9. During the operation, Professor Ye took Director Guan and Chen Ge to perform the operation.

This surgery is also a quadruple reconstruction, the intercondylar fossa is deformed, and when the femoral tunnel is opened, the medial femoral condyle is split, which is troublesome.

Let Professor Ye do it, there will be no problem at all, the operation will be done in half an hour, and the fork will be reconstructed, Chen Ge wants to try, Chen Ge is Director Guan's doctor, and he is also Professor Ye's nephew, not to mention that he also followed Professor Ye for a year when he studied in the Third Academy, so it doesn't matter if he tries it.

Because the posterior fork reconstruction is also bifascicular and has two tunnels in the medial femoral condyle, the tunnel location is more crowded. Chen Ge was inexperienced, and Professor Ye was also careless, as soon as the tunnel opened, it collapsed, the inner condyle was split into three pieces, and the drill bit was pinned inside.

Now to take the broken drill bit out of the bone, when Yang Ping and Su Nanchen went in, Professor Ye had just finished the perspective and determined the position and direction of the drill bit.

Professor Ye didn't speak, Chen Ge and Director Guan didn't speak, they all frowned, and there were many people around the operating room.

Su Nanchen pointed to the patient, and the anesthesiologist said, "General anesthesia!" "It's a lot easier to talk that way.

Professor Ye looked at the image on the screen of the C-arm X-ray machine and wondered how to take the drill bit, he wanted to take it out minimally invasively, that is, not to cut it, but to take it out under arthroscopy, which was very difficult.

How is this drill hit? Professor Ye scolded his mother in his heart, and now he has the heart to vomit blood, if this is in the Third Academy, he estimates that he will scold Chen Ge when he gets off the stage.

Take the drill bit or the first step, after taking the drill bit, but also to fix the fracture, fix the fracture, and reopen the tunnel, generally speaking, only the back part of the condyle is split, does not affect the suspension fixation, now the whole condyle is broken, trouble is dead.

Su Nanchen looked at the screen and was speechless, this patient did not have osteoporosis, let alone pathological factors such as tumors, and the medial condyle was broken and broken into three pieces.

In this case, each step can be counted as an independent and difficult operation, and the combination of several steps is very difficult and daunting.

If it weren't for Professor Ye, who is at the top level in the country, it is estimated that he would have given up the operation, cut it directly, got the drill bit out, fixed the fracture, and waited for a few months, at least three months, when the fracture has healed, and then come to the operation.

Professor Ye deserves to be the top level in the country, not in a hurry, calm and calm, he used nucleus pulposus forceps to reach into the joint cavity, took a little bit from the bone, and handed it to the nurse, who took it with saline gauze.

Professor Ye explained: "Send pathology!" ”

This kind of accidental fracture should not have been, and once it appears, as a rigorous professor, it is definitely necessary to consider pathological factors, especially tumors. For the sake of prudence, Professor Ye took a little bone tissue for pathological examination to rule out tumors.

Arthroscopic drill bit removal is a difficult technical job, which ordinary doctors can't do, and they have to cut it to take it out, but Professor Ye doesn't seem to be ready to cut it, and he plans to use arthroscopy to take it.

The camera found the best angle and saw that the drill bit was stuck in the bone tissue, revealing a little bit, the intercondylar fossa was like a hole, buried in the wall of the hole, not something you wanted to take out, the instrument could not reach, it could not be used, it was stuck in the bone.

The drill bit is hollow, and Professor Ye took a guide needle and passed through the hollow hole in the middle of the broken drill bit under arthroscopic surveillance, to the inside of the lower end of the thigh, through the skin, and poked out.

"The thinnest drill!"

Professor Yip threaded the thinnest drill bit along the exposed guide needle on the inner thigh, made contact with the broken drill bit, pressed against the tip of the broken drill bit, and then removed the drill and pushed the guide pin to the level with the tail of the fine drill.

"Hammer!"

Professor Ye gently struck with a hammer, and slowly broke the drill bit and was beaten out like this.

Sure enough, it's a master, this kind of drill is put in other hospitals, either don't take it, or cut it to take it, and it will be tossed for a long time when it's cut and taken.

Using such a method is very ingenious, but it requires a lot of experience and feel, otherwise not only will it not be able to be removed, but it will also lead to new fractures.

Professor Ye took out the drill bit easily for a few minutes and handed it to the nurse: "Pair with the other half to see if you can match it?" Prepare the C-arm machine for a perspective. ”

If the two halves are combined, if they can be aligned, it means that there is no residue, and if they are not aligned, it means that there is still residue.

Sure enough, the operation was done steadily, meticulously, taken out, and the severed end was also seen through to ensure that nothing went wrong.

The drill bit was taken out, it didn't seem that Yang Ping had anything to do, Su Nanchen thought that Professor Su asked Yang Ping to come over to save Taiwan, but now it seems that there is nothing wrong, so it will not delay people's time.

"Professor Su, if it's okay, I'll send Dr. Yang back." Su Nanchen asked cautiously.

Professor Su said, "Wait! ”

He turned his head to Yang Ping and said, "Xiao Yang, please wait a little longer, is the operation at home urgent?" What surgery? Is it okay to let Nanchen come over and help? ”

Professor Su said so, it seems that if he stays here, there should be something else, and Yang Ping is not easy to go: "It's okay, they can take the operation, but they want me to check it, and it won't get in the way later." ”

"Professor Sue?" Su Nanchen meant, nothing to do, let the family go back.

Professor Su waved his hand, no longer explained, and ignored Su Nanchen.

"Concentrate on it! Let's see how Professor Ye responds on the spot and how to deal with this situation. ”

Could it be that Yang Ping was left behind so that he could learn from Professor Ye? How to deal with this rare accidental comminuted fracture of the medial or lateral condyle in quadruple reconstruction?

"Xiao Yang, it's troublesome, you can arrange things at home." Professor Su commanded again.

Yang Ping responded, Professor Su spoke, what else did he say, follow the instructions.

"How? Keep doing it? Or wait three months later? Director Guan took the opportunity to ask.

In this case, it is generally operated on according to the fracture, the fracture is fixed, after three months, the fracture is healed, and then the ligament is reconstructed, and the difficulty of the operation is not only increased, but there is not much space for the remaining bone to make a tunnel, and even if there is space, many of them are operation dead ends, and a good tunnel cannot be played at all, so the operation will not achieve the effect.

This kind of surgery is not just to reconstruct the ligament, but also to ensure the effect. It's like doing a test paper, you don't chase the grades, just fill the test paper, how easy it is, if you pursue the final high score, you don't just fill in the test paper.

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"Go on! The patient is under general anesthesia, right? Professor Ye confirmed again.

"General anesthesia!" The anesthesiologist replied.

Professor Ye took a short break, and the doctor in the audience was pushing the C-arm machine to see through, and everyone moved away to give way.

"I always say, there is no size of the operation, every step must be careful, we surgeons are walking on thin ice every step, you see, a little careless, something went wrong, if the operation is stopped, the patient is off the stage with a fracture, how to explain? How do you explain it? Delaying the recovery time, affecting the competition period, not to mention, also leaves new problems. Professor Ye's tone was not bad, he just reprimanded, not scolded.

"C-arm machine, push it well, go higher, come in here!" Chen Ge had a bad temper, held his breath in his heart, and poured his anger on the little doctor who pushed the C arm.

Although Professor Ye has a big temper, he will not lose his temper, he is the more demanding kind, if you don't do well, if you don't do as he wants, you will scold.

"Chen Ge, what are you doing?" Director Guan looked at Professor Ye with a wrong look and stopped Chen Ge.

Sure enough, Professor Ye was furious, glaring at Chen Ge, he caused trouble, everyone helped him wipe his buttocks, and he scolded the doctors below.

If it weren't for Professor Su beside him, Professor Ye would have cursed, but Professor Su was beside him, although he was Chen Ge's uncle and a foreign guest, it was not good to scold his doctors in front of Professor Su.

Everyone went out of the operating room, and after the fluoroscopy, they went in to see that the drill bit had been completely taken out without any residue.

"Prepare hollow screws, which are usually used for internal and external femoral condyle fractures, and fix the fracture."

The C-arm machine withdrew, Professor Ye returned to the position of the chief knife, and everyone returned to their positions.

This kind of transarticular fracture, some with cartilage, is very skillful to fix, not only to fix well, but also the position of the nail can not affect the next step of ligament reconstruction to open the tunnel, and the nail head or nail tip must be buried and not exposed.

This step is also difficult to fix the fracture under minimally invasive arthroscopic reduction, Professor Ye grabbed a bone block with grabbing forceps, the grasping forceps are very small, generally not used perfectly, and he can't grasp such a large bone block at all, he grabbed it firmly at one time, put it in the original position, and when the forceps were loosened, the bone piece has not been loosened and fell, and in an instant, Professor Ye used the closed end of the grasping forceps to resist the fracture, and the operation was the same as acrobatics.

"Guide pin drill!"

To fix this bone block, you can't insert the guide needle from the inside, because the intercondylar fossa is an arched fossa, which is equivalent to a hole, from the inside to the outside, there are some dead ends, and this bone block is in a dead end, and can only be driven from the outside to the inside.

Entering from the outside in, he encountered the same problem as Yang Ping's tibial tunnel, which was to snipe at the target behind the wall through the thick wall.

The difference is that Yang Ping's goal is a point, and now Professor Ye's goal is a circle, whether it is a point or a circle, it is very difficult!

From the outside, he pierced the guide needle through the skin muscles, pressed against the bone cortex, thought about it, and then repeatedly moved the needle insertion point and angle of the guide needle, sometimes looking at the electric drill and guide needle in his hand outside, and sometimes looking at the bone block on the screen with the other hand with grabbing forceps.

Adjusted many times, rustling, the electric drill sounded, the guide needle drilled through, hit the bone, came out of a nice position, awesome! Everyone was amazed and almost applauded.

This bone block is relatively small, a screw is fine, and the upper screw can only be from the outside to the inside, after measuring, a half-threaded hollow nail was screwed in, just fixed the fracture, tightly pressurized and fixed, and the tip of the screw entered the subchondral bone, and was not exposed.

The first-class level in the country is well deserved, and when this kind of thing happens, the general experts think that it is a catastrophe, and they directly surrender and are forced to give up the operation. But he could easily continue, and depending on the level of this processing, he reached the peak.

Just this hand sniping the circle behind the wall, this level of drilling into the steel needle, few people in the country can do it, and even less can do it at one time.

Senior brother is really powerful, Director Guan admired this operation, Chen Ge drooped his head, and was glared at by Professor Ye and Professor Guan from time to time, where did he dare to have a temper.

There are three bone pieces in total, and the other one is about the same size, and Professor Ye used the same method to fix the bone pieces with a hollow nail. The last one is larger, and two screws are used, but they are both from the outside to the inside, and the guide needle is accurately inserted at one time, and the position is good.

"That's it! Reopen the femoral tunnel! Professor Ye put down the screw cutter and moved his wrist.

"Still double beams?" Director Guan asked.

It is already very difficult to continue the double beam, and three problems lie ahead.

One problem is that there are four screws that occupy the space of the medial femoral condyle tissue, and the tunnel is easily blocked by the screws.

Another problem, all three bone pieces were reduced, but there were several fracture gaps, and the tunnel was opened to the gap, which was not very good.

There is a third problem, the suspended steel plate needs a certain thickness of leather to bear, and now there are not many such places in the suitable area.

"Of course—" Professor Ye was unquestionable.

Replaced with a single beam reconstruction, the surgical effect will be reduced, this is a professional athlete, people ask him for surgery, is to pursue high quality, if he compromises in the quality of surgery, Professor Ye can't do it.

His professional conscience would not allow it, nor could it be for the sake of his reputation.

Perspective! Another C-arm X-ray machine fluoroscopy, the perspective is to see the distribution of several screws, in preparation for opening a tunnel to avoid the screws.

"Guide pins! Open the femoral tunnel! ”

Professor Yip put the guide needle through the lateral opening and estimated the point.

I tried a few times, shook my head, no, the point out is not in the safe zone. The exit point must be within the safety zone, otherwise there is no sufficient thickness of the cortical suspensory ligament, and it is easy to pull the cortex apart.

From straightening to extreme flexion of the knee, it will not work.

Not from the outside of the mouth, from other positions, puncture the skin, penetrate in, almost the point that can be tried, Professor Ye has tried, but it still doesn't work.

The best position of this tunnel is currently only one direction, there is no room for adjustment, this direction is just a dead end, too tricky.

It seems that only from the outside to the inside.,Use the technique of sniping on the wall.,Last time it was the sniper target of the wall was a circle.,Now it's a point on the target of the sniper.,The difficulty has escalated.。

Today I earned it, and I saw the top bulls in the country performing magic-like tricks, sniping through the wall, or sniping a point, this is a god operation.

The people who observed the operation were all experts, all of them were holding their breath, waiting for Professor Ye's wonderful performance, the operating room was very quiet, and the itinerant nurses walked lightly.

Professor Ye used a ruler to reach in, measured the medial condyle several times under the microscope, planned several lines, and used the intersection of the lines to find the anatomical center of the ligament footprint. Then use a plasma knife to burn a dot mark at this point.

Song Zimo didn't urge, and Yang Ping didn't call back, he kept watching, looking at the whole process of Professor Ye's operation just now, it is really the top level in the country.

Professor Ye held the drill steadily, without the slightest shaking, the technique of holding the drill is also strictly trained, the guide needle is above the medial femoral condyle, the cortex on the inner side of the lower end of the femur, impartial, the hand does not shake or move, very stable.

After adjusting the position and direction of the guide needle many times and observing repeatedly, Professor Ye finally pulled the trigger.

Rustling! The guide pin is driven in, and the place where it is pierced out is about 5 mm away from that point, that is, it is 5 mm off, and if someone else is supposed to be very successful, it can be tunneled.

But he is the first-class level in the country, how can he accept this 80 points, he wants 100 points.

The guide pin exits, and again, this time the distance is closer, and the error is smaller, about 3 mm.

One more time!

It's far again, this time it's almost 7 mm.