The Godfather of Surgery

The news spread quickly, and the entire orthopedics department knew that Yang Ping was going to have a 3,000-piece comminuted fracture of the lower end of the humerus, using only steel wires and needles.

Including the spine, joints, and sports medicine, many young doctors, graduate students, and interns have inquired about the operation time in advance.

Xiaowu Zhanglin had long said, "One seat, one meal! No bargaining." Even the registered textbooks were collected from the head nurse.

They also took away the ink pad that Corey signed, saying that it would be written in black and white at that time.

"Old man Zhang is here. He must be sitting in the middle of the front row. I'll put a layer of glue on his chair." Zhang Lin had a lot of ideas.

"The operating room has been urged three times, and you are still applying glue here." Head nurse Yao Ling patted him lightly with the medical record book.

The prestige of the head nurse is still relatively high in Corey, equivalent to Corey's housekeeper.

Everyone has searched for the person who will replace the surgery, rolled up their sleeves and prepared to observe it. Anyway, there are a lot of people in the department, and there are a lot of graduate students who are regulated by Pearson. They are waiting in line for surgery. It is very simple to deploy manpower.

Song Zimo, Zhang Lin, Fang Yan, and several other groups, the people under the two groups of Director Ouyang and Director Bai also came, as well as a dozen people from the spine, joints, and sports medicine.

Everyone wants to see how to do this 3,000 yuan operation, the key is to use steel wire Kirschner wire, it is impossible.

After the shift was over on Thursday, everyone was afraid that they would not have a seat. They sat in the classroom next to the main operating room early in the morning, and almost didn't hold a box of popcorn.

Wearing hand-washing clothes and wearing masks, everyone greeted each other. They are all from a major orthopaedic department. They can't see their heads when they look up. They may have worked together in the previous round of orthopaedics.

Doctors who have just graduated, usually start with the rotation department, and they will rotate through the departments of the surgical or internal medicine system for three months. They will be fully familiar with the knowledge of surgery or internal medicine, and by the way, they will be familiar with colleagues in various departments.

Some interns had no place and just stood in the back, huddled together in a chair. The front row is automatically reserved for old man Zhang and the director. The director may or may not come.

But when old man Zhang heard that he was coming, his assistant had already spoken.

"Professor Zhang, hello!" Doctor Peng on the other side of the spine greeted Zhang Lin immediately when he saw Zhang Lin.

Everyone was so frightened that their hearts jumped, thinking that Professor Zhang Zongshun had arrived.

Zhang Lin immediately shook hands: "It's a pleasure to meet you, Professor Peng, come in person?"

These young doctors tease each other in private, calling each other professors and directors.

Next door, Song Zimo was sterilizing, Xiao Wu raised his hand, Director Tian was sitting on the side, the equipment nurse Su Yixuan was sorting the equipment, Yang Ping had already put on the surgical gown and was standing aside waiting.

Director Tian is relatively stable and has solid skills. He is the kind of person who is usually inconspicuous, but can come in handy at any time.

Seeing the pair of presbyopic glasses wrapped in tape, everyone didn't dare to make a sound, and their bodies shrunk by half. He really came.

Professor Zhang Zongshun, guided by his assistant, came in and took a seat in the middle. Zhang Lin quickly informed Director Han, and soon, Director Han also appeared.

It's just one operation, and nothing can be delayed. Other operations can be pushed aside, so Director Han has also arranged the time.

Director Han shook hands with the old man Zhang: "Professor Zhang, why are you here in person? We'll send the video over and give you a score."

"Come and see, doesn't it say that this kind of fractured Kirschner can't be done? I just want to see, how can I go to the imperial capital if I don't have the money to buy a plane ticket?" Zhang Lao always speaks with such a poignant humor.

Director Han accompanied him: "Quick, find a cushion for Mr. Zhang to lean on."

A student came over with a silicone body pad, and Mr. Zhang was polite and put it on the back of his waist: "Young man, if you dare to come on stage, add a point first."

"Young people are inexperienced, so how can the basic skills be as solid as a doctor at Zhang's time." Director Han said.

"Don't be humble for him. I'm afraid this kid is a bit aggressive. If you don't squeeze it, it's hard to estimate the weight. The collarbone fractured, and his Kirschner wires can't be punched by anyone. Besides, it's really impossible. , isn't this what you know?" Zhang Lao said slowly.

Director Han knew in his heart that Mr. Zhang knew what to do, and wanted to test Yang Ping, but it was really impossible. The two of them could give him the bottom line. Mr. Zhang's purpose in coming to the operating room was to give him the bottom line.

"When the stage starts, just pretend that the old man doesn't exist, just do it well--" Tian Yuan cheered Yang Ping.

"Side-lying position, the choice of body position is good." Zhang old man said.

Prepare to open the stage, check before surgery.

The knife was slapped on Yang Ping's palm, the standard pen-holding style, the knife was in place, and the skin was incised at one time, neither deep nor shallow. Change the electric knife, the blood has not come out, the electric knife is already on, and the bleeding point is completely eliminated. Continue to cut the deep fascia with the knife.

Olecranon osteotomy approach, this approach is the most convenient for exposure. A miniature chainsaw, a beautiful V-shape, opens the olecranon and opens it upwards, exposing the entire lower articular surface of the humerus.

The suction device removes the accumulated blood, and the broken bone inside is exposed, with cartilage, without cartilage, coronal plane, sagittal plane, cross section, various shapes, messy.

"How is this done?" Worse than what the X-film shows.

Everyone looked at the video on the screen, clearly and completely stunned. Originally, I wanted to see how to do it, but the operation simply couldn't be done.

There is a special word to describe this: a bag bone!

A bag of bones!

The bone fragments are like stones, and the skin and soft tissue outside are like a bag.

The piecing of these bone fragments is extremely difficult and can be said to be impossible.

If it is an extra-articular fracture, it is easier to handle and does not need to be stitched together. Intra-articular fractures are different. Any unevenness will wear out the joint. Once worn, it will cause long-term pain and impairment of movement. Intra-articular fractures require anatomical reduction, that is, what is the original and what you want to fight back.

If you can't fight it back, you will be left with arthritis by a little bit;

A lot of training in the system has allowed Yang Ping to summarize the rules. There are certain methods for this kind of bone piece piecing. The order of reduction and the distribution of Kirschner wires are the most important. The whole process is like restoring the Rubik's cube, it must be in a scientific order, not random.

Seemingly simple things require enormous effort.

An empty eggshell is broken, someone can restore it with bare hands, believe it or not, Yang Pingxin anyway.

The fractures were a mess, and there were no large pieces that could reflect the original appearance. Even the largest bone piece could not be seen where it came from.

It's like a house that collapses into a pile of rotten bricks, how can you still tell where the brick is?

Director Han frowned, and Old Man Zhang remained silent.

The ghost eye with the strongest brain can find the few that he has seen from thousands of the same leaves.

A lot of training has given Yang Ping a sharp eye. He carefully clamped the bone pieces, identifying them piece by piece. If the bone pieces had soft tissue attachments, no matter how many, they would be absolutely protected.

Vascular forceps are like clamping an egg shell, and the strength is excellent, which is stable and does not break.

After all the bone pieces have been identified, I already know where each piece should be, and in what order to build and restore it, it gradually takes shape in my mind.

If you can't find the scientific order, this piece will go up, and the other piece will fall; this piece is right, but it blocks the reset of the other piece; just after this piece is set, that piece is missed again, and it can't be done. to recovery.

"Cut the other end of the Kirschner wire and prepare five of these."

Xiaowu did the same. A normal Kirschner wire has only one pointed end and the other flat. Now the other end needs to be cut into a beveled point.

"He really wants to reset, how does this reset?"

"This is hard to do even with steel plates."

"I didn't do CT."

"He wouldn't dare to come to power if he was killed by CT."

"It's embarrassing now, how can you step down?"

Everyone was discussing it carefully. Originally, they wanted to see an operation. Now, how can we deal with this situation? There is absolutely no way to do it. The so-called worst case is easier to deal with. Possibly on, off.

Some people were very disappointed and came to observe and study with enthusiasm, and this turned out to be the case.

Old man Zhang leaned against the silicone pad, took off his glasses, and wiped them.

After irrigating the surgical field, the Kirschner wire has been cut and inserted into the power drill.

The first bone fragment was moved up, and the Kirschner wire was firmly fixed at the proximal end of the humerus, allowing the Kirschner wire to pass through the bone on the opposite side and through the skin, and the bone fragments were tightly sutured.

Good eyesight, Director Han secretly applauded, this piece did not even try to match, it was reset at one time.

Unscrew the holding head of the electric drill with the key and withdraw it; in turn, clamp the exposed other end and slowly withdraw it until only a little of the flat bone surface of the tip is exposed.

The second piece is moved up, or the original Kirschner wire is used, but reversed and passed back; the third piece, facing the proximal end of the humerus, has a Kirschner wire obliquely from the opposite side, which is 60 degrees from the first Kirschner wire. Cross the degree, put the fourth piece in the middle, and wear it together.

I don't know why the fourth piece is placed in the middle, but I can't tell it's in the middle?

Everyone is confused, not to mention the fourth piece, the few pieces that have been nailed up now, I can't see where one piece is, and it still feels messy.

The fifth piece was pierced by the Kirschner wire just through a vacancy.

Just like the restoration of the Rubik's Cube, each step will be related to other steps, and it must be done in accordance with the established method, otherwise it cannot be restored. Also before the restoration, what others see is also messed up, why is the red here in this step, and why is the blue there in that step.

After a long time, it's still messy, messy.

Wouldn't it be okay to wear it with a steel needle and end it? Everyone is worried.

Song Zimo was worried that Yang Ping had been a little flabbergasted recently and had to undergo such an operation.

But looking at his seriousness, he seems to have a good idea, not like a fool.

Is it really possible to put these bones back together intact?

Not so stupid.

When the sixth piece was inserted, the two Kirschner needles were punched back and passed through the sixth piece; the seventh piece was pasted with the previous gap, and a new gap appeared; the ninth piece just filled this gap, and the third A Kirschner wire was put on, not only putting on these two pieces, but also passing through other bone pieces.

The steel needle penetrates the bone block, and it is in place every time. Even the small and thin bone block is not allowed to be pierced a second time, but it is also safely passed through.

Song Zimo had already seen the clue, and felt an indescribable feeling in his heart.

The lateral condyle has been formed, and the Rubik's cube has spelled out the first layer. The tenth, eleventh, and twelfth pieces are embedded obliquely, and each piece is precisely positioned. The fourth thin Kirschner wire, fixed at one time, just passes through the strongest cortical part.

In the medial condyle, the prototype is emerging, and the Rubik's cube spells out the second layer.

The thirteenth piece was pasted, the fourth piece was pushed forward, passed through this piece, and the fifth Kirschner wire was inserted, not only through this piece, but also through several other pieces.

The shape of the medial condyle was completely revealed, and the articular surface was successfully assembled, smooth and without defects.

Smooth articular surface formation, no gaps, no steps.

So far, the third layer of the cube has been successfully restored.

Wow! A small exclamation from the audience.

Those who felt bored began to cheer up; those who were about to leave early, gave up their thoughts and focused their eyes on the screen. Some people began to regret that they did not read the details of the reset just now, wasting valuable learning opportunities.

A standard tension belt is used on each side to bind the steel wire, and then an oblique tension belt is used on each side to form a responsible three-dimensional triangle shape, just like the steel frame structure of a building.

Tighten the steel wire, cut it, handle the tail, cut the Kirschner wire, and bend the tail.

Like Rubik's Cube restoration, the process is incomprehensible, but the ending is bright.

Really restored, Kirschner wire and steel wire, forming a wonderful three-dimensional stable structure.

Move the elbow joint, very stable.

This rude operation!

At this time, everyone understood that the order of the bone pieces and how the Kirschner needles were punched were all planned. Only in this way can we achieve the greatest consideration, lock each other, and finally form a whole. One step is messed up, and one is missing. , cannot be completed.

I can't accept it!

wonderful! It was also the first time that Song Zimo saw someone use steel wires and Kirschner wires like this.

What kind of surgery is this? It is using bone blocks and steel needles to build a miniature self-stabilizing structure.

"Second Han, this kid under your command is not easy, take good care of him." Old man Zhang got up.

"Why, Mr. Zhang, didn't read it?" Director Han said.

"The prostate doesn't live up to its expectations, it can't hold back anymore." Zhang Lao got up.