Fang Xian just looked around Wuling Hospital for a while, and then returned to the dormitory and didn't do anything more.

Fang Xian couldn't do anything to other hospitals.

The next day, in the operating room of Cixian People's Hospital.

A total of two surgeries were arranged, and the first one was to arrange Fang Xian's release surgery.

In fact, surgeries such as release should be arranged after open reduction and internal fixation of fractures. However, it may be that Huang Bohang is trying to give Fang Xian face, so he will be given in advance.

When Huang Bohang personally served as an assistant, Chen Fangling's choice to be the chief surgeon disappeared without a trace, and the other party said: "Doctor Fang, we still rarely come into contact with such a disease in our hospital. ”

"Doctor Chen, he basically has no experience, so you should personally guide and lead it, Doctor Fang, right?"

"Chen Fanglu, what do you say?"

Huang Bohang is not only the deputy chief physician who leads the group, but also the director of the ward, Huang Bohang said so, so how can Chen Fangjun not give Huang Bohang face.

"Director Huang, what you said is reasonable, but I didn't think about it before, and I have a hot brain." Chen Fangjun temporarily retreated.

At this time, Zhou Xiyin, who was not on stage, opened his mouth and said: "Director Huang, since Senior Brother Fang is in the operating room today, why don't you let Senior Brother Fang do two teaching operations, Director Huang, what do you think?" ”

Huang Bohang's eyes narrowed slightly when he heard this, and asked, "Doctor Fang is also involved in fracture surgery?" ”

It seems to mean that trauma surgery is his family, and although Fang Xian's basic skills are solid, this is for emergency first aid such as trauma centers, which does not mean that the specialty is powerful.

Before the medical association came out, first aid such as emergency departments and trauma centers were just transit stations for clinical departments, and there were not too many delicate operations at all, but only developed in recent years.

"A little bit, Director Huang." After Fang Xian politely replied, he stopped being entangled, picked up the scalpel, and began to operate.

Although it sounds like a simple release technique, the release of the calf throughout the whole process is not easy to operate.

The difficulty of the operation, the area of the operation, the scope of the operation, and the things that need to be grasped delicately are quite complicated things, which are equivalent to Fang Xian having to turn over the whole leg as if it were a cultivated field.

And this happens to be the organic integration of various concepts such as curettage and blunt puncture in debridement level 4.

In the whole operation, there are not too many bells and whistles, only solid and shocking basic skills.

"It's the gastrocnemius muscle."

"Tibialis anterior muscles, this is the ......" Fang Xian began to explain to Huang Bohang and others in the process of relieving them, and when loosening the muscle scars, if they encountered blood vessels and nerves, Fang Xian also protected the nerves very well.

As the operation continued to progress, Huang Bohang changed his thoughts and thoughts slightly: "Doctor Fang, this full-thickness calf release surgery still looks extremely decompressing. ”

Regardless of whether Huang Bohang admits it or not, the patient with the kind of muscle interstitial adhesion is extremely decompressing in the process of the adhesions being continuously removed and separated.

"Director Huang, in fact, the most decompressive feeling is the feedback of patients after surgery."

"Once the lower limbs are adhered to, to them, it is just a stone, as if it is not their own foot, it is a foreign body."

"And once they are relieved, even if there is a painful activity, it will make them feel relieved."

"This is the inner and outer head of the gastrocnemius muscle, and the ...... between the inner and outer head of the gastrocnemius muscle," Fang Xian continued to say solemnly.

Huang Bohang's face immediately changed.

"Eh, eh."

"Doctor Fang, you can't enter here, this is the popliteal fossa." Huang Bohang immediately spoke out to persuade him.

Basically, orthopedic surgeons know that orthopedics generally speaking, there are four forbidden areas, which can not be opened without opening.

One is the axilla, one is the femoral artery sheath, the other is the popliteal fossa, and the last one is the retroperitoneal hematoma.

Because of these four places, the shape of the blood vessels is particularly complex, and the position is relatively concentrated, as long as in the process of operation, if there is a little deviation, it may lead to damage to multiple nerves and blood vessels, resulting in massive hemorrhage.

Generally, prefecture-level city hospitals will call these four places "no death and no entry".

Unless the patient has to go in to stop the bleeding, otherwise, go up, I can't handle it here.

Fang Xian, a good guy, performed the first operation alone, and pestle the popliteal fossa.

However, it is impossible for the sound to stop the movement of the main knife.

"Director Huang, do you have a certain degree of misunderstanding about the complete release technique?"

"The gastrocnemius muscle is an important part of the calf muscles, and the popliteal fossa is the starting point of the posterior tibialis muscle shape, which naturally needs to be released, otherwise, there will still be postoperative local insufficiency."

"Doctor Chen, look, this is the popliteal nerve ......" Fang Xian pointed as he pointed at Chen Fangjun and Du Lixiao.

But at this moment, both of them had faint numbness in their scalps.

Even if they all felt that Fang Xian was a master of art and bold, but at this moment, Fang Xian was playing like this, and it was already beyond their psychological bottom line.

You have to be careful, if there is a little deviation, it is possible that we will have to open the popliteal fossa for vascular exploration, and there is no vascular surgery consultation in our hospital.

However, it is obvious that Fang Xian's operation process is still very fast, and there is no danger all the way.

And, after the release, Fang Xian said: "After the release, the bleeding point of the wound must be cleaned, otherwise, there will be hematoma left in the muscle space, and the chance of re-adhesion will become very large." ”

"If this can be done well, and then combined with nerve block to relieve pain after surgery, the patient's postoperative pain can be controlled to a certain range, then the patient is also willing to avoid the recurrence of adhesions through functional exercises. The postoperative results are worth looking forward to......"

Although Fang Xian said this, it seemed that Fang Xian's operation at the moment scared Chen Fangjun and Du Lixiao.

The eyes of the two were jealous, and they looked at Fang Xian as if they were looking at a madman.

After all, Fang Xian is a person who took a scalpel and said that he would enter the popliteal fossa, even if such a person is skilled, he is still a dangerous element.

Of the 1,000 patients, you have treated 999 of them, all of them deserve it, and if there is one injury caused by unnecessary injury, that is the culprit, and this is the medical industry.

But in fact, Fang Xian felt that the debridement of the popliteal fossa was fine, but the worst thing was vascular nerve damage, and then sutured up, how terrible could it be?

The popliteal fossa is a place where the blood vessels and nerves of the lower limbs are densely formed, and in the case of a tourniquet, even if the popliteal artery is ruptured, the amount of bleeding is extremely limited, which is not so scary.

Just stop the bleeding.

……

Half an hour passed, Huang Bohang and Chen Fangjun took turns to persuade Fang Xian, hoping that Fang Xian would be a little more stable in the future operation process.

"Doctor Fang, the patients and the medical association have very high expectations for the tasks that our county hospital needs to undertake, as long as we can ensure basic diagnosis and treatment services."

"Conventional diseases can be treated, common emergencies can be treated urgently, and the ability to achieve transport in necessary special circumstances is already the limit of what we can do."

"We just need to keep the limit, and there is no need to create the limit." This was said by Chen Fangjun.

And Du Lixiao also said: "It's such a doctor, you see, we must be different from the Affiliated Hospital of Shonan University, at least, the anesthesiologist here is not as good as the professor in the Affiliated Hospital of Shonan University?" ”

As he said this, the anesthesiologist who was anesthetizing the fractured patient took a look.

His brows froze slightly, and after thinking for a while, he said, "Doctor Fang, you are an expert in a big hospital, and a small place like ours can't withstand such a toss from you." ”

"When you entered the popliteal fossa just now, I was too nervous here."

"Hmmm! Okay, teacher, I'll pay attention to it later. Fang Xian immediately nodded back.

The anesthesiology department is not an orthopedic department, it is another department, and the relationship with other departments is the relationship between departments, and it is impossible for Fang Xian not to take care of their emotions.

Naturally, the emotions of Huang Bohang and other doctors in this hospital should also be taken care of.

The second patient was a patient with a fracture of the nature of a double tibia and fibula.

The diagnosis was clear, and there was an indication for surgery, so surgery was scheduled.

And because of Zhou Xiyin, in order to take care of Fang Xian's face, Huang Bohang also handed over the authority of the main knife of this operation to Fang Xian.

Fang Xian is the attending physician, and he performs fracture incisional reduction and internal fixation, which is still no problem.

In the medical association's assessment of the level of trauma surgery physicians and the management of surgical authority, fracture open reduction and internal fixation is the foundation of the foundation.

"Dr. Fang, do you plan to do traction before the surgery, or do you want to do traction reduction temporarily during the operation?"

came to his own industry, Huang Bohang is quite professional.

The treatment of fractures focuses on reduction, fixation, and functional rehabilitation.

All health care workers can offer their patients is reduction and immobilization.

And it is reduced first, and then fixed.

After the patient is anesthetized, the surgeon can try to reduce the reduction in advance to see if he can do the reduction well or partially under the patient's painless situation, so as to slow down the workload of traction reduction in a sterile state during the operation.

Fang Xian said, "Director Huang, then I'll try to reset it before the operation." ”

"Shein, you come and wear a sterility examination glove and cooperate with me."

Zhou Xiyin nodded hurriedly when he heard this, hurriedly went to get the gloves, and handed one to Fang Xian.

Everyone did not doubt him, but Huang Bohang instructed resident doctor Ning Han to hurry up and prepare for the irradiation of the C-arm machine.

After each reduction, a C-arm fluoroscopy, which is a simple X-ray, is temporarily found during the operation.

In the operating room, as long as you see the chief surgeon and anesthesiologist and others, they are all running out of the operating room one after another, basically orthopedic or spine surgery doctors, using the C-arm machine to do things.

Intraoperative temporary fluoroscopy, which is very commonly used.

Then, Fang Xian and Zhou Xiyin cooperated slightly, doing the traction and reduction of the lower limbs.

The operation is naturally not gorgeous, it is a manual reset.

However, there is nothing eye-catching between the two people.

After the cooperation was completed, within the visible range of the naked eye, Huang Bohang, Chen Fangjun and others saw that the deformity of the patient's right lower limb after the tibia and fibula fracture disappeared.

Let all the knowledgeable people in the operating room rub their eyes violently.

The diagnosis of fracture lies in the following points.

One is the patient's pain, the second is local swelling, the third is the deformity of the affected limb, and the fourth is the physical examination and auxiliary examination showing signs of fracture.

The pain is not felt by the anesthetized patient and the swelling continues.

But the deformity disappears, as if symbolizing something.

Huang Bohang couldn't believe his eyes, and then instructed Ning Han to quickly push the C-arm machine closer, and then everyone went out, in the isolation room, after stepping on the foot-pedal shooting pedal, the image of the patient after repositioning appeared in everyone's field of vision.

As soon as the results of the plain X-ray appeared on the display screen, even Zhou Xiyin was stunned and bowed forward, and glanced at Fang Xian from time to time.

The innocent eyes seemed to say, Senior Brother, we didn't agree on this before?

Didn't you say that it was better to conquer with technology?

Fang Xian touched his nose at this moment, and said softly: "Director Huang, it seems that the reduction is not bad, the fracture line is almost hidden, whether it is the fibula or the tibia, it is the same. ”

"And there is a certain chimeric alignment at the broken end of the fracture, there is no lateral displacement and shortening, if you take a lateral view, there is no anterior and posterior angular displacement, is it possible to look forward to..."

Before Fang Xian's words were finished, Huang Bohang hurriedly instructed Ning Han: "You go in first, change your posture, and take a side film." ”

Huang Bohang's scalp was faintly numb.

It stands to reason that Fang Xian, a person from a trauma center, could not have such a high attainment in trauma surgery.

He understood what Fang Xian meant, Fang Xian was saying, is there no need for surgery now.

Direct manual reduction with plaster external fixation can end the operation.

Huang Bohang couldn't be sure, Fang Xian was angry, one was that he felt that he had told Chen Fangjun and others before that Fang Xian had too many scenes and didn't need too many operations, so he directly drew his salary from the bottom of the kettle and gave a second operation, then don't do it.

The second breath is that Fang Xian is deliberate, deliberately tempting.

Fracture manual reduction is the basic skill of trauma surgery, which is the foundation of improving fracture open reduction and internal fixation, and can be said to be the core of this type of surgery.

Fang Xian is now showing such a high-quality and proficient technique of reset, is he just waiting for himself to find him, come to a Jiang Taigong fishing, and the one who wishes to take the bait.

Huang Bohang didn't like all the basic operations such as hemostasis and debridement of Fang Xian, but this manual reduction technique hit the biggest G-spot in his heart, and he had to envy and covet it.

In grassroots hospitals, who cares how solid your basic skills are, and being able to learn specialized skills well is the greatest ability and the most able thing to help people eat.

However, thirty seconds later.

Huang proved his guess right.

Everyone in the operating room, including the busy instrument nurses, itinerant nurses, and anesthesiologists, fell silent.

As soon as the operation began, it seemed like it would be over......

Fang Xian sat firmly on the Diaoyutai platform, looking indifferent, he was only responsible for the operation, and he was not responsible for talking and signing. Anyway, the current reduction effect is here, whether to continue excessive medical treatment or not, it only depends on Huang Bohang's attitude.

(End of chapter)