After the patient's left upper arm fracture was treated, the next step was hip replacement surgery.

"Xiao Chen is in charge of suturing his left upper arm. ”

Liang Qunfeng gave an order, and then he didn't care about the patient's left upper arm, and with Dr. Chen's level of sutures, the rest of the things could be completely handled.

Because the patient had an injury to his left upper arm, Liang Qunfeng was in a supine position with his hips raised, and the sutures of his left upper arm and hip replacement surgery were not affected.

Liang Qunfeng explained as usual: "The selection of surgical incision should be based on hip deformity, soft tissue contracture, and the experience and habits of the surgeon, and the principle of selection should be convenient for soft tissue release, joint full exposure and prosthesis placement.

Generally speaking, when using a posterolateral incision, the patient lies on his side with the affected side on top, and when the lateral or anterolateral incision is made, the patient lies flat with the hips on the affected side raised.

As he spoke, Liang Qunfeng had already begun to move the knife, and at the same time explained: "The first step of the operation is to expose the hip capsule, after exposing the hip capsule, separate the adhesions outside the joint capsule, fully expose its front, above and below, up to the periphery of the acetabulum, down to the base of the greater trochanter, and remove the joint capsule and synovium. The hip joint was externally rotated and adducted to dislocate the femoral head, and the remaining joint capsule and synovial membrane behind the hip were removed......"

Liang Qunfeng explained while doing it, Fang Han and Li Xiaofei were very serious, but Fang Han was the only one who could really understand it, even if he was an assistant resident doctor, he couldn't intervene at this time.

Whether it is orthopedic or Western medicine surgery, the doctor must be very clear about the bone structure of the human body, so as to ensure that the operation is smooth, the two doctors who are assistants today are not professional surgeons, nor professional orthopedic surgeons, they belong to the half-hanging, so that the task of the chief surgeon is relatively heavy.

Fortunately, Liang Qunfeng's current role is mainly the role of a mentor, and it is impossible for Fang Haoyang to arrange surgery for Liang Qunfeng without restrictions, which also leads to the overall surgical intensity of Liang Qunfeng.

The hip replacement surgery itself is not a major operation, if it is a simple hip replacement, at the speed of Liang Qunfeng in the past, that is, half an hour, today because of the fracture of the left upper arm, coupled with the unfamiliarity of the team, the assistant is not strong, the time will be slightly longer, but the overall operation will definitely not exceed two hours.

"The following is to remove the femoral head, trim the femoral neck, and expand the medullary cav......ity," Liang Qunfeng continued to explain, but he was very skilled under his hands, with Liang Qunfeng's current level and level, in Fengzhou Orthopedic Hospital, he would not be able to operate on such an operation as hip replacement, and the grade was too low.

"The next step is to clean the acetabulum with a toothed retractor. As soon as Liang Qunfeng stretched out his hand, the nurse on the side hurriedly put the tool in the palm of Liang Qunfeng's hand.

In this operation, not only the assistant was not strong, but the nurses were also a little weak, and the nurses who participated in the operation were all first, and there was no tacit understanding with Liang Qunfeng at all.

If it was the original team, what tools should be used next, the chief surgeon had an expression, a gesture, and even before the chief surgeon signaled, the nurse would have been ready.

But now, every time you need tools, you have to open your mouth.

Liang Qunfeng took the tool and explained while operating: "You must know that there are sciatic nerves, femoral arteries, veins and femoral nerves in the soft tissues around the hip joint, in order to avoid injury, use a pointed or toothed pull hook, after the sharp teeth are hooked on the bone outside the acetabular margin, and the surrounding soft tissues can be pulled away by tilting outward, so as to avoid slippage and the acetabulum can be satisfactorily exposed." ”

"Next, the labrum, round ligament, all intramolar soft tissues, and cartilaginous surfaces are removed. It should be noted here that if the bone is very hard, a layer of subchondral bone can be removed with a round chisel, if there are too many osteophytes at the acetabular margin, it should be appropriately removed, and if the cephalar is fused, the head should be cut with a flat chisel, and then the head should be chiseled off with an acetabular chisel to form a false mortar.

Attention should be paid to the direction when using acetabular files, that is, camber 40°~50°, flash tilt 10°~15°, so as to facilitate the placement of artificial acetabulum. ”

Liang Qunfeng not only explained the current situation of surgery, but also appropriately interspersed the key to joint replacement, such as how to deal with what kind of situation is encountered, etc., which is explained in great detail.

The surgery gradually came to the final procedure, which was the placement of the acetabulum.

"Change your gloves. ”

Liang Qunfeng put down his tools, pricked up his hands, and asked the nurse to help change his gloves.

Liang Qunfeng began to pay attention to the mixed bone cement, and when the mixed bone cement did not stick to the gloves, then used his fingers to evenly fill the bone cement into the dry acetabulum.3 and then pressed the acetabulum on the cementer of the acetabular bed.

"Next, you scrape off the spilled adhesive around the acetabulum, taking care not to damage the cement between the bone and the mortar cap. Maintain the pressure until the binder has cured, then remove the pressure regulator. ”

Liang Qunfeng gave an order to the resident doctor who was an assistant, this job was relatively simple and did not need to be operated by him personally.

"Okay. ”

The resident doctor answered, and after watching it for a long time, it was finally time for him to get started, although this procedure was similar to cleaning up garbage, and there was no technical content at all, but he was still very excited.

For doctors, the more cases treated and the more papers published, the easier it is to evaluate job titles, and the number of surgeries is critical for surgeons and orthopedic surgeons.

Don't underestimate the role of a second assistant or a third assistant, with the first time, it is equivalent to having experience, even if you don't do anything, that is also experience, the next time you choose someone for similar surgery, you are inexperienced on the one hand, and you are experienced on the other hand, and the surgeon knows who to choose without thinking about it.

This joint replacement surgery is the first case in Jiangzhong Hospital, and the main surgeon is still a big name like Liang Qunfeng, there is no doubt that this surgery will definitely occupy a large proportion in the emergency department of Jiangzhong Hospital.

Dr. Chen didn't say anything for the time being, but the resident doctor was very excited, with this time's energy, in the future, the orthopedic injury division of the emergency department of Jiangzhong Hospital would be established, and there would be similar surgeries, he would definitely have an advantage.

Liang Qunfeng walked to the side and asked Fang Han with a smile: "How is it, what do you think?"

"Joint replacement is a really good procedure, especially for some older patients, to minimize the risk. Fang Han commented very pertinently.

What he obtained from the system is a very formal traditional Chinese medicine orthopedics, and he does not know about joint replacement, but he can understand the whole operation, and he can also see the scope of adaptation of this joint replacement.

For some osteoporosis and elderly patients, normal orthopedic traction is not suitable, the elderly have soft bones and poor tolerance, and some too complex orthopedic manipulations cannot be used at all, and it is possible that you will cause a second fracture when you reduce.

Liang Qunfeng said with a smile: "The integration of traditional Chinese and Western medicine naturally has the merits of the integration of traditional Chinese and Western medicine, you Director Fang are still a bit of a layman, I have been here for three months, in fact, I can't teach you much." ”

Speaking of this, Liang Qunfeng hesitated slightly, but continued: "I'm not afraid to say a word that your Director Fang is angry, Xiaofang, your orthopedic techniques are really good, but it is not easy to learn other means in a short period of time, the difference between traditional Chinese medicine orthopaedic and integrated Chinese and Western medicine therapy is still very big, orthopedic manipulation is only one aspect, Western medicine surgical skills still need to be possessed, this is not an overnight thing." ”

Fang Han nodded, what Liang Qunfeng said was reasonable.

Liang Qunfeng continued: "Actually, Xiao Fang, if you really plan to learn the combination of traditional Chinese and Western medicine, I suggest that you go to our Fengzhou Orthopedic Hospital for a period of time, it doesn't take long, two or three years, with your talent, you can definitely learn to become a teacher, and then come back, then you can afford to provoke the bone injury division of your emergency department." ”

Fang Han glanced at Liang Qunfeng, feeling that Liang Qunfeng was waiting here after saying so many words.

To be honest, Fang Han was really a little excited, as the so-called skills are not oppressive, he naturally can't ask for more things, but his talent.

He knows his talent, without a system, can he really be a teacher in three years?

Instead of wasting time on bone injuries in the combination of traditional Chinese and Western medicine, he might as well accumulate some more worship points and exchange them for other skills, besides, Fang Han really didn't plan to take the path of bone injuries all the time, with the system in hand, he could become a full-time Chinese medicine master.

"Lao Liang, you're digging the foot of the wall here again. Fang Haoyang's voice came, I don't know when Fang Haoyang had already changed into a brush suit and came in, but no one paid attention.

Liang Qunfeng was taken aback: "I said Lao Fang, you are also a director-level person, can you be a little more majestic, sneaky, and scare people to death, do you know?"

"Don't do bad things, don't knock on the door, what are you afraid of. Fang Haoyang scolded with a smile.

"What did I do wrong, isn't what I said the truth?" Liang Qunfeng sneered: "Don't say that I stay here for three months, even if I stay for half a year, I may not be able to bring you a team." ”

Fang Haoyang didn't care: "I don't expect others, as long as Fang Han can master something." ”

Fang Han looked at Fang Haoyang, you are so confident in me? I don't have confidence myself.

Liang Qunfeng smiled: "Don't forget, Xiao Fang is injured, at least within two months, you can't get started, the operation still has to be exercised, no matter how many theories you master, no matter how much experience you have, it's useless." ”

"Then you'll stay a little longer. Fang Haoyang said.

"Think beautifully. Liang Qunfeng glanced at Fang Haoyang: "I can stay for three months to give you face, stay longer, don't do anything over there?"

Li Xiaofei on the side was envious, look at Director Fang Fang Han, that is really fanciful, they were directly ignored.

Fang Han didn't have the heart to pay attention to Fang Haoyang and Liang Qunfeng at this moment, his face suddenly became very exciting, because a system prompt sound had just sounded in his mind.

"Ding...... Temporary quest, master joint replacement within 3 months (joint replacement reaches the primary level), quest reward, advanced item card - copy (1), quest failure, no penalty. ”

"What does copying mean?" Fang Han asked the system, he had already seen the high-level prop cards produced by the system, the prop cards last time were temporary grandmaster-level stitches, but this time he was a little confused about copying.