godfather of surgery

Chapter 6 Fractures not visible on CT
A few minutes later, Director Tian's resident physician, Chen Xiaobo, called from the operating room: "Director Tian, ​​there is ecchymosis and swelling in front of the left knee."

"Xiaobo, the operation is suspended, and the patient is sent to the imaging department for bilateral hip MRI. Yes, the family will explain it, right now, immediately, immediately."

Really damage to the dashboard!If so, there is a real possibility of occult fracture of the femoral neck, which is one of the orthopaedic traps.

Director Tian hung up the phone and cast an approving look at Yang Ping: "It's true that the dashboard is damaged! You should be right, I immediately suspend the operation, and now push the patient to have an MRI of the emergency hip joint, thank you for reminding me!"

It was not easy for a deputy chief physician who led the group to admit his omissions in public and thank a young newcomer. It seemed that the atmosphere in this department was very good, and Yang Ping breathed a sigh of relief.

Director Han nodded slightly: "Well, if there is a hidden femoral neck fracture, the surgical method needs to be changed. Do you have any other opinions?"

No one spoke, Director Han said, "Then take your place, Tian Yuan, you will go to the imaging department immediately, and I will go down later to see the MRI together."

Director Han dismissed everyone, found a computer by himself, and carefully read the patient's X-rays and CT films.

Song Zimo came over and asked Yang Ping softly: "This patient really has a hidden fracture of the femoral neck? The hidden fracture can't be seen on X-ray and CT, right? How did you find it?"

"I can see it with my eyes." Yang Ping said with a smile.

Song Zimo glared at him, then said, "I'll go to the imaging department to see, do you want to go?"

Yang Ping has nothing to do. He went to work on the first day and did not arrange any tasks.What's more, if the doubt is raised by yourself, you must go down and take a look.

Director Han came over at this time: "Come on, let's go down and have a look. I just looked again, and I do have doubts."

The three went straight to the imaging department, and many others followed Director Tian to the imaging department.

The patient is also sent to the MRI room, where preparations for examination begin.

Director Han called in advance Director Meng, the director of the imaging department. Director Meng was also waiting in the reading room. Director Han, Director Tian, ​​Song Zimo, Yang Ping, as well as some graduate students and Gian Peisheng who were watching the excitement gathered in a large circle. .

When everyone saw Yang Ping come down, they all gave up their positions and stood inside for him. They were very curious whether there was any fracture or not. Anyway, they didn't see it.

"Old Han, what's the matter? I was in a hurry to perform an MRI on this patient. I just checked his CT and X-rays, and there is no femoral neck fracture?" Director Meng heard from several young orthopedic surgeons that they suspected a femoral neck fracture.

"Xiao Yanggang from our department raised doubts, and the occult fracture was seen on the X-ray and CT. In order to clarify, I did an MRI. I will take a look at the MRI later. I also carefully looked at the film. This patient does have doubts. " Director Han said.

"That's it!" Director Meng stopped talking, quietly waiting for the MRI image to appear on the screen.

The nurse in the MRI room checks the patient for magnetic metals, asks if there are contraindications such as claustrophobia, and then signs a sheet to confirm.

Magnetic resonance imaging is a magnetic examination. If there are magnetic metals, they are not allowed to be brought in. There are magnetic metals implanted in the body, and some are not allowed to be done. The strong magnetic force will move these metals.

Other non-magnetic metals are fine, but today's internal plants are generally non-magnetic.

Magnetic resonance does not have ionizing radiation, unlike X-rays and CT.

Chen Xiaobo, a resident doctor under Tian Yuan, is assisting in moving the patient, and the attending physician Fang Yan is also among them.

"Brother Fang, why did Director Tian suddenly stop the operation and take the patient down for MRI?" Chen Xiaobo didn't understand.

"The new Dr. Yang said that our patient had a femoral neck fracture. Director Tian didn't see it, but he did." Fang Yan was also not very happy.

The patient was on the operating table, and the anesthesiologist's puncture needle was inserted into the spinal canal. He almost pushed the medicine. The operation was suddenly stopped, and he had to be pushed here for an MRI. Naturally, he felt a little unhappy.

"What kind of character is this new here? So awesome!" Chen Xiaobo asked.

"It's bullshit, let's wait for the MRI to come out." Fang Yan said.

"You too, how do you listen to the new doctor, he will pull it down and do it, two doctors, let's go out, it can be checked." The technician also helped to complain.

"He said that, Director Tian doesn't pay attention to it. We are the ones who are tired." Fang Yan said.

Everything is ready, the technician presses the switch on the outside console, and the moving tablet carries the patient slowly through the circle-shaped opening of the machine.

On this side, the two directors did not speak, and the others did not speak, and everyone quietly waited for the results of the examination.

The time required for MRI is slightly longer than that of general examinations, but Sanbo Hospital has introduced the world's most advanced 3.0T light-speed MRI, which is much faster than ordinary MRI scans.

After a few minutes, pictures started appearing on the screen and then filled the screen.Director Meng immediately grabbed the mouse and began to read the film. In fact, he was also curious whether the patient had a fracture.

Director Han leaned over, and the others tried their best to surround them under the premise of keeping a certain distance from the two directors.The pictures were turned over, enlarged, passed one by one, turned over, and overturned.

Then a picture was locked and zoomed in. Director Meng moved forward, pointed the mouse at a part, and watched it for 5 minutes.

"It is true that there is a fracture of the femoral neck. Look, Lao Han, here, T1 and T2--" Director Meng said with certainty.

Director Han turned to look at Yang Ping behind him, then leaned over: Indeed!Broken!

This kind of hidden fracture can be seen on X-ray and CT. It is very difficult to find the lines on the wings of mosquitoes.

"Broken, broken!"

When the answer came out, everyone looked at Yang Ping at the same time.

Fang Yan and Chen Xiaobo came to the reading room from the MRI room. Did you hear it right? Are they really broken?
Director Han immediately instructed Director Tian: "Let's talk to the patient's family again, the informed consent for the operation must be re-signed, and the surgical procedure must be re-determined. It is best to use a lengthened PFNA to fix the femoral shaft and femoral neck at one time. In this way, the operation can be postponed until Tomorrow, this afternoon we will discuss. Fortunately, we rush to do an MRI, otherwise we will fall into the pit."

"Thank you!" Director Tian patted Yang Ping's shoulder.

"Wait a moment in my office." Director Han also patted Yang Ping's shoulder.

Song Zimo felt a little miraculous, how could he see the fracture and how he did it.

"Ding Dong, help colleagues avoid the trap of diagnosis and treatment, reward 1200 points."

Now that Yang Ping is used to the system, he will not be frightened by the sudden sound and subtitles of the system.

This system should be changed to: Reward system for good people and good deeds, Yang Ping slandered.

Office of the Director.

Director Han and Yang Ping were separated by the desk, earnestly speaking: "I should thank you for today's matter, to avoid a dispute for Corey, have you studied imaging before?"

Yang Ping shook his head.

But he immediately said: "When I was in the People's Hospital, as long as it was stored in the computer system, I studied almost all the orthopedic images one by one."

Director Han thought for a moment, so he could figure it out.

This is not a lie. Yang Ping is indeed very hardworking in studying medicine. He used to study almost all the imaging materials in the department at the People's Hospital, and he often went to the radiology department to ask for advice.

With such an accumulation of foundation, coupled with systematic training, it has been solidly fed with keen eyes.

Abnormalities on X-rays and CT films, no matter how subtle or indistinguishable, could be seen at a glance.

(End of this chapter)