After Li Xiyang finished speaking, the entire operating room was as quiet as death.

The two assistant doctors stared at Li Xiyang with wide eyes and like fools.

Dean Li is so polite, you really dare to say it.

And the median nerve in the armpit, why don't you say that there is a tumor in the head?

They were doing surgery on the patient's right index finger replantation, and it was pulled down to the armpit.

However, Li Jingliang stared at the patient's right hand, revealing a thoughtful look,

Turning to the little nurse, he said, "Bring the patient's MRI." ”

The little nurse hurried to find it.

Mo Kai asked in a low voice, "Are you sure you're not mistaken?" ”

Li Xiyang nodded.

It was the median nerve that told him, how could it be false?

After a while, the little nurse found the patient's MRI and handed it to Li Jingliang.

Li Jingliang held the light under the shadowless lamp, and after looking at it for a while, his pupils suddenly shrank.

It's not very obvious, but the patient does have an abnormality in the armpit.

"Xiao Li, how can you be sure that it is a torn median nerve?"

Li Xiyang had already thought of the words, so he was not flustered.

Pointing to the patient's right hand, he said, "During the operation just now, I noticed that the patient's middle finger and thumb twitched. ”

Li Jingliang was taken aback, "I was careless!" ”

The two assistant doctors on the side were stunned, "Dean, what do you mean by this?" ”

At this time, Mo Kai spoke, "The median nerve is a nerve formed in the axillary area by the lateral and medial tracts of the brachial plexus.

After walking along the biceps brachii in the arm, descending to the cubital fossa, the anterior teres biceps are between the superficial and deep flexors of the middle finger of the forearm to reach the carpal tunnel, and the deep surface of the palmoaponeurosis is penetrated to the palm, and it is divided into several common volar nerves. ”

"If the median nerve is damaged, there will be numbness in the thumb, index finger, middle finger, and ring finger near the middle finger, accompanied by convulsions."

"Dr. Li must have discovered this and deduced that the patient's median nerve was damaged."

The two assistant doctors tugged at the corners of their mouths, "Is this okay?" ”

Li Xiyang ignored the two of them, but said to Li Jingliang, "The patient's median nerve is torn, if the finger nerve anastomosis is done first, the finger nerve will be extracted, which will seriously affect the patient's postoperative finger function recovery, so I recommend repairing the median nerve first." ”

"Xiao Li is right!"

Li Jingliang decisively made an incision under the patient's armpit.

really

Median nerve tear!

The two assistant doctors looked at each other in disbelief.

Just by looking at it, it can be judged that the patient has a torn median nerve, is this a human CT machine?

Li Jingliang quickly sutured the median nerve, and the replantation operation continued.

This time, Li Jingliang deliberately slowed down the operation and let Li Xiyang look more carefully.

At the same time, he did not forget to explain to Li Xiyang the precautions for amputated limb replantation.

"When the finger is severed, the bone and joint should be fixed first, then the tendon repair, the finger vein anastomosis, the digital nerve anastomosis, and finally the artery."

The fixation of the bone and joint requires the use of K-wire, stainless steel wire, curved vascular forceps, and needle forceps, and the whole process has many similarities with patellar cerclage.

Finger tendons, which are divided into extendor tendons and flexor tendons.

Repair of extensor tendons should be done according to different disconnection planes:

Repair of flexor digital tendons, mainly of flexor digitoris deep.

When anastomosis of the dorsal digital vein, the blood vessel should be clamped with a vascular clip first, and after anastomosis, the vascular clip should be opened to observe the venous filling.

Anastomostom the digital nerve with the volar side facing up and adjusting the digital nerve tone.

When anastomosis of the digital artery, a flat-tipped needle is inserted into the proximal blood vessel and heparin saline is rushed in to prevent vasospasm.

Finally, there is the repair of the volar skin...

An hour later, the operation ended perfectly with Li Jingliang's explanation.

Li Xiyang bowed to Li Jingliang gratefully, and he gained a lot from this operation.

……

Out of the operating room.

Li Jingliang quipped at Mo Kai, "You kid, you haven't been promoted to director yet!" ”

Mo Kai smiled, "The hospital has regulations, and my seniority is still poor." ”

"What bullshit rules, regulations are used to restrict ordinary people, for talented talents, our hospital has always been eclectic, when you were asked to follow me, you had to go to Yuncheng."

"How about it, do you want to come back and continue to follow me, as long as you come, you will be promoted directly to director, yes!"

Li Xiyang secretly spoke, it seems that Dean Li values Dr. Mo very much.

Mo Kai rubbed his nose, "Teacher, this kid is listening, don't dig a pit for your apprentice!" ”

Li Jingliang pursed his lips, "Are you stupid, you just bring him to the fire." ”

"I like this kid very much."

Mo Kai rolled his eyes, "You're waiting here." ”

"But forget it, let me tell you, it doesn't matter if I leave, if this kid is abducted, our director will have to pick me a layer of skin!"

Li Xiyang smiled bitterly, how could it be so exaggerated.

With Mo Kai's status in the emergency department of the first hospital, even a hundred of them can't be compared.

However, Li Jingliang raised his eyebrows, "If it's Zhang Zhenhua, it's not impossible." ”

Zhang Zhenhua's name is not small in the world,

With his ability, how can he be blind.

"But you really don't want to come to me?"

"Although the comprehensive strength of our hospital is not as good as that of the first hospital, my prestige outside my hands..."

Without waiting for Li Jingliang to finish speaking, Mo Kai pulled Li Xiyang and ran away.

"Teacher, we'll visit you next time..."