medical simulator

Chapter 121 Do You Call This a Level II Surgery? (Please subscribe!)
Zhou Cheng also saw An Ruo's dodging action, and smiled at her kindly, even though she didn't see it.

Seeing this series of actions, Zeng Yi shrugged his eyelids, feeling a little funny.

As a student, I seem to be a little scared by the orthopedics department, but in fact, Zeng Yi still feels that the orthopedics department is still one of the most kind departments in all surgeries.

Except for the occasional violence, it's actually quite clean, isn't it much more beautiful than neurosurgery to turn the brain, thoracic surgery to turn the lungs, and general surgery to turn the intestines?
……

Cai Dongfan washed his hands, dressed and walked into the operating room. After approaching the operating table, he turned to Dou Chengpeng and asked, "Chief Dou, we are all ready, can we start?"

The medical department is a functional department, and it is the superior management department of all disciplines and departments in the hospital, and it is also the management department of all doctors.

Therefore, it is another level of leadership besides the director.

It's just that the medical department doesn't care about the clinical practice, and doesn't go into the professional rivers and lakes. When it's time to scold, you can point your nose and scold, but when you want to respect, you still have to be polite.

Dou Chengpeng said confidently: "Then let's get started, and I'll see if our hospital can, for the first time ever, grant a level II surgical authority to residents in advance. This will also help improve the teaching strength of our hospital." It will definitely help."

Although the medical department doesn't care about teaching, there are two general directions that Eighth Hospital is working on recently——

Specialty Hospital.

teaching hospital.

Each one is extremely attractive, and before each of the above two titles is obtained, it is extremely hoped that the brand will be hung in the hospital.

And the teaching hospitals are secretly divided into many levels, which are related to the affiliated medical schools, but now the Eighth Hospital relies on the cooperative schools, which is a bit stretched, but there is no choice...

Cai Dongfan nodded, and said to Zhou Cheng to start.

When Zhou Cheng heard this, he took a deep breath, and in order to show his importance and respect for the event arranged by Zeng Yi, Director Wang Yongjin and others today, he took a few steps back from the operating table, and then walked to the viewer again .

The ninth time before the operation, after entering the operating room, the third time to carefully observe the imaging examination data of the patient.

This is an assessment of surgical authorization, not an ordinary operation.

Zhou Cheng naturally had to pay enough attention to it.

Seeing Zhou Cheng walk out from the operating table again and go to the viewer, everyone didn't feel that he was putting on airs and wasting time and was upset. On the contrary, they could all understand Zhou Cheng's nervousness at the moment and praised him for his stability .

Cai Dongfan said to Luo Yun in a low voice: "Xiao Zhou seems to be such a mature and stable person since he entered the department?"

Luo Yun nodded, agreed with Cai Dongfan, smiled, and said helplessly, "If he wasn't such a person, Director Cai, you must have noticed him a long time ago."

"On the contrary, I think he is a little bit tied up by the current secular rules, and his thinking is too rigid."

"It's a bit pitiful, and it will also affect his future."

Zhou Cheng was too steady. From the beginning to the end, if someone hadn't asked him to come to the stage to help, he would have been able to stand on the sidelines coldly, just like Yan Luo in the present world, without any momentum.

And drive is the characteristic of young people, and it is also one of the essential characteristics of young people's unlimited potential.

Dare to venture and dare to do, this is the style that young people should have.

Cai Dongfan shook his head: "No, no, you are wrong, Luo Yun."

"You can't rely on Xiao Zhou's own experience. Instead, you have to think about it from Luo Yun's point of view. Before and now, he was just ordinary training. He was not stable. If something happened, there would be no teacher for him. endorsement?"

Luo Yun shook his head and stopped talking.

To be honest, he has never been a simple trainee, so he may not understand Zhou Cheng's current situation.

When Luo Yun graduated, standardized training had not yet been promoted across the country. At that time, he only had to follow his teacher and simply manage the bed, and there were not so many moths.

-

After Zhou Cheng read the film carefully, he confirmed that the patient had only a simple fracture of the lower end of the fibula, without other hidden injuries or other accompanying problems. Then he let out a sigh of relief, and then walked Come to the stage.

Then he asked Cai Dongfan in a low voice, "Mr. Cai, I'll start first?"

"Well, let's get started. Would you like to have a X-ray first?" Cai Dongfan immediately started to go through the procedure, which is also the routine procedure of closed/open reduction and internal fixation of fibula fractures.

The operation plan he prepared was to send both open and closed reduction, and he discussed the same with the patient. He mainly hoped that Zhou Cheng would not perform difficult operations, and this minor operation, the simplest type II operation, was for Zhou Cheng. Used it for practice today.

So it was placed on the first one to give Zhou Cheng more confidence.

Moreover, even Du Yanjun can do this operation, and Cai Dongfan believes that Zhou Cheng can also do it.

Zhou Chengcheng took the initiative to answer and said, "Let's not see through, Mr. Cai."

"Two people, you and Mr. Luo, help me fix the pelvis by one person, and fix the mid-thigh by one person. I will do manual reduction first to see if I can reset the existing fractures that are not very displaced first."

In fact, for a simple fibula fracture, it is quite difficult to simply perform manual reduction.

The tibia and fibula are parallel lower limb bones, and the tibia is very thick.

If the fibula is fractured, if the factors that cause pain are not considered, it will not affect the patient's walking or any function, because the length and hardness of the tibia are enough to support a person's normal walking.

It is precisely because of this that without the characteristics of plasticity and displacement, it is quite difficult to reset the fracture of the fibula.

But that's for the average person.

Zhou Cheng's understanding of manual reduction of fractures is a perfect redefinition, so he naturally didn't find it difficult.

Closed reduction and internal fixation with Kirschner wire is also one of the standard orthopedic grade II operations and operations.

Luo Yun and Cai Dongfan nodded instantly.

After standing in their respective positions——

Zhou Cheng immediately started the reset operation,
Three-piece set of standard fracture manipulation reduction.

Continuing traction——

Orthopedic displacement——

Keep the traction position temporarily fixed——

After pulling his hands for a while, Zhou Cheng gently bent the patient's ankle towards the medial malleolus.

Then the left hand continued to exert force, and the right hand immediately arrived at the patient's fracture site neatly, and began to palpate and stroke up and down.

After wandering up and down for about ten seconds, Zhou Cheng hurriedly turned his head and shouted, "Sister Yan, the Kirschner wire is equipped with an electric drill, I will fix it temporarily!"

Liu Yan is a very professional orthopedic nurse, otherwise Cai Dongfan would not call Liu Yan to the operating room every time he encounters a critical operation, either as a patrol nurse or as an instrument nurse——

Liu Yan quickly handed it over.

After Zhou Cheng took over the Kirschner wire with the electric drill, he immediately aimed at the protruding position of the lower part of the fibula, which all of us ordinary people can touch, the bony protrusion on the outside of the ankle——

The lateral malleolus formed by the swelling of the lower part of the fibula.

For Zhou Cheng's first Kirschner wire, the insertion point was selected slightly outside the lateral malleolus, and the insertion direction was obliquely upward.

By crossing the fracture line obliquely in this way, the fixation effect can be achieved.

The principle can naturally refer to candied haws skewers——

"Da da da da da!"

The Kirschner wire is very sharp, and the battery of the electric drill is new, so the Kirschner wire was driven in quite smoothly, and the fixing effect was achieved.

"Mr. Cai, Mr. Luo, it's all right, it's done."

After Zhou Cheng said something to Cai Dongfan and Luo Yun, he turned his head and looked at the itinerant nurse: "Teacher, please push down the C-arm machine."

But this tour has already been prepared. It seems that they have been informed of the operation process in advance, and they will have a X-ray before the operation begins.

Although Zhou Cheng omitted this step, she was always ready behind the C-arm before receiving other orders.

Today's surgery is special, Cai Dongfan has thought of every detail in every aspect.

Although Cai Dongfan's eyes are small, his heart is not small. Only when more details are perfected, can there be more fault tolerance.

When the itinerant nurse started pushing the C-arm machine, Zeng Yi and the others stood up naturally, including Dou Chengpeng.

Because of the detailed steps of the operation, I wrote this article.

Zeng Yi called softly: "Ruo Ruo, see through, go out of the isolation room."

-

After a while, everyone came to the isolation room and closed the lead door.

The result came out immediately.

Cai Dongfan and Luo Yun looked normal, while Zeng Yi and Yan Haihan rubbed their eyes in disbelief.

Because they wondered if their eyes were blind—

The Kirschner wire after TM fracture is running, but what about the fracture line?
Wang Yongjin's eyes flashed immediately, and he kept looking up and down Zhou Cheng after four or fifty years of clinical experience.

Zhou Chengcheng hurriedly said: "Mr. Cai, Mr. Luo, Sister Yan, you can wait for me here for a while. I will go in and inject another Kirschner needle. Then take another photo. It will save some time."

After finishing speaking, Zhou Chengcheng took the initiative to step on the sensor door of the lead plate door, and then strode in wearing a sterile green surgical gown. When he arrived at the instrument nurse's table, he found the Kirschner wire by himself and put it into the electric drill. Lock the drill.

The second crossed Kirschner wire was quickly completed to achieve a more stable fixation.

The principle can be referred to the cut chicken legs on the barbecue stand, which are fixed crosswise, which is stronger than threading sticks in parallel!

When Cai Dongfan saw that Zhou Cheng had withdrawn the electric drill, he said to the itinerant nurse: "Yali, call the department later and pick up the next patient."

"Ah?" Nie Yali was stunned on the spot.

Because the ignorant operation is a bit too difficult for her, it is estimated that no other girl is willing to cooperate...

Immediately, An Ruo was like an ant on a hot pan, holding onto it with her little hands.

He raised his head and looked at his teacher Zeng Yi, blinking his eyes non-stop, as if innocently asking for help: Teacher, teacher.

It comes, it comes again, what should I do?
Didn't you say that the pace of the operation would not be too fast?
At this moment, Zeng Yi still remembered what he said just now. Seeing that his student was a little stressed, he immediately squeezed his throat and coughed to remind her to pay attention to her image and not lose her demeanor in front of outsiders.

It was impossible for An Ruo to do such a thing, but she kept cursing in her heart:

Orthopedics is toxic.

Orthopedics is the devil.

orthopedics--

Curse, the enemy of life.

Zhou Cheng walked out into the isolation room again, so Cai Dongfan stepped on the C-arm perspective for the second time.

The results are still good.

After Zhou Cheng saw it, he breathed a sigh of relief and said, "Ms. Cai, Mr. Luo, I'm going to put on a plaster cast. You can get off the stage and rest."

The corners of Cai Dongfan and Luo Yun's mouths twitched immediately.

Glancing at the timing panel in the operating room.

00:04:42!

Four minutes and 42 seconds.

This is still two times of fluoroscopy, and the total time it took Zhou Cheng to go back in and get the second Kirschner wire, that is to say, Zhou Cheng's own operation time may be less than 1 minute!

Zhou Cheng walked in again.

Nie Yali still didn't react, why is it over?

When exactly did the surgery start?

Seeing Nie Yali still not moving, Zhou Cheng was already wandering in front of the operating table, as if he didn't know where to start the next operation.

After all, the sterile C-arm cover is only placed on the top of the C-arm machine, and the rest of the machine is still sterile.

Cai Dongfan reminded: "Yali, go and push down the C-arm machine, and then prepare for the second operation. It's hard work."

Nie Yali reacted immediately, trotted into the operating room, and went to help.

Then Cai Dongfan said to Luo Yun: "Luo Yun, you also go in and help Xiao Zhou put on a plaster cast, I will step down first."

After speaking, he began to undress himself.

In fact, Cai Dongfan felt that this operation was too fast. He originally thought that if Zhou Cheng had to inject two Kirschner wires, the reset would be slower than the previous technique?
However, it seemed that he was thinking a little too much.

When Cai Dongfan took off his clothes, he saw Zeng Yi's frown tightly, so he immediately smiled silly and apologized to him, "Director Zeng, thank you for your hard work, go and take off the anesthesia, and then work hard to give the next one anesthesia."

Zeng Yi walked into the operating room calmly, without saying anything.

Now that the people in the medical department are face to face, even if he has 1 opinions and complaints in his heart, he dare not say a word.

The operation in the clinical department is done quickly, can your anesthesiology department have any opinions?During meetings on weekdays, why do you complain about being slow?

An Ruo immediately turned into a diligent little ant, running around in the operating room, pouting under the mask.

I'm so hard-

……

Dou Chengpeng was stunned when he saw Cai Dongfan undressing. He looked at Yan Hanhan, Zeng Yi and Wang Yongjin. All three scored their own points on the score sheet.

Suddenly he was a little anxious.Quickly asked: "Director Zeng, Director Wang, how do you rate this?"

"So many scoring rules have not been made."

After listening to Zeng Yi, he quickly explained: "Director Dou, well, Xiao Zhou's surgical method is closed reduction and internal fixation with Kirschner wire for Class II surgery."

"It's not the plate and screw internal fixation we routinely carry out, so the details of the operation are in the back."

Naturally, Cai Dongfan prepared very comprehensively, and wrote several scoring rules for the surgical plans.

Dou Chengpeng stared immediately.

You guys of TM are so coquettish.

This is an assessment of surgery authorization, not a game, so why are you still playing multiple-choice questions?
Adults can choose both or just one.

Do you still play Ke Hai Ke Chun Qing during surgery?

Then I opened the back of the detailed scoring table, and suddenly felt that the orthopedic people were even more coquettish——

I see, closed reduction and Kirschner wire internal fixation for fibular fracture, surgical procedure and scoring rules:

1. Routine disinfection towels, the disinfection range is from the middle of the thigh of the upper limbs to the whole range of the lower limbs.

2. Preoperative C-arm fluoroscopy.

3. Manual reduction and Kirschner wire internal fixation.

4. C-arm perspective.

5. Plaster external fixation.

Even if Dou Chengpeng is not a specialist in orthopedics, he can still understand it anyway. Writing these five points is simply too damn watery.

Disinfection shop towels, C-arm perspective, accounted for three of them.

The really useful ones are probably manual reduction, Kirschner wire internal fixation and plaster external fixation.

Do they also feel that the scoring rules are too rough?

Dou Chengpeng's expression fluctuated for a while.

At this time, Wang Yongjin explained: "Mr. Dou, the steps of four-person manipulation are simple, but in fact, it is the most difficult level II operation among these operations."

"Basically, only a few hospitals dare to carry out this kind of operation routinely, because they can't grasp the degree of reduction of the operation."

As the chief director, Wang Yongjin has the most say, and Wang Yongjin doesn't mind giving his younger generation a hand.

As he spoke, he pointed to the C-arm see-through display screen and explained to Dou Chengpeng: "Chief Dou, you see, we assess whether the fracture has been reduced and fixed well, mainly by looking at the degree of closure of the fracture line and the degree of reduction of the displacement."

"We can see that the previous lateral displacement has basically been reset."

After hearing this, Dou Chengpeng immediately raised a question: "Director Wang, is this just the basics? What's better?"

Hear this.

Wang Yongjin, Zeng Yi, Yan Haihan and Cai Dongfan almost choked to death on their own saliva.

Wang Yongjin also shrugged his forehead, dug his ears with his hands, and said to Dou Chengpeng with some embarrassment: "I said basic, but I was just being polite."

"Although my surname is Wang, I'm not a mother-in-law, and I don't sell melons."

Wang Yongjin and Dou Chengpeng were joking.

Wang Yongjin is the generation of teacher Dou Chengpeng, he can joke with Dou Chengpeng casually.

Dou Chengpeng immediately shut up, feeling bitter in his heart, well, this exposed his unprofessionalism.

Taking a peek at director Zeng Yi and the others, he felt that he might have been a little ridiculous just now, and the translation of modern words is the scene of the death of the society.

It seems that we still need to say less and make less mistakes...

It doesn't necessarily mean that what this little doctor does must be poor, and a great director like Wang Yongjin Zengyi will definitely be able to find flaws.

In fact, Dou Chengpeng did nothing wrong, he just subconsciously asked Wang Yongjin, how is the completion of this operation, can it be better.It's just that Wang Yongjin couldn't answer, and Zeng Yi and the others felt rather embarrassed.

It seemed as though maybe this was the ceiling.

……

Finally, the second operation started on time at 54:[-].

For the first operation, Cai Dongfan brought Zhou Cheng and others down at 08:21!

The operation is over and the time for the patient to leave the operating room is 08:27!

The Department of Anesthesiology and the tour completed the operation turnaround of sending and receiving patients and anesthesia in 27 minutes, and they are already stepping on the hot wheels in the dark.

Little sister An Ruo felt that the soles of her feet were a little hot, and her wrists were also a little hot.

This is a precursor signal of lactic acid accumulation during short-term overload exercise.

After the anesthesia was finished, he leaned back on the chair used by his teacher to rest a bit suspiciously, while Zeng Yi stood up and went to the operating table to watch Zhou Cheng's operation.

Under the timing panel in the operating room, Wang Yongjin, Zeng Yi, Dou Chengpeng, and Yan Hanhan No. [-] Middle School were sitting there holding a clipboard, as if they were going to evaluate the second operation very seriously.

Yan Haihan, who knew the operation situation best, quickly explained: "Director Wang, Director Zeng, Section Chief Dou, this second operation is a fracture of the lateral malleolus. From the professional point of view of our orthopedics department, this operation is strictly open surgery."

"The alternative to the surgery is the second one, which is to put a locking plate on the outside."

"This time, these scoring rules can be used."

Wang Yongjin also said: "This operation is a routine orthopedic operation, more routine than the previous one, and it is already one of the very mature surgical methods."

Dou Chengpeng breathed a sigh of relief.

But because of the lessons learned just now.

He still flipped left and right, and then looked at the detailed surgery scoring rules, but there was no surgical plan like the one with a few simple ones for the previous surgery, which made him breathe a little.

He replied calmly: "Well, in fact, it is mainly based on the four majors of Director Wang, Director Zeng, and Director Yan."

"I'm an outsider."

Dou Chengpeng began to show weakness with lingering fear.So as not to die again.

After watching Cai Dongfan and the others, Zeng Yi did not expose his calf like the first one, but took a few steps back after applying a sterile film: "An Ruo, this time it must be an operation. Look, the sterile drape for surgery has been done."

Zeng Yi knew that two anesthesia machines in a row would consume a lot of physical strength for the anesthesiologist.

Anesthesiologist is a professional technical job, even if Zhou Cheng forced her to do physical work, it was hard enough for a female student like herself.

An Ruo nodded, not daring to think about anything, just stood up, gave up his seat to Zeng Yi, then sat on his small round stool, nodded and said, "Yes."

Very well-behaved, very sensible.

Because she found that if she doesn't complain, she will actually feel much more comfortable, and complaining will not reduce her workload.

In fact, it is a matter of resignation.

Cai Dongfan didn't have the business of welcoming people, so he participated in the whole operation, including disinfecting the towels.

Finally, everything is pending.
Cai Dongfan stood in the first assistant position and said to Wang Yongjin and others: "Director Wang, Section Chief Dou, we are starting the operation."

Wang Yongjin and others saw that Zhou Cheng had already raised the round knife, so they stood up quickly.

Then they walked slowly to the operating table one by one.

Zeng Yi wiped his forehead with the back of his hand.

Anyway, you took a scalpel, unlike the first one, which said it was surgery, but didn't even mention the scalpel, but it was ready. Isn't this a waste of resources and a burden on the patient.

Of course, I just think so in my heart, I don't know how many patients expect and desire such a 'burden'!
The operation can be completed without using a knife, and then it only costs a few extra dollars for the scalpel, which cannot be done elsewhere.

Do you think he would be happy?

An Ruo also settled down, patted her chest, took a long breath, and then began to rest.

"Start the operation!" Seeing Zeng Yi and others approaching, Cai Dongfan immediately ordered Zhou Cheng.

Zhou Cheng had already prepared, and Luo Yun and Cai Dongfan had already exposed the patient's lateral ankle, which was just right for the direction and position of Zhou Cheng's knife.

However, after Zhou Cheng lifted the knife, he put down the round knife again, and after thinking about the type of fracture for a while.

Zhou Cheng shouted to Liu Yan, the itinerant nurse: "Sister Yan, please give me a Kirschner wire electric drill first."

Liu Yan was taken aback when she heard this.

For this operation, what Cai Dongfan told her was to cut it open first, then temporarily fix it with Kirschner wires, and then put on the steel plate?
Liu Yan looked at Cai Dongfan.

Cai Dongfan's small eyes rolled around: "Electric drill with Kirschner wire."

On the side, Wang Yongjin also noticed a slight change in the operation procedure, so he quickly explained to Zeng Yi and others: "Xiao Zhou changed the operation strategy a little bit, first fixed it temporarily with Kirschner wires, and then followed the progress of the Kirschner wires. Needle-point incision can be more precise."

"It can also reduce the incision for patients to place the steel plate."

Wang Yongjin used to have surgery on the toes from the atlas, so he knows more about fractures of the lower limbs than Zeng Yi, who assigned the lower limbs to the second department of orthopedics several years ago.

Dou Chengpeng glanced at the sixth item of the operation procedure, and he found this out.

Immediately nodded secretly, said: "In order to reduce the length of the surgical incision for the patient, this is a good thing. But it won't affect the patient's recovery, right?"

Wang Yongjin shook his head: "No, and the inner ankle is also protruding, even blind typing is quite troublesome."

"That's fine, that's fine."

Dou Chengpeng nodded hurriedly: "After all, quality is the priority."

After Wang Yongjin said so, Liu Yan could only temporarily pass the Kirschner wire to Zhou Cheng.

Then Zhou Cheng inserted the Kirschner wire in one direction, from outside to inside, without much hesitation.

Immediately afterwards, Zhou Cheng said again: "Sister Yan, give me the other Kirschner wire too!"

Liu Yan was not suspicious, so she gave the Kirschner wire over.

But this behavior made Cai Dongfan a little confused, why are you giving so many Kirschner needles?
The more Kirschner wires, the better.

"Zhou Cheng, the fracture of the medial malleolus is too large, and the fixation effect of the Kirschner wire is inaccurate." Cai Dongfan hastily reminded.

"I know, Teacher Cai." Zhou Cheng had already stood in the chief knife position at this moment, so he naturally knew about this.

However, he already has his own surgical plan.

Class II surgery, immobilization of the medial malleolus.

Just as he was talking, Zhou Cheng made another Kirschner wire form a certain angle with the first one, and sent the Kirschner wire in.

After finishing these, Zhou Chengcai said: "Sharp knife!"

Cai Dongfan wasn't suspicious, instead he let out a sigh of relief.

Fortunately, Zhou Cheng didn't yell, "Teacher on the tour, push down the C-arm machine, otherwise, he will really hit someone on the operating table."

Liu Yan handed over the sharp knife.

Zhou Cheng took the sharp knife, and then made an opening of about 0.6cm at the insertion point of the first Kirschner wire, which directly penetrated into the bone end.

Cai Dongfan frowned immediately after reading it, and Luo Yun reminded: "It's better to peel it slowly with a sharp knife."

"There are no nerves or blood vessels at the protrusion of the outer ankle, Mr. Luo." Zhou Cheng replied.

The sharp knife was pulled out, and then a second parallel opening was made again at the place where the second Kirschner wire was inserted.

Seeing this, Cai Dongfan's expression changed drastically!
People are stupid.

what are you doing?
The principle of surgery is that if one incision can solve the problem, never make a second incision.

You can even extend it up and down, and do not make parallel incisions. Parallel incisions will be used unless they are used for tension-reducing sutures.

But now?
Cai Dongfan's scalp was slightly numb.

Zhou Cheng has already fallen, and it is impossible to turn back. It is impossible for Cai Dongfan to dismantle Zhou Cheng's platform on this one, but he is secretly thinking about how to deal with it, how to explain this to Dou Chengpeng later. The mouth is good.

Luo Yun was also taken aback, his glutes pinched with tension, and his hands twitched a little, but he didn't speak.

Yan Haihan inadvertently said: "Uh."

Immediately, Wang Yongjin and Zeng Yi glanced at Yan Hanhan, and each squeezed their throats.

Uh-huh.

It was as if the collective had suffered from pharyngitis at the same time.

Signal him to shut up.

Dou Chengpeng doesn't understand majors, so don't demolish your own platform.

Only then did Yan Haihan come to his senses and did not speak.

Zhou Cheng put down the sharp knife, and saw Cai Dongfan kept giving him eyes, almost bursting into flames, asking him what he was doing.

However, when Zhou Cheng returned the sharp knife to Liu Yan, he patted Cai Dongfan's hand lightly, and said in a low voice, "Teacher Cai, don't worry, I have the bottom of my heart."

"Sister Yan, give me two headless compression screws, one 5.5 and one 4.5!"

After hearing Zhou Cheng's words, everyone's brains went down at that time.

Only Luo Yun suddenly looked up at Zhou Cheng in amazement, as if he understood Zhou Cheng's intention.

The headless compression screw is a single fixation screw used in posterior malleolus fractures. It has a very strong fixation force. It is also feasible to use two screws to fix the lateral malleolus.

What Zhou Cheng has to do is to make the incision as small as possible to minimize the trauma...

But he is also too courageous! ! !

Liu Yan handed the headless compression screw to Zhou Cheng, only to find that the eyes of Cai Dongfan, Zeng Yi and others were a bit strange.

But he didn't say anything to stop her, and he didn't intend to take over the operation, so he had to listen to the surgeon first.

After Zhou Cheng took the screw, he put pressure on it and began to screw it in.

This twisting process is neither fast nor slow, it is a laborious work.

……

While Zhou Cheng was doing all this, Luo Yun appeared next to Cai Dongfan's ear and explained in a low voice: "Director Cai, what Xiao Zhou is doing now is to use headless compression screws to fix the medial ankle. This is infinitely repeated." Shrunk the incision."

"This method, currently in trauma surgery, is a cutting-edge small incision surgery."

"Madou and Kyoto have already started to do it."

Cai Dongfan immediately felt struck by lightning.

Looking at Zhou Cheng, he continued to push the screws into it with a calm expression, and suddenly felt that Zhou Cheng seemed to have driven the nails into his heart, constantly pressing and blocking his coronary arteries, feeling uncomfortable like being squeezed .

Cai Dongfan was not stupid, so he understood Luo Yun's words.

But the word frontier made his scalp numb.

Cursing in my heart, Zhou Cheng, Zhou Cheng, don't fucking hurt me, I gave you a military order in front of Zeng Yi, frontier surgery?

You call this a class II operation?
……

Luo Yun then took a few steps back, pulled Zeng Yi, Wang Yongjin and others aside, and explained again: "Director Wang, what Zhou Cheng is doing this week is the cutting-edge small incision for fractures that has great potential in trauma surgery. Reduction and internal fixation."

"His process and choice are correct. In the posterior ankle fracture, many doctors have performed closed reduction."

It's okay if Luo Yun didn't say anything, but when it was clear, the four of Wang Yongjin became at a loss.

You look at me, I look at yours.

Then, it was Dou Chengpeng who looked through the grading rules prepared for him by the Orthopedics Department, and asked, "Then how do you score this?"

"It's not written on it either?"

"Director Wang, then I will score with you?"

Dou Chengpeng's words made Wang Yongjin's eyes and upper body twitch slightly.

After pondering for a full five seconds, Wang Yongjin tilted his head slightly, and said apologetically to Dou Chengpeng: "Well, Chief Dou, I can't give a score, and I don't know this kind of surgery."

Dou Chengpeng looked at Zeng Yi and Yan Haihan.

Zeng Yi and Yan Haihan could only bite the bullet and learn from Teacher Wang Yongjin, and stood closely behind Teacher Wang Yongjin.

Shaking his head: "We won't either."

Dou Chengpeng suddenly felt a little sad.

Damn it, you orthopedic staff don't know how to grade, so what should you say about today's surgery authorization?

3 minute later.

After Zhou Cheng drove in a total of two headless compression screws, he let out a long sigh of relief.

Feel a little hot in the palm of your hand.

Sure enough, it's girls who like to spin, and men don't feel pleasure when they spin and rub.

Said: "Sister Yali, thank you for pushing the C-arm machine. Let's take a look."

In fact, when Wang Yongjin and others were whispering, and Cai Dongfan and Luo Yun were neither polite nor polite, she knew that there might be something wrong with the operation, so she was very nervous and at a loss, and focused on the operation process.

Nie Yali looked at Cai Dongfan.

Cai Dongfan was extremely helpless at the moment, and looked at Zhou Cheng with complicated eyes, thinking that it was a bit ignorant for Zhou Cheng to be such an asshole today.

But things have come to this, and we can only take a picture first to see the situation.

Then he nodded and said dryly, "Let's see through it first."

His voice is like a landlubber that doesn't understand water, quacking, quacking.

Hear this.

Groundhog - An Ruo immediately sat up straight, eyes wide open, innocent and cute, as if waiting to be beaten to death.

What happened again?
Didn't Zhou Cheng take the knife?

Why do you want to see through again?
Could it be?
An Ruo looked at the timing panel of the operation, which showed the progress of the operation.

00:08:08!

Looking at Zhou Cheng with complicated eyes, he spat secretly.

Can't you hold on longer?

Immediately afterwards, I saw everyone walking towards the isolation room silently, but no matter whether it was Cai Dongfan or Luo Yun, including Wang Yongjin and Zeng Yi, none of them laughed as much as they did during the previous operation. The faces are quite heavy.

I was secretly happy.

Could it be that something happened and something happened, and the operation time should be prolonged?

so good?
But after this idea floated out, An Ruo was startled, and hurriedly clasped his hands together and murmured a few times.

Then secretly explained: I didn't mean that, I definitely didn't mean that...

Wang Yongjin and others naturally felt worried.

A surgery that he didn't quite understand and understand appeared in front of him, and it was at such a critical moment, this Zhou Cheng was simply too reckless.

If something goes wrong, you don't know how you died.

Still showing off at this time?

However, when everything was prepared and the results of the C-arm fluoroscopy came out, the expressions of Wang Yongjin, Zeng Yi and others changed again in shock.

This fracture line and displacement?
Could it be that the normal imaging of the patient on the previous machine was copied, and it was PSed onto the ankle of this patient?
However, the last one is the left leg, this one is the right ankle, and the direction is different.

Wang Yongjin hurriedly greeted and said: "Yali, Cai Dongfan, you go in quickly, take a side view and take a look."

The tone was a little anxious.

Zeng Yi also hurriedly patted Cai Dongfan on the shoulder.

Small incision, internal fixation.

Trauma, minimally invasive!
Even if Zeng Yi is an idiot, he knows how influential it is, and there is no systematic surgery in this area. If it can be done so well, then, in the future, it will be used in academic exchanges.

The Eighth Hospital will definitely no longer be a sideshow, it will blind everyone in the province.

Zeng Yi suddenly became enlightened.

If Zhou Cheng knew Zeng Yi's thoughts, he would definitely say, Director Zeng, you are small...

No, this kind of small incision, open reduction and internal fixation took Zhou Cheng a lot of time to get the perfect grade. If even Wang Yongjin and the others couldn't shake it, it would be a waste of time.

And if it's just domineering in the province, then I'm too sorry for his simulation for so long. In the simulation copy, he has done all the things of abandoning his wife and children...

Two minutes later, the lateral film also came out.

Zhou Changcheng let out a long sigh of relief, leaving Cai Dongfan and others to continue to be dumbfounded in the isolation room, and called Nie Yali to complete the finishing work of the final suture.

Until Zhou Cheng finished suturing, none of Zeng Yi and the others came out of the isolation room——

After a full minute, it was Nie Yali who called An Ruo, who was in a daze, and An Ruo walked back from the isolation room to the operating room with complicated eyes. After wandering between Zhou Cheng and the operating room timing panel in despair, Resigned to fate.

When I meet this devil, I am no longer the teacher's beloved student, nor the head student in the department, but a senior senior sister with a high status in the world, let alone the beloved young lady at home, I am a tool of hard life people.

Tool man, never tired.

I went to withdraw the anesthesia, An Ruo shouted mentally, and hurried...

Half a minute later, Luo Yun walked in again, beckoning to Zhou Cheng: "Zhou Cheng, when the stitching is finished, come over here, I have something to do with you."

After Zhou Chengfang finished tying the last bow of the plaster cast, he hurried to the isolation room.

On the C-arm perspective panel, Wang Yongjin was still pointing at the inspection results above, judging whether the operation was done well or not from a very professional point of view.

Although he can't do it himself, he can understand the operation process and thinking, but he still understands the strength and ability to evaluate whether the operation is good or not.

Seeing Zhou Cheng coming in, Cai Dongfan pulled him in front of him.

Wang Yongjin glanced at Zhou Cheng, and asked with a smile in a very amiable tone: "Xiao Zhou, how did you think that you would use headless compression screws to fix it like this instead of a steel plate?"

Zhou Cheng scratched his head: "Director Wang, the fracture of the lateral malleolus, a small incision, temporary fixation with Kirschner wire, fixation with screws, and external fixation with plaster, are considered level II surgery, right?"

"Strictly speaking, the plate and screw internal fixation of the lateral malleolus fracture should be classified as a grade III operation, right?"

"After all, it is a fracture in the joint!"

It was fine if Zhou Cheng didn't explain it, but after explaining it like this, Wang Yongjin was so frightened that he fell back a little bit, and was quickly supported by Zeng Yi and Zeng Yi.

Wang Yongjin looked at Zhou Cheng, his mouth under the mask squirmed, unable to speak.

Shouting in my heart, it turns out that this is how you TM define level II surgery.

(End of this chapter)