"Traction outside the booth, the fracture is not reduced well, and the stage is opened?"

"Wait for the trouble, the intramedullary nail can't be inserted."

"Isn't this kind of fracture very rare?"

"Look, I don't know."

"I heard that I will be able to walk normally the next day after surgery, but it is still unknown whether the surgery can be completed."

"If the cowhide is blown up, it will break."

There was a discussion in the classroom next door, and everyone was disappointed with the start.

is like a movie, before it was released, it was hyped up, and everyone was holding back their strength to watch it. On the day of the release, thousands of people were empty, crazy and crowded to the theater, finally bought a ticket, and after watching it - a completely bad movie, nothing, not even an attractive shot.

Yang Ping's tall image was naturally discounted in the hearts of these young people, Qian donkey skills were poor, Jiang Lang was exhausted, and everyone sighed in their hearts.

For greater trochanteric fractures, minimally invasive methods are generally used now, and the elderly are preferred for internal fixation with PFNA intramedullary nails because of osteoporosis. In this kind of surgery, the body position is very important, both the adduction position and the neutral position are OK, and it must not be done in the outer booth, and the intramedullary nail in the outer booth cannot be inserted at all. Fracture reduction is also important, and the fracture must be reduced first, otherwise, the next steps will not be able to continue. Correct positioning and good reduction of the fracture are necessary for surgery.

Now that the two necessary conditions are not met, how can the operation be successful?

In the classroom next door, the senior doctors are Dr. Jin, and the director-level directors are Director Ouyang and Director Bai, and they all want to come to see Yang Ping for surgery, after all, everyone says that Yang Ping is amazing.

Young doctors, except for some rotational doctors and trainees, most of the others are orthopedic specialties, and they still have a certain understanding of these routine surgeries. opened the stage without getting this kind of position repositioning, and couldn't help but say a few words.

"This kid doesn't have much contact with lower limb fractures, right, and he hurriedly went into battle?" Director Bai's chief officer, Fat Tsai asked Dr. Jin.

Dr. Kim shook his head: "I don't understand!" ”

Fat boy said: "How can Director Han rest assured that he will do it, and he will not touch the bottom, the hand surgery is doing well, and the other operations are a mess, and there are many." ”

"Director Han caught the plane, I guess I didn't explain it clearly?" Another doctor said.

"No, I heard that Old Man Zhang asked him to do it by name." Informed explanation.

"It's embarrassing now, but it's okay, the countryside will definitely come, not the countryside, it's a matter of minutes." Someone on the spine surgery side accosted me.

"This operation is actually very simple, the bone on the inside, I heard that the muscle is inserted, and it will definitely not be reduced without incision. Minimally invasive, this kind of bone block does not care, the main body bone block is in the positive and lateral position, and the nail is inserted, it will be over, he is not even the main body bone block is not reduced well, how to end it later. ”

"What a reset, the position is wrong."

People are becoming more and more daring to speak.

At this time, Tian Yuan also came in, he saw that Song Zimo was there, and there was no shortage of manpower, he was afraid of staying in the operating room, so that Old Man Zhang was suspicious of many people, and the concept of sterility was not strong, so he simply came next door to watch the screen with everyone.

Although Su Yixuan is a nurse, she is an orthopedic specialist instrument nurse, and she also knows a lot about surgery.

She pinched a handful of sweat in her heart, this wood, usually the operation is even a piece of the sheet is to strive for perfection, today to Professor Zhang surgery, how to reset the position of the body did not get it right, so I hurriedly opened the stage, I will not be nervous to make mistakes.

Yang Ping and Song Zimo went to wash their hands.

Through the glass, Song Zimo looked at the expressions of everyone next door and knew what everyone was thinking.

At the sink, Song Zimo said: "Everyone is worried, don't you explain?" ”

Yang Ping said while washing his hands: "Explain what? If you do it and take two steps, you will know. ”

The words are not rough, boxer, shouting 10,000 times before the game that I want to win, it is not as practical as going on stage to knock out the opponent with one punch.

After washing his hands and Song Zimo disinfected, Yang Ping began to wear a surgical gown and gloves, his face was very calm, and he did not react too much to everyone's doubts.

Su Yixuan looked at her a few times, with a little anxiety in her eyes, Yang Ping smiled at her, signaling her not to worry, she knew it in her heart.

As if she had a heart, Su Yixuan immediately calmed down and began to sort out the instruments, checking the PFNA intramedullary nails, spiral blades, lock nails, steel cables, and supporting instruments.

The engineer of the instrument manufacturer was on the side, using a laser pointer to check with Su Yixuan, in case of a mistake, if he encountered a bad-tempered main knife, he would be scolded for his blood, so he didn't dare to be sloppy at all.

After the disinfection of the shop is completed, connect the electric knife and suction device, and the ceremonial preoperative check, and open the table!

Yang Ping made a three-centimeter incision above and below the large trochanter, took the bone hook handed by Su Yixuan, and gently probed into the bone hook from the incision under the large trochanter.

"He won't want to reduce the fracture on the inside, then he should have inserted a muscle, and there is no way to reduce it."

"When I was studying in the imperial capital, there was a big guy who wanted to show off and minimally injured the bone block that was inserted into the muscle on the inside of the reduction, but he didn't succeed, and finally gave up."

"Once the muscle is inserted, either give up or open up."

"Yes, the fracture fragment inserted into the muscle, incision and reduction, sometimes it is laborious, how can the closed reduction be made."

"You don't have to reset all the bones."

The bone hook reached in, and with little temptation, hooked back.

"Four steel cables, one by one!"

Three steel cables, one after the other, attached to the bone surface, were sent by the guide to their respective positions on the opposite side. The fourth cable and the other three are intertwined and intertwined, and I don't know what they mean.

"Traction, adduction!"

Zhang Lin and Xiaowu immediately helped to adjust the traction.

"Continue adduction, yes, continue, stop!"

"The lever is three turns back."

"Good! OK. ”

Every sentence is like an order from a commander, clear and unquestionable. On the operating table, all actions are subject to the chief surgeon, and the authority of the chief surgeon is the guarantee of surgical discipline.

Zhang Lin and Xiaowu couldn't understand the steps at all now, so they could only do it mechanically.

"I underestimate you, you know the attachment of each part of the bones, the role of each muscle, and the relationship between different muscles." Song Zimo said next to him.

"It's all called Senior Brother, if you don't have anything, will you be convinced?" Yang Ping said while operating.

The bone block inserted in the muscle is easily hooked out, the tip of the bone hook buckles the bone block, and then gently moves, reduces, the first steel cable is pressed against the center of the fracture piece, the ring is locked, and the tail of the steel cable is sheared.

Perspective!

Everyone quit the operating room again, and after an exposure, back to the operating room, the X-ray on the screen of the C-arm machine, the fracture has been anatomically reduced, if you don't look carefully, I think there is no fracture.

This is the direction and strength of the traction, which is just right to grasp very accurately.

"Holy! Can it be like this? ”

"I don't understand."

"The position and reduction just now seem to be deliberate, but I don't understand it, it has something to do with the bone pieces inserted into the muscles inside the reduction, right?"

Dr. Jin said to Director Ouyang.

I don't know what the next door thinks, anyway, Xiao Wu Zhang Lin felt like he was pitted, and he thought that he was in a hurry at the beginning, and he was worried that he wouldn't be able to get off the stage. Now I found that it was completely redundant, and even the bone inserted in the muscle came out. As for how it came out, I don't understand.

The second steel cable, the third steel cable ring sleeve, locked, cut the tail.

The tip of the trochanteric is directly opened, the guidewire enters, and then the intramedullary nail follows in, once in place, the guidewire is withdrawn, and the guide needle of the spiral blade is inserted.

Perspective--

The guide needle of the spiral blade is just in the standard position, no more, no less than one point, the midline of the lateral femoral neck, the middle and lower third of the anteroposterior femoral neck, and the tip is just a little bit away from the circular border of the femoral head.

"90 mm spiral blade."

After the measurement, the electric drill drills the hole and drives the spiral blade into it.

The locking nails at the lower end, drilling, bathymetry, and screwing in the screws are done in one go.

Cable!

The fourth steel cable, locked, cut the tail, now looks at it, and the first three heels are intertwined to form a monolithic structure, which forms a wonderful tension band structure on the outside.

I couldn't understand this operation, and even Song Zimo was a little puzzled: "What are you?" ”

"If your IQ is close to 250, you still need to ask me." Yang Ping screwed into the tail cap of the intramedullary nail and exchanged positions with Song Zimo.

Song Zimo began to rinse the sewing skin, just a few small incisions, and quickly sewed it up, and he didn't even need to drain it.

Finally, the perspective is confirmed.

The whole process is about ten minutes, like an ordinary intertrochanteric fracture, a top hospital with a large amount of surgery, very skilled, done in about ten minutes, there are many people. However, in this case, the fracture end is inserted into the muscle, and there is no way to reduce it with minimal trauma, and it is likely that it will eventually be incised, or the fracture will be abandoned.

Everyone stares at the screen, and the operation is over? Don't you understand? The first three steel cables are easy to understand, but the last steel cable really can't be understood.

Dr. Kim sat in the crowd and kept looking at the screen, taking pictures with the surgery. Director Ouyang was also beside him and said, "This operation is a bit wild, do you understand the steel cable at the end?" ”

"I don't understand it for the time being, but I should understand it tomorrow." Dr. King shook his head.

Song Zimo lifted the sheet, and Professor Zhang suddenly spoke: "Please consult the ophthalmologist tomorrow for me, my eyes are not working." ”

He literally lay down and watched the whole operation.

didn't say a word, it didn't fit his temper, at least he would give a few pointers.

Yang Ping held Professor Zhang's hand: "Don't worry, tomorrow morning, I will ask the nurse to give me a walker, and you can walk on the ground, and you won't give me zero eggs, right?" ”

Professor Zhang said, "Let's take two steps tomorrow. ”

The head nurse of the operating room came over: "Teacher Zhang, do you feel okay?" ”

Dean Xia also called, directly to the mobile phone of the head nurse in the operating room, and asked Yang Ping to answer.

Yang Ping went to the locker room to make a call to report to Director Han that he was safe.

Song Zimo leaned back on the bench: "Fantastic ideas! ”

And others are talking about it.

"What do you mean by that steel cable at the end? I really don't understand. ”

"You ask me, who do I ask?"