My medical path

Chapter 91 Something went wrong with the surgery
Tonight is Chen Bo's night shift. While he was having dinner, his cell phone rang.

It's seven o'clock in the evening. The phone call at this time gave Chen Bo an ominous premonition.

"Doctor Chen, the foot of the patient in bed 32 is getting more and more swollen, come out and have a look!"

As soon as Chen Bo answered the phone, Gu Yu, the nurse on duty, heard the anxious voice from the opposite side.

"Got it!" Chen Bo hung up the phone.

"32 beds? Isn't that the patient number that Deputy Director Zhao had surgery on today?"

Chen Bo still has a little impression of this patient. It is a patient with a plateau fracture. Today he underwent open reduction and internal fixation with plates.

"Is the dressing too tight?"

Chen Bo's first reaction was this question.

Sometimes young doctors do not pay attention when bandaging. There is no soft pad under the bandage. When bandaging, the bandage is easily rolled into a rope, causing local strangulation, blocking the venous return, and causing the feet to become more and more swollen.

After covering up the half-eaten meal, Chen Bo put on a white coat and went to check the patient number.

Bed No. 32 was near the door of the ward, so when Chen Bo walked into the ward, he saw the patient's condition at first sight.

This is a 40-year-old middle-aged man, Zhang Tingfeng, who suffered a comminuted fracture of the left tibial plateau due to a car accident.

When Chen Bo took over the shift, he had seen the film of this patient, which belonged to the Schatzker type V injury, which was quite serious.

During the operation, plate fixation and bone grafting are required to fill the bone defect on both the inside and outside of the platform.

"Brother, I'm Dr. Chen on duty, what do you feel uncomfortable about?"

Chen Bo asked after entering the door to confirm the patient number.

"My feet are swollen, painful, and numb..."

Seeing Chen Bo, Zhang Tingfeng finally had a chance to pour out his bitterness.

He felt uncomfortable before, and told his family members, who comforted him that the surgery would definitely hurt, and told him to bear it...

But the growing pain and numbness made him feel that his aunt could bear it, and his uncle couldn't bear it...

After lifting up his trouser legs, the family members were also frightened. The left calf was completely bigger than the right.

He hurriedly called the nurse, and called Chen Bo over.

At this time, Chen Bo was looking through the patient's records.

"The operation was completed around three o'clock. Now it's seven o'clock, and it's been four hours. The effect of the spinal numbness should have passed, so the foot pain is understandable, but it shouldn't be getting more and more numb..."

Chen Bo thought to himself.

"Move your feet and show me."

Chen Bo made a demonstration with his hand to show Zhang Tingfeng to move his ankle.

"There is no problem with the ankle movement, and the muscle strength has recovered... It means that the effect of the anesthesia has indeed passed..."

Chen Bo frowned slightly, he had a premonition that the patient's foot numbness problem might not be simple...

Pulling up the trouser legs on both sides of the patient, Chen Bo saw at a glance that the surgical side was bigger than the other side, especially the skin below the dressing area was shiny.

Checked the dressing, it's a little tight, but there's no calorie in the itinerary...

Seeing this situation, Chen Bo felt a bit of doubt in his heart, and at the same time, there was also a hint of uneasiness.

"It wasn't caused by the dressing, and the patient's blood vessel B-ultrasound before the operation did not find any thrombus, so the swelling can only be caused by the surgical site..."

Chen Bo turned on the smart system to scan, and the condition of the patient's surgical site was clear at a glance:
"The fracture reduction is pretty good... Then the shattered fracture platform is basically restored to flatness, it's not easy..."

"Wait, this is?..."

The sudden discovery made Chen Bo's heart lift up...

Under the system scan, Chen Bo suddenly discovered that a screw driven to the back of the platform actually penetrated a blood vessel! ! !
"Oh my god...how can the nail be driven so long in this position? This happened...the nail pierced the popliteal artery..."

While Chen Bo was speechless for a while, he also realized the trouble of this matter.

It may be because the piercing time is not long, the popliteal artery is thick enough, there is still some blood passing through, and there is also collateral circulation support, so the foot has not yet shown symptoms of ischemia...

But if this problem is not dealt with in time, the patient's calf will soon develop compartment syndrome, which will lead to very serious consequences...

After seeing the patient, Chen Bo understood clearly. He didn't say much, and returned to the duty room after comforting the patient a few words.

He needed to understand the situation at the time of the operation first, so he made the first call to Deputy Director Zhao.

When the phone was connected, Chen Bo said:
"Director Zhao, there is a situation that needs to be reported to you now."

On the other end of the phone, Deputy Director Zhao was obviously a little dazed, "Chen Bo usually doesn't look for himself when he has something to do. This is also the reason why he doesn't like Chen Bo. Why is he calling now?"

"What's the matter?" Deputy Director Zhao said calmly.

"It's like this. Today, the 32-bed patient with tibial plateau fracture has obvious swelling and numbness in the calf and foot. The dorsalis pedis artery of the affected limb is weakened, and the extremity is cold. I think it may have injured the blood vessel... "

Chen Bo made a concise report.

After listening to Chen Bo's words, the other end of the phone was obviously silent for half a minute before a deep voice said:
"You can arrange to have a lower extremity CTA first, I'll go there right away!" Then he hung up the phone.

After the other party hung up the phone, Chen Bo thought about it, and then briefly reported the situation to Director Wei.

After listening to Chen Bo's report, Director Wei attached great importance to it, and told Chen Bo to complete the inspection immediately, and call him as soon as there is a result.

Chen Bo agreed to come down and immediately arranged for an inspection.

Family members were required to sign for this inspection, and Chen Bo simply told the family members of his judgment, which shocked the family members.

The large blood vessels have been punctured, is this okay?
Because the family members were in a hurry, they didn't bother to complain, and immediately signed and sent it for inspection.

This time, Chen Bo accompanied him throughout the inspection. One reason was to get the film as soon as possible, and the other reason was that he had to tell the technician who processed the image to make the image better, because there is a steel plate on the fracture site, and the metal will produce artifacts. If this is not removed The uploaded image will be unclear.

The film was finished quickly and uploaded to the computer simultaneously, but the vascular imaging picture still needs to be processed by the radiology technician before uploading.

When Chen Bo returned to the ward for the examination, Deputy Director Zhao was already waiting in the office.

When Chen Bo retrieved the checked films from the computer system, Deputy Director Zhao was dumbfounded.

Chen Bo was right, one of the screws pierced the popliteal artery...

After measuring the length of the screw, Deputy Director Zhao was stunned, "There are [-] nails attached to this position?!"

Deputy Director Zhao has the urge to scold her!

Now that he remembered, when most of his surgery was completed, the last two nails were left to Wu Zhennan because of a temporary emergency...

"This guy who succeeds more than fails!"

(End of this chapter)