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

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

Xiao Wu Zhang Lin had already released his words: "One seat, one meal!" No counter-offers. "I even went to the head nurse to get the registered textbooks.

The ink that Corey signed was also taken away by them, saying that it was black and white when the time came.

"Old man Zhang will come here, he must be sitting in the middle of the front row, and I will apply a layer of glue to his chair." Zhang Lin has a lot of ideas.

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

The head nurse still has a relatively high prestige in Corey, which is equivalent to Corey's housekeeper.

Everyone has found the person who will replace the surgery, rolled up their sleeves and is ready to take a look. Anyway, there are a lot of people in Corey, and there are a lot of graduate students, waiting in line for surgery, and it couldn't be easier 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, and more than a dozen people from the spine, joint, and sports medicine side also came.

Everyone wants to see how to do this 3,000 yuan operation, the key is to use a wire K-wire, it's impossible.

After the shift was handed over on Thursday, everyone was afraid that there would be no place, so they sat in the demonstration classroom next to the main operating room early in the morning, and almost didn't hold a box of popcorn.

Wearing hand clothes and masks, everyone greeted each other. It's all a big orthopedic department, and you can't see you when you look up, and you may have worked together when you were in the wheel department before.

Doctors who have just graduated are generally rotated first, and the departments of the surgical or internal medicine system are rotated all over for three months, so that they are fully familiar with the knowledge of surgery or internal medicine, and by the way, they are familiar with the colleagues in each department.

Some of the interns didn't have a place, so they stood in the back, and the good relationship sat on a chair. The front row is automatically set aside, which is for Old Man Zhang and the director to sit, and the director may or may not come.

But when Old Man Zhang heard that he was coming, his assistant had already spoken.

"Hello, Professor Zhang!" Dr. Peng, who was on the other side of the spine, saw Zhang Lin and immediately greeted him.

Frightened, everyone's little heart beat violently, thinking that Professor Zhang Zongshun had arrived.

Zhang Lin immediately shook hands: "Fortunately, Professor Peng, come in person?" ”

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

Next door, Song Zimo was disinfecting, Xiao Wu raised his hand, Director Tian was sitting on the side, instrument nurse Su Yixuan was sorting out the instruments, and Yang Ping was already wearing a surgical gown and standing on the side waiting.

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

Seeing the pair of tape-wrapped reading glasses, everyone didn't dare to squeak, and their bodies shrank half shorter, he really came.

Professor Zhang Zongshun, under the guidance of his assistant, came in and sat down in the middle seat. Zhang Lin hurriedly informed Director Han, and soon, Director Han also appeared.

It's just one operation, and it can't delay anything, and other operations can be pushed, so Director Han has also arranged the time.

Director Han shook hands with Old Man Zhang: "Professor Zhang, why are you here in person, let's send the video over and give you a score." ”

"Come and see, doesn't it mean that this kind of fracture K-wire can't be done? I just want to see, how can I get to the imperial capital if I don't have money to buy a plane ticket? "Mr. Zhang always speaks so spicy and humorous.

Director Han was by his side: "Quick, find a mat for Mr. Zhang, lean on." ”

A student brought a silicone body cushion over, and Zhang Lao was not polite, and put it behind his waist: "Young man, dare to go on stage, add one point first." ”

"Young people are inexperienced, how can the basic skills be as solid as the doctors at the time of Zhang Lao." Director Han said.

"Isn't that your backing? Let me tell you, Han Lao Er, these boys, don't spoil them every day, hit them when they should beat them, scold them when they should scold, otherwise they won't grow up, you see, one by one, the hats are crooked. ”

Those who were sitting in the back, everyone, immediately touched their hats, whether it was crooked or not, and adjusted it.

"Wait for the stage to start, just treat the old man as if he doesn't exist, just do it well--" Tian Yuan cheered Yang Ping.

"Lateral decubitus position, good position selection." Old man Zhang said.

Prepare for opening the stage and check it before surgery.

The knife slapped in Yang Ping's palm, the standard pen-holding style, the knife was in place, and the skin was cut at one time, not a point deep, nor a point shallow. Changing the electric knife, the blood has not come out, the electric knife has already been pointed, and with a slight click, the bleeding point has been completely eliminated. Continue to cut the deep fascia with a knife.

The olecranon osteotomy approach, which is the most convenient to expose. The miniature chainsaw, a beautiful V-shape, opens the olecranon and flips it upwards, exposing the entire articular surface at the lower end of the humerus.

The suction device removes the accumulated blood, and the broken bones inside are exposed, with cartilage, without cartilage, coronal, sagittal, cross-sectional, various shapes, messy.

"How?" It's worse than what the X-ray shows.

Everyone looked at the video on the screen, and they were all confused. Originally, I wanted to see how to do it, but I couldn't do it at all.

There's a word for it: a bag bone!

A bag of bones!

The broken bones resemble stones, and the skin and soft tissues on the outside resemble a bag.

The assembly of these fragments is extremely difficult, so to speak, impossible.

If it is an extra-articular fracture, it is easier to deal with and does not need to be put together. Intra-articular fractures are different, any unevenness will wear out the joint, and once worn out, it will cause long-term pain and impaired mobility. Intra-articular fractures need to be anatomically reduced, that is, what was the original and what you want to put back together.

If you can't fight it back, it's almost a little bit, and you will be left with arthritis; Much worse, directly crippled.

A lot of training in the system allowed Yang Ping to summarize the rules, this kind of bone blocking, there are certain methods, the order of reduction and the distribution of K-wire are the most important. The whole step is like restoring the Rubik's Cube, there must be a scientific order, not just random.

Something that seems simple, requires a lot of effort.

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

The fracture was a mess, and it was impossible to find a large piece that could reflect the original appearance, and even the largest bone could not be seen where it came from.

It's like a house that has collapsed and turned into a pile of rotten bricks, can you still tell where the bricks are?

Director Han frowned, and Old Man Zhang was silent.

The ghost eyes of the strongest brains can find the ones they have seen from thousands of identical leaves.

A lot of training has made Yang Ping also have a sharp eye. He carefully clamped the bone blocks, identifying them piece by piece, and if the bones were attached to soft tissue, no matter how much they were, they were absolutely protected.

The vascular clamp is like clamping an eggshell, and the strength is very good, which is stable and will not be pinched.

After all the bone pieces were identified, and where each piece should have been, I already knew in what order to build and recover, and gradually took shape in my mind.

If you can't find the scientific order, one piece will be repeated, and the other will be dropped; This one piece is well aligned, but it blocks the reset of the other; As soon as this piece was ordered, that piece was leaked again, and it was never restored.

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

Xiao Wu did the same, and the normal K-wire needle only has one end pointed and the other end is flat, and now the other end should be cut into an inclined point.

"He really wants to be reset, how can he be reset?"

"It's hard to do even with steel plates."

"Didn't do a CT."

"If you want to do CT to kill him, he won't dare to go on stage."

"It's embarrassing, how can you step down."

Everyone discussed carefully, I originally wanted to see surgery, but now how to clean up this situation, this can't be done at all, the so-called most serious, the treatment is simple. It is likely to be opened, closed.

Some people were disappointed and enthusiastically came to observe and learn, and the result was like this.

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

Rinse the surgical field, the K-wire has been cut and loaded into the power drill.

The first bone fragment is placed on the proximal end of the humerus, allowing the K-wire to penetrate the contralateral bone, penetrate the skin, and the bone fragment is tightly sutured.

Good eyesight, Director Han secretly applauded, this piece didn't even try to match, just reset it once.

The key unscrews the clamping head of the electric drill and withdraws; In turn, clamp the exposed other end and slowly pull back until only a little bit is exposed on the flat bone side of the tip.

The second piece is leaning up, or using the original K-wire needle, but in reverse, piercing back; The third piece, on the proximal end of the upper humerus, is placed diagonally with a K-wire from the opposite side, crossed by 60 degrees with the first K-wire, and the fourth piece is placed in the middle and put on together.

I don't know why the fourth piece is placed in the middle, I can't see that it is in the middle?

Everyone is confused, not to mention the fourth piece, the few pieces nailed up now, one of them can't see where it is, and it feels like it's still messy.

The fifth piece was pierced by the K-wire just now, separated by a gap.

Just like the restoration of the Rubik's Cube, each step will be related to the other steps, and it must be done according to the established method, otherwise it cannot be restored. In the same way, before the restoration, what others see is also chaotic, why is this step red here, and that step blue is there.

It's still messy and messy for a long time.

Won't it be ignored by three-seven-twenty-one, and it will end up with a steel needle, right? Everyone is worried.

Song Zimo was worried that Yang Ping had been a little drifting recently and undergoing such an operation.

But looking at his serious appearance, he seems to be confident, not like a fool.

Is it really possible to put these bones back together?

It won't be so awesome.

When the sixth piece is embedded, two K-wire needles are punched back, both passing through the sixth piece; The seventh piece was pasted with the gap just now, and a new gap appeared, and the ninth filled the gap, and the third K-wire was threaded, not only through the two pieces, but also through the other bone pieces.

The steel needle pierces the bone block, and each time it is in place, even if the small and thin bone is not allowed to be worn a second time, it is safely passed through.

Song Zimo had already seen the clues, and the indescribable feeling in his heart.

The lateral condyle has been formed, and the first layer of the Rubik's Cube has been spelled out. The tenth, eleventh, and twelfth pieces, embedded obliquely, each with a precise position, and the fourth fine K-needle, fixed at one time, just 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 is pasted up, and the fourth one is pushed forward, through this piece, and then a fifth K-wire is inserted, not only through this piece, but also through several other pieces.

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

Smooth articular surface formation, without a single gap or step.

So far, the third layer of the Rubik's Cube has been successfully restored.

Wow! A small exclamation from the audience.

If you feel bored, start to cheer up; Those who were about to leave early dispelled the idea, and their eyes were focused on the screen, and some people began to regret that they did not look at the details of the reset just now, and wasted their precious learning opportunities.

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

Tighten the wire, cut it, and dispose of the tail, cut it with a K-wire needle, and bend it to dispose of the tail.

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

It is really restored, K-wire and steel wire, forming a wonderful three-dimensional stable structure.

Move your elbow joint and it will be very stable.

This riotous operation!

At this time, everyone understands that the order of the bone block, how to hit the K-wire, are all planned, only in this way can we achieve the greatest consideration, lock each other, and finally form a whole, the steps are chaotic, one is missing, and it cannot be completed.

If you don't accept it, you can't!

Wonderful! It was also the first time that Song Zimo had seen someone use steel wire and K-wire like this.

This is surgery, this is the use of bone blocks and steel needles and wires to build a miniature self-stabilizing building.

"Second Han Lao, this kid under your hand is not simple." Old man Zhang got up.

"What, Mr. Zhang, don't you finish reading?" Director Han said.

"The prostate is not angry, and it can't hold back." Elder Zhang got up.