godfather of surgery

Chapter 50 Can I really walk normally tomorrow?

After leaving old man Zhang's single ward, Yang Ping went to the office to find Xiao Wu. Xiao Wu was not there. Zhang Lin was writing the medical records and preparing the informed consent to sign. Although Professor Zhang belongs to the hospital, the process cannot be omitted.

Song Zimo was watching the CT reconstruction on the electronic reading screen. He leaned back in his chair and was very fascinated. After watching for a while, he stopped to draw something on the paper.

Yang Ping didn't bother him, just glanced at the paper.Medical Drawing!This guy can draw medical drawings, and he draws them very well, even better than the drawings in some surgical books.

Yang Ping went to the duty room. Xiao Wu was installing some software on a tablet computer. Yang Ping was surprised: "How do you know that Professor Zhang wants to watch the live broadcast of his surgery?"

Xiao Wu said, "Professor Zhang doesn't know that person. I prepared it in advance. If I bring it up in the operating room, it will be too late to prepare."

Yang Ping said, "You guessed it right. Professor Zhang really told me to prepare a tablet to connect to the video system in the operating room. He wants to watch the live broadcast while performing the surgery."

"I have downloaded the connected APP on the website of the video system. I just checked with the operating room. There is a long dedicated data cable. When the time comes, fix the tablet on the head frame, and he can watch it while lying down." Xiao Wu said .

Yang Ping was a little surprised. The kid said without thinking that he was really delayed by studying medicine.Yang Ping found a bed and lay down: "I'll rest for a while, and call me when old man Zhang is sent to the operating room."

"Let's have something to eat, I ordered several takeaways and they will be delivered right away." Xiao Wu said while working on his computer.

Yang Ping lay down to rest and entered the library in the system space. The time here needs to be paid in points, and each point corresponds to an hour.

There is no way to bring the film into the space, only to draw pictures in the space from memory, and then study the reset of each bone block, focusing on how to form a bony support.

The system makes it extremely convenient to look up information. As long as it is published publicly, it can be found, and it will be translated into Chinese no matter what language it is.Yang Ping consulted a lot of information on this aspect, especially on intertrochanteric fractures of the femur.After reading each paper word by word, I have accumulated more than [-] points in my hands anyway, and I concentrated my resources to complete the task.

After theoretically clearing it up, Yang Ping went to the shopping mall and found a hip fracture surgery training package in the dense training package. With [-] points, he bought another [-] cases, including many closed intertrochanteric fractures. Surgery to reduce the internal fixation of PFNA.

PFNA, short for proximal femoral anti-rotation intramedullary nail, is currently the best fixation device for this fracture in the elderly.Hip fractures in the elderly - acetabular fracture, femoral neck fracture, intertrochanteric fracture, known as "death fracture", "the last fracture in life", the mortality rate within two months of conservative treatment at home is as high as 68% -70% ; The survival rate after one year is 50%, that is, 100, 50 will die, and the vast majority of these 50 are conservatively treated.Therefore, surgery can be performed as much as possible, and fractures are not fatal, but the complications caused by bed rest are fatal: deep vein thrombosis, lung infection, bedsore, urinary tract infection, etc.

Professor Zhang has been engaged in orthopaedics all his life and deeply understands the powerful relationship among them, so every moment is not equal, and he urgently wants emergency surgery.

In the system, another [-] operations were performed, and almost all kinds of comminuted fractures were done again.After checking the stability, think about improvement.

It also cost [-] cents to read, and there are still [-] cents left. I bought the fracture of the femoral shaft and tibia and fibula, and spent another [-] cents, leaving only [-] cents left.

Complete the training package without delay.

4 hours of water deprivation and 8 hours of fasting have come. Professor Zhang was pushed into the operating room for surgery, and the head nurse of the operating room followed in person.

Yang Ping and a few people followed the flat car into the elevator. There were too many people. There was a flat car in the elevator and it was too crowded. They had to ask Zhang Lin to follow him. Everyone took the elevator next to them to the operating room.

When changing clothes, Tian Yuan said: "Doctor Yang, you have enough face, this old man's prostate has not been electrocuted for several years, and now the intertrochanteric fracture is called, and you will be called for emergency surgery. For meals, you don't have to line up, no one dares to stop you."

Wearing a mask, Yang Ping said with a smile, "This is absolutely necessary. The last fracture in my life, the name was not chosen for nothing. The old man understands it very well."

Get dressed and go to the operating room.Maybe it was because the requirements of the operation were too high, or maybe it was because of the special status of the old man. Everyone sat early in the classroom next to him. There were twice as many people as they came last time, and people from other departments came.

President Xia came with several hospital leaders. No matter how busy he was, he had to make time to come.In fact, when Yang Ping was resting, Dean Xia went to see Professor Zhang in the ward, but Yang Ping didn't know it.

Combined spinal-epidural anesthesia, the director of the anesthesiology department personally anesthetized, but because he hadn't performed anesthesia himself for too long, he was afraid of hand injury, so he instructed him, and it was Fatty Liang who actually did it.

"Xiao Yang, Mr. Zhang will leave it to you." Dean Xia patted Yang Ping on the shoulder. He knew about Yang Ping's level. Needless to say, the last five-stage replanting, Professor Zhang personally ordered, That would be wrong.

At that time, President Xia learned that Zhang Lao had broken bones and wanted to keep Director Han, but Zhang Lao refused to agree, and wanted to arrange him to live in the Overseas Chinese Building, but he still refused.Dean Xia had no choice but to follow him, Zhang Lao, whoever he decided, even eighteen cows could not pull back.

After the anesthesia, Zhang Lin and Song Zimo put on the traction frame. Xiao Wu connected the tablet to the video system, adjusted it, and fixed it on the anesthesia head frame, so that Zhang Lao could watch the live broadcast of the operation while lying down.

Several cameras have also been adjusted, one facing the screen of the C-arm moving X-ray machine, one facing the surgery area, and one facing the surgeon.

"This operation shouldn't be difficult, just use PFNA, and it will be done in half an hour."

"Old man Zhang is going to walk with a heavy load tomorrow."

"No way? The fracture is broken into several pieces. How could it be possible to walk with weight after the operation."

"I don't know, I heard what Zhang Lin said."

"This guy is amazing, he did the last replantation of a severed limb"

"Trauma Orthopedics is really good now, Director Han is a great figure, Tian Yuan seems to be very good, Song Zimo is a genius, and now this guy is more powerful than Song Zimo, Director Han is planning to make Orthopedics a national brand, We're going to do our best."

"Yes, Director Han is now going to apply for the Orthopedic Research Institute. It seems that he is cooperating with Fudan. Didn't you see that he didn't come tonight, he went to the magic capital."

"Oh, then the development of our orthopaedics will be great."

The operation did not begin, and everyone began to talk about it.

Dr. Jin came in, with a bluetooth headset on his ear.The last time he was in surgery, he didn't see Yang Ping suffering from a comminuted fracture of the lower end of the humerus. This time, he must come and have a look.

Dean Xia exchanged a few words with Professor Zhang, and it was not easy to stay for a long time.There were already a lot of things to do, and besides, a high school dean stood here, putting pressure on the doctors.He knew that he left in time.

"Xiao Yang, it's alright for our Xiao Su to provide you with a special channel. If you have any comments, please feel free to ask." The head nurse in the operating room is also in her 40s, and she is vigorous and fast-paced.

Yang Ping was sitting in the corner, Su Yixuan had washed her hands and was about to wear a surgical gown.

Yang Ping said: "Nurse Su is really excellent. We cooperate very well."

The head nurse said: "That's good, Xiao Su will be handed over to you in the future. You can't bully her. She is a kind, smart and good girl. She has been trained in orthopaedic specialist equipment nurses in Modu, Hong Kong and Japan before. ."

Chatting here, the tow frame has been installed over there.

Traction reduction, this kind of fracture is first traction reduction, and then sterilized and laid sheets, and open surgery.

Traction reduction occupies a very important position, almost half of it, if the reduction is not done well, the following operations are difficult to do or even impossible to complete.

Song Zimo instructed Xiao Wu Zhang Lin to adjust the angle and strength of the traction. Yang Ping went over to take a look and readjusted it himself.He replaced the adducted position that had been set with the abducted position, and he also adjusted the tension of the adjustment rod. After being satisfied, he said, "Okay! That's it, see through."

"Senior brother, this is the booth!" Zhang Lin reminded him, thinking that Yang Ping had made a mistake.

When performing an operation, the assistant finds out the problem and reminds the chief surgeon in time, which is a common thing.

Yang Ping said clearly: "Yes, the booth."

How to insert intramedullary nails in the abduction position, Xiao Wu is also puzzled.

The neighbors were also talking.

"Isn't this kind of surgery in an adducted position? How to abduct, and how to insert nails after abduction?"

"Yeah, have you forgotten?"

"Song Zimo doesn't remind me."

"What are you worrying about, focus on watching."

A graduate student was in charge of controlling the C-arm X-ray machine. He skillfully pushed the machine in, adjusted the position and angle, and everyone went out.He was outside using the remote to control the machine.

The doors and walls of the orthopaedic operating room are protected by lead to avoid excessive radiation exposure.After the filming, everyone went in again.The lateral position was completely reduced and satisfied.

Another anteroposterior fluoroscopy showed that the fracture still had a certain angle on the anteroposterior film, and the angle of the angle was still very large, and it was not completely reduced.In this kind of surgery, it is absolutely impossible to have an angulated fracture if the fracture is not properly reduced. This angulation will cause the intramedullary nail to be unable to be inserted, and the operation will be embarrassingly difficult to advance.

"I haven't recovered yet, I have to reset it again." Zhang Lin looked at the screen and said.

Xiao Wu was about to adjust, but Yang Ping stopped him: "That's it, don't adjust."

Xiao Wu came back puzzled, and Song Zimo was going to persuade Yang Ping: "This reset won't work, so-".But after thinking for a while, and then looking at Chengjiao on the screen, I suddenly remembered something: "Senior brother, you are indeed a senior brother, you can't accept it."

"What's the matter?" Xiao Wu, Zhang Lin looked confused.

Song Zimo said with a smile: "You are in the audience, it's enough for me and my senior brother. Take a good look. Today our senior brother will perform another unique skill for you to see. You can see it clearly."

Yang Ping had already gone out to wash his hands, Song Zimo hurriedly chased out: "Hey! Wait for me."

"What's your opinion?" Yang Ping stood in front of the sink, and when he sensed that the faucet began to flow out, he began to brush his hands.

"You're really getting more and more incomprehensible. You really want to try micro-trauma and anatomically restore the broken bones, including the one inserted into the muscle? Can you really walk on the ground tomorrow?" Song Zimo chased after him.

"What do you think, he said, if you can't do it, give me a zero." Yang Ping brushed his hands.

"I found out that Mr. Zhang is a god, how could he know that you can do it." Song Zimo said.

"Don't you say that he is a god? Does a god need a reason to do things?" Yang Ping choked Song Zimo with one sentence.

(End of this chapter)