, when the buttons are repaired, the chicken legs are stuck in the mouth before thinking of filling the teeth." Yao Ling reprimanded several graduate students and regular trainees, but she was a knife-mouthed tofu-hearted person.

It was too late to find the linen room, so I wanted to call a nurse to make it up.Immediately dispel this idea, these little girls are usually very slippery for injections and infusions, sewing clothes and mending buttons, don't think about it.

Yao Ling found the sewing box and buttons from the department warehouse, and sat down in the doctor's office: "Come one by one."

Several young men lined up to nail the buttons, someone was watching at the door, and there was an early warning at any time.

"Quick, quick, old man Zhang has a broken bone and will be hospitalized immediately." Someone went to the duty room to report.

A few guys took advantage of their free time to play a few kings, and when they heard the shout, they couldn't hold their mobile phones steadily, so they closed the game directly, forcibly quit, and then took a book and flipped through it, pretending to be.

"Where is the fracture?" someone asked.

"Intertrochanteric!" replied the messenger.

Oh—he took a deep breath, no need to pretend, put down the book in his hand, and definitely dare not play the game again.

Gurgling, the sound of wheels rolling over the ground, the beeping sound of the emergency elevator opening.

Professor Zhang was pushed to the ward by a flat cart. Yao Ling personally guarded the door with the most capable nurse, Cai Qiaojun, but Cai Qiaojun was obviously a little nervous.

Not to mention nurses, the entire hospital, except for President Xia and Director Han, should not be nervous in front of him.

Professor Zhang criticized people without a single dirty word or an angry word.Criticism is clear and logical, which pages of the book, who published the paper, and the latest consensus on the guidelines. It is word-for-word.You can't accept it.

Yang Ping pulled the injured leg, and everyone worked together to get over the bed.Xiao Wu brought a device for skin traction. Since it is an emergency operation, there is no need for bone traction, and skin traction is maintained.

The wrist identification strap is buckled on the wrist, and the sign of the pre-surgery patient is hung on the bedside, and the fasting of food and water is started immediately.I have blood drawn and a bedside electrocardiogram done. I have no respiratory symptoms such as cough recently. I have done a chest CT for the annual physical examination, and the chest X-ray is avoided.

Everyone helped Professor Zhang to adjust the best body position, straighten out the rope pulled by the skin, and shake the head of the bed to 45 degrees, so that he could lean on it comfortably. He didn't want to lie down.

With the rubber band tourniquet tied, Cai Qiaojun swiftly began to puncture the back of Professor Zhang's hand, preparing to put an indwelling needle.

But I don't know if I'm nervous, or Professor Zhang's blood vessels are really hard to find, and there is no blood return after wearing it once.

Cai Qiaojun is a benchmark among orthopaedic nurses. In the city's nursing skills competition, he won an award.If he misses the shot once, if he is another patient, he will definitely not change his face and heart, and calmly puncture again.

But now it's Professor Zhang lying there, how could she not be nervous, sweat can be seen on her forehead.Professor Zhang put his right hand on the side to give the needle, and turned his body slightly.

He stretched out his left hand and said, "Give it to me!"

The tone is very kind, the more kind, the more nervous everyone is.He took the puncture needle for blood draw and had to do the venipuncture himself.

"Look, 45 degrees first, shorten the puncture path, the layers of the puncture needle should be clear, the skin, the subcutaneous, and then the veins. Each time you pass through a layer, you will feel your hands, but you are still not skilled." Professor Zhang operated, Explain patiently.

He turned the needle upside down with his left hand, pushed it casually, went in and returned the blood.

"After inserting the needle, lower the puncture angle to keep it in line with the blood vessel. As long as the blood vessel is thicker than the needle, it can be inserted. There is no such thing as tension. The tension is due to inexperience. No matter how nervous you are, you can answer one plus one equals two. "Professor Zhang continued, Yao Ling and Cai Qiaojun flushed.

Professor Zhang let go, Cai Qiaojun took out the needle, left the tube inside, fixed it, connected the balance solution, and started the infusion.

It used to be just a legend, but now it's a close encounter, the nurse dared to refute the old man's technique of puncturing himself, so he could only obediently listen to the lecture.

Director Han came in with a briefcase: "Mr. Zhang, I have to catch a flight, so you can stay at ease. I also said hello to Tian Yuan, and then Xiao Yang, Xiao Song, and Tian Yuan will all come to power."

"Okay, I know what to do. You are busy with your work. The research institute must be taken care of without delay." Professor Zhang was playing with the remote control, watching TV.

Director Han greeted a few words and left in a hurry.

The head nurse said to help adjust the TV, but he refused: "What are so many people doing around me? You are busy with yours, and you can deal with it as usual."

The TV was turned on, flipping over and over, turning over the old movie "A Raid on the White Tigers", an old movie about resisting US aggression and aiding Korea.

"You all go to work, there are so many patients, don't worry about me, please help me with an escort, man, the urinary catheter was not inserted before the operation, don't make it difficult for you, the metal spy of the urology department may not be able to go in smoothly. There are three meals a day after the operation, there are no contraindications, you can order whatever you want. You guys can go, you guys stay." Seeing that everyone didn't want to leave, he started rushing people again, naming Yang Ping to stay.

The head nurse saw that there was nothing to do, said a few words of relief, and led everyone out of the ward, leaving Yang Ping behind.

"Sit, why are you standing, and you didn't make a mistake." The old man asked Yang Ping to sit down.

Yang Ping moved the accompanying chair over and sat down beside the bed. Professor Zhang paused the TV: "These movies are still good. At that time, I was a teenager, and my father was one of the first batch of Western orthopedics. He worked in Xiehe, when the Fifty Years War broke out, he voluntarily applied to go to the battlefield, in the battle of Changjin Lake, a piece of shrapnel was left in his body--the old man insisted on going out to the clinic at the age of 90, and closed his eyes on the office chair in the clinic-"

Yang Ping listened silently and couldn't help being awe-inspiring. Professor Zhang suddenly stopped and said, "Bring the film over and let's discuss it."

Yang Ping took out X-rays and CT films from the bag at the bedside. Professor Zhang put on his reading glasses and pointed to the films with natural light: "The biggest difference between the lower extremity and the upper extremity is that the lower extremity has to bear weight. Any fracture of the lower extremity must be In the early stage, you must have bony support, that is, the more you press, the tighter the implants are. The implants are only auxiliary and cannot be replaced. The simplest interlocking intramedullary nail fixation for transverse fractures of the tibia, which was done by Germans in the past, operated in the morning, and walked back in the afternoon. , we were too scared to speak, we only dared to bear partial weight for six to eight weeks, and fully bear weight 3 months after the operation. At first we thought it was a material problem, but later we found out that the main problem is not the material, but the theory of bone support , their interlocking intramedullary nails use longitudinal sliding holes, lateral locking, and longitudinal sliding, so that the fracture ends are automatically pressurized, and weight-bearing becomes a favorable factor, and the faster the fracture heals.”

Yang Ping listened carefully, and Professor Zhang continued:
"To pull out this bone block, these pieces must be anatomically reduced, and this piece needs a steel wire and a steel cable. Now, as soon as a steel wire is used in fracture surgery, it is considered to be backward, and without a steel wire, it is taller. Surgery is not a fashion trend. You have to think for yourself, medicine has to move forward, but new things are not necessarily the best, and it takes time to test. Your last comminuted fracture of the lower end of the humerus was done very well with steel needles and wires, and the entire reduction and fixation sequence was arranged. It must have taken a lot of thought.”

"I think the sequence of fracture reduction and fixation is too profound. It is not a simple process. It is like building a house. It is not a simple accumulation of bricks. There should be a complete theory." Yang Ping expressed his feelings.

"Well, it's very good to be able to recognize this. I've been thinking about this problem. Many things seem to be very simple on the surface, but only after researching, I find that they are very profound and complex. It's like a Rubik's Cube. Go, in fact, how to restore, how to arrange the order, is a university question." Professor Zhang put down the film.

Yang Ping put away the film, and Professor Zhang said: "Surgeons, especially orthopedic surgeons, must have an important ability—spatial imagination. There must be a three-dimensional anatomical construction in their minds. This construction must be precise and specific. Chess players can play blind chess, and we surgeons need to be able to perform operations in our minds. Close our eyes and we can go through the operations in our minds. Bring paper!”

Yang Ping pushed the mobile table over, put it on the bed, put it in front of Professor Zhang, and locked it firmly.Then take out the white paper and gel pen from the drawer of the bedside table.

The old man started to outline on white paper with a gel pen. In less than 3 minutes, a figure of a hip joint appeared on the paper, and his own fracture was completely drawn.Then draw the reset and fixed figure on another piece of paper.The image is extremely realistic and fine, and the three-dimensional effect gives people a strong visual impact.

"At that time, we had to master the technique of drawing. Today's doctors can't find anyone who can draw. If you need it, I have some drawing manuscripts, you can take a look." Professor Zhang put down his pen.

Yang Ping was shocked by him, no wonder the whole hospital was afraid of him.It's not that he likes to scold people, but that everyone really can't meet his requirements.When Yang Ping picked up the two pictures on the table, they were completely on par with those of Western realist painters.This painting is not flat, it is three-dimensional. Just a black gel pen can express the three-dimensional effect so perfectly. This level can be used to perform three-dimensional painting on the street.

"Surprised? If it's colored, you think there are joint models and steel plate screws on the paper. A simple combination of lines can achieve such a state, why can't medicine? After I taught myself modern 3D painting, I combined it with medical drawing. There is this kind of 3D painting technology." Professor Zhang smiled.

Yang Ping became very interested in Professor Zhang's drawings. He didn't have this concept before. He put away two pieces of paper: "Can you give me these two pieces of paper?"

"It was originally drawn for you. You can study the operation process. You are a little thirsty, and the combination of rehydration is not right." Professor Zhang said.

Yang Ping hurriedly poured a glass of water. There was a cotton swab on the bedside table, soaked it with the cotton swab, and smeared Professor Zhang's lips again.

"Wait for the operation, you can ask someone to make a tablet and connect it to the video system in the operating room. I have to watch the whole process myself." Professor Zhang urged.

Yang Ping said: "I will have people prepare now."

"Go get ready, I'll take a break. I've done surgery on others for a lifetime, now it's my turn."

"Remember, I'm going down to the ground tomorrow."

When Yang Ping walked to the door, Professor Zhang did not forget to remind him.

(End of this chapter)