The manifestations and principles of manual reduction of fractures are similar to those of joint dislocation to a certain extent.

So much so that Fang Ziye has not seen the downstream skills of manual reduction on the panel, and there is also the distinction between fracture and joint dislocation manual reduction.

However, manual reduction does have its advanced curve-

Pry reduction, rotary reduction, squeeze reduction......

The proficiency of these downstream skills is not particularly high, but Fang Ziye feels that the current proficiency of the manual reduction technique is enough.

After silently thinking about the principle of manual reset mentioned by Huang Haitao, he could only ponder and speculate on the corresponding manual reset ideas by himself.

It is equivalent to the internal stability of the fracture and the broken end of the bone through anatomical compression, and then assist the external fixation of the plaster cast to achieve the effect of fixation, which is the most basic principle.

However, how to compress the broken end of the fracture to the corresponding benefit, how to pull it, and remove the traction force at the right time, so that the broken end of the fracture is just retracted, this is the difference in the form of expression.

Huang Haitao and the others did not disrupt Fang Ziye's thinking, and Huang Haitao didn't know what Xue Tao said about Fang Ziye's technique reset a bit of kung fu, what kind of kung fu it was.

However, just a minute later, Fang Ziye came to the patient.

But the strange thing is that Huang Haitao did not find that after the patient knew that the person who reset him was replaced by Fang Ziye, he had the opinion of rejection and rejection.

Instead, he said, "Doctor Fang, in the end, you still did a manual reset for me?" ”

Yesterday, when Fang Ziye was doing the manual reset, he was outside the operation room with his family, looking at those who could line up with some envy, because these people can go home after two clicks of the reset.

But he had to be hospitalized, operated, injected, recovered, and had his blood drawn.

Now that it's finally his turn, he's actually looking forward to it.

Moreover, how many patients did Fang Ziye reset yesterday? It was all from Fang Ziye's own eyes that he had seen Fang Ziye send people out of the department.

Hearing is false, seeing is believing, Fang Ziye has kung fu in his hands, and he is not empty-hearted.

"Well, don't be nervous, there are a few directors watching next to me, if I can't do it, Director Huang and Director Wu will definitely be able to do it." Fang Ziye slowly calmed down, and at the same time saw that Xue Tao had arrived at a fixed position to prepare for anti-traction.

Fang Ziye was no longer entangled, and grabbed the right position for traction, and the biceps brachii in one hand and the muscles in the forearm were all raised.

Orthopedics, whether it's joints or trauma, or other subspecialties, requires a lot of effort.

Fang Ziye is not tall and does not have adiptocystic muscles, but his strength is definitely not small, after all, he has been working in the trauma surgery department of Zhongnan Hospital for more than three years.

Moreover, Fang Ziye found that when his manual reduction technique was at level 3 proficiency, he could already rely on all his own strength, and the level 4 manual reduction technique was even more so, Fang Ziye could use the dexterity of muscle disformation and appropriate part of the strength as traction.

This is Fang Ziye's unique discovery, he doesn't know if he understands wrongly, he doesn't dare to ask, and he doesn't know if others do the same.

The purpose and direction of traction are actually relatively pure, which is to allow the displaced fracture to be fully traction and the broken end of the fracture to be separated.

This process requires strong traction, but the patient will not be painful, but will have a stretching sensation.

This is the difference between manual reduction of fractures and manual reduction of joint dislocations.

When the manual reduction of the joint dislocation is continuously stretched, there will be a fear of pain, and the manual reduction process of the fracture is because the displacement of the fracture is pulled away, and the pain will not appear or even disappear after the broken end of the fracture is separated.

The patient was prepared for pain, but he didn't expect that after the pain was relieved, his breathing rhythm gradually stabilized.

Seeing this, Fang Ziye knew that his traction this time was in place.

Then, a scene that was very difficult for everyone to understand appeared.

Fang Ziye, who was originally using both hands for traction, actually took off his left hand at this moment, and then used his left hand to touch the position of the patient's fracture, while the other hand continued to pull like this, as if it was easy.

In an instant, everyone's faces changed dramatically!

This scene is really too incredible.

Big brother, that's the patient's leg, how about you respect the proverb, the arm can't twist the thigh, even if it is the continuous traction stage of traction, you can pull it with one hand?

How strong is this muscle on Fang Ziye's body, and can one punch kill someone?

Everyone's first reaction is that Fang Ziye's strength is super strong, and he is an absolute good orthopedic seedling.

Great strength, in the eyes of orthopedic surgeons, is an absolute talent.

But in fact, Fang Ziye was just skillfully appropriating part of the traction of his muscles at this time.

The strength he used himself was only forty percent of his whole body strength, and his forty percent strength would naturally not be small, and it was easy to lift fifty or sixty pounds, but it was not as powerful as others imagined.

Naturally, Fang Ziye's focus at the moment is not at all on the performance of others.

Rather, Fang Ziye was thinking about how to use the strength of the muscles to bounce back or squeeze the displaced fragments that were not directly connected to the fracture by lifting a part of the muscle adjacent to the broken bone in the middle of the fracture, and squeezing it to its original position.

Anyway, Fang Ziye didn't know why he had such thoughts, but Fang Ziye could do this.

Therefore, in the eyes of others, Fang Ziye's operation was just to touch the broken end of the fracture a few times, and then press the surrounding muscles.

After pressing the muscles, through the force of the elastic muscles themselves, the fracture fragments came into contact with the broken end of the fracture, and Fang Ziye began to slowly loosen the traction force.

The rebound force of joint dislocation is very strong, but the rebound force of fracture is not as explosive and violent as the rebound force of joint dislocation.

As a result, there is no so-called click.

can see Huang Haitao, who saw this scene, his eyes were about to protrude.

The eyes are anxious, as if there are more than 10,000 questions, and the mouth opens and closes, but it seems that there is no strength to pronounce syllables.

Because shock is not a bad pen, the remaining IQ let him know that at this time, even if he was slashed, it could not affect Fang Ziye's most critical operation link.

What about shock?

Fang Ziye felt the broken end of the fracture, and after the anastomosis was relatively good, he gradually and completely relaxed the strength of his right lower limb.

The proximal and distal retraction of the fracture and the fracture fragment in the middle are stuck together under the retraction force of the muscle, and at this moment, there is a slight pain.

"Ouch." The patient's stretched brow furrowed slightly at the pain and let out a dull moan.

It's not too big, because the pain stimulation at this moment is at most a bee sting, and it is the pain at the time of the sting, not the burning pain of the bee venom after the sting, so it is acceptable.

When he opened his eyes and saw that Fang Ziye had already unloaded, Xue Tao naturally followed Fang Ziye's rhythm and relaxed his strength, so he asked, "Doctor Fang, have I already been reset?" ”

Fang Ziye is also not sure, because according to his usual understanding, this patient is not suitable for manual reduction, but if it is evaluated according to the reduction effect of manual reduction of fractures-

Before Fang Ziye could reply, he was squeezed away by an ass.

It was because he couldn't hold back his shock anymore, and after seeing Huang Haitao after Fang Ziye's operation, he squeezed away half of Fang Ziye's body with his buttocks, and immediately went to the patient's right lower limb, and then touched the patient's lower limb fracture.

The movement is gentle but powerful, which does not make the patient feel extra pain, but the pressure is not small, which is also a lot of effort.

This is his unique way of diagnosis, and Fang Ziye is difficult to understand.

However, it was only after half a minute that he changed from bowing to standing up, and then looked sideways at Fang Ziye and became thoughtful.

"Director Huang, how is it?" Wu Guonan hurriedly asked.

I was a little anxious, but it was okay.

Because of Huang Haitao's anxious performance, he would subconsciously think that Fang Ziye had made a bad result.

However, Wu Guonan himself is not a pure second-hand, he has no thinking of his own at all, as a very professional trauma surgeon, how to assess the quality of fracture reduction, he can be sure.

The disappearance of the fracture deformity, the patient's pain relief, and emotional relaxation are the most superficial indicators of reduction.

Specifically, it is still necessary to rely on plain X-rays to finalize.

Huang Haitao thought for a while: "It should be good, but I'm not good at appraising, so I'd better wait for the X-ray results, right?" ”

Huang Haitao said, his face full of hesitation and disbelief.

Hearing this, Fang Ziye and Xue Tao hurried to get a plaster.

The purpose of manual reduction is only reduction and preliminary fixation, and if it is really necessary to fully achieve the reduction and fixation of the absolute principle of fracture treatment, external fixation is also needed to assist fixation, otherwise there is no plaster cast, in case of repeated misalignment, it will be another fracture story.

The process of applying a cast is not slow.

After listening to Huang Haitao's words, Wu Guonan still asked politely: "Director Huang, so for now, there is no need to make corrections for the time being, and then talk about it after reading the results?" ”

Huang Haitao glanced at Wu Guonan very seriously, he didn't see the banter in Wu Guonan's eyes and expression, and he didn't hear the weirdness of yin and yang, so he nodded.

The re-examination items of the patient's X-ray examination are prescribed in the doctor's order before the reduction, and the examination list is given to the patient and the family, so the patient only needs to be pushed down by the family after the cast is fixed and the cast is applied.

The setting time of the plaster only needs to be waited outside the operating room.

Xue Tao and Fang Ziye went out together and made a corresponding explanation: "After the review, you don't have to wait for the results, you can come up directly first, we can watch the results of the film directly in the ward, and after two hours, the family members can print it out." ”

"In five minutes, you can go downstairs to the X-ray room."

"It's where you took the film yesterday, right? Doctor, is the reduction okay? The patient's family members were his wife and son, and the wife was the one who asked the question, and the son helped the father to the cart while asking how he felt......

After Fang Ziye and Xue Tao entered the door again, Huang Haitao, who had been talking to Wu Guonan, looked at Fang Ziye suspiciously and asked, "Doctor Fang, when you reduce the position, can you mobilize a few muscles around the fracture?" ”

“？？？” Fang Ziye was stunned when he heard this, and cast a puzzled gaze in the past.

After a few seconds, seeing that Huang Haitao still didn't explain, he asked, "Director Huang, can you make it clear?" I'm a little confused about what you mean. ”

What mobilizes several muscles around the fracture? Is it saying that I will use some of my ingenuity when I reset the technique?

I haven't done this thoroughly.

Wu Guonan and Xue Tao heard the conversation between the two and looked at each other, Wu Guonan's eyes looked directly at Xue Tao, and Xue Tao consciously came to Wu Guonan's side again, and explained in a low voice some details of Fang Ziye's joint dislocation manual reduction yesterday.

At the same time, Huang Haitao was a little entangled before explaining: "That is, according to our traditional Chinese medicine statement, when resetting, the operator's own power is used in the early stage. ”

"Then there is the ability to call on a part of the inter-articular skill, and further on the use of muscle skill as an auxiliary role in reduction."

"Some people can call one to four or five bars, using elastic force or thrust as the lateral force of the fracture fragment when reducing it."

"For example, if I say that, at the moment I can only use three muscles in the same patient as an aid."

When Fang Ziye heard this, he was a little foggy.

He shook his head blankly: "Director Huang, maybe your understanding of the realm is too profound, I don't know." I don't know much about the theories in Chinese medicine, I actually solve problems according to the thinking of modern medicine, such as traction, release, reduction, and prying. ”

"I don't know what the muscles are mobilizing, but I will think of the muscles as a variant of the pryer, and after thorough traction, let the broken bones be pulled to where they should be."

Fang Ziye has never heard such a statement in Zhongnan Hospital, even Professor Deng Yong, occasionally when doing osteotomy and orthopedics, also said that if it is a closed reduction, which muscles can be used, which may become an auxiliary point for manual reduction, but only experience to summarize, there is no theoretical support.

What is not supported by theory can only be taught as popular science and experience, and cannot be fully believed or disbelieved.

Huang Haitao's face continued to be suspicious, and in addition to being uncertain, he was a little more melancholy, as if Fang Ziye's appearance made him appear in this ward, which was very embarrassing.

After the first patient went out, the second patient came in very quickly.

This time, Huang Haitao reined in his sharpness a little, he felt that Fang Ziye was definitely not simple, so he asked Fang Ziye to try it directly?

Fang Ziye immediately shook his head like a rattle, and explained in a low voice: "Director Huang, I can't do this, I can't design it now, according to my understanding, this patient should be surgically treated." ”

"If it is possible to reset the position manually, I have already suggested to Director Wu and Director Xue, and I will not wait until now."

To know is to know, and not to know is not to know.

Fang Ziye can advise patients who can't be reduced manually to go for surgery, and can also suggest some patients who can't be reduced manually without surgery, this is an equal exchange and suggestion, Director Wu can not choose, but Fang Ziye will also suggest this and fulfill his duties.

Fang Ziye's words instantly embarrassed Huang Haitao.

But if you look at Fang Ziye's expression carefully, it doesn't look like teasing. So he passed his own theory again, dismantled it again, and asked if Fang Ziye could do it.

When Fang Ziye heard this, he nodded: "So that's the case, Director Huang, I can give it a try." ”

Fang Ziye gradually understood something.

The indications and contraindications of TM's own belief in manual reduction have completely become the prison circle of their own thinking, and this prison circle, even if their own manual reduction has reached a very high level, still cannot break the shackles of thinking and cognition.

Huang Haitao is different, he theoretically does not particularly recognize the kind of guidelines, indications and contraindications that modern medicine follows, so he can easily list some methods and routines that are difficult to reset according to common sense.

Fang Ziye's operation level is no problem, after designing the corresponding routines and methods, Fang Ziye's side can repeat.

It didn't take much effort, the second patient, Fang Ziye, was also assisted by Xue Tao, and with a few clicks, he was reset......

When Huang Haitao saw this, he only felt that he had seen a ghost.

At that time, Wu Guonan was pulled out of the door, leaving only the operation room, Fang Ziye and Xue Tao looked at each other.

After about a few seconds, Xue Tao didn't see the two directors come back, so he turned his head to look at Fang Ziye and said, "Ziye, your technique of repositioning is at a very high level, it doesn't surprise Director Huang Haitao, it all shocked him." ”

Amazing and shocking, are completely different moods.

Fang Ziye thought about it seriously, and while watching his super large amount of knowledge points enter the account, the ups and downs of his mood became even more intense.

"Knowledge +74!"

"Knowledge +81!"

The two patients, two reductions, directly caused Fang Ziye's knowledge points to skyrocket by 155 points at once, is this considered to poke into the nest of knowledge points all of a sudden, making the knowledge points overflow directly?

Fang Ziye guessed that this might be the case.

And, the reason why this is the case, Fang Ziye speculates, may be related to the current guidelines for the treatment of fractures.

After all, the current manual reduction cases done by Fang Ziye are, to a certain extent, a product of the reverse guidelines.

Let's put it this way, if you go down the guidelines, you will only produce standard surgeons at most, but once you go against the guidelines, the results will be very extreme, either to desperation, or to nirvana and rebirth.

Why is there so much knowledge about manual reduction of fractures?

Because it is new, the understanding of it, the existing theories, are too shallow, they are immature systems, and they are the breaking points that can be worth going deeper.

What is knowledge, new cognition is knowledge.

Fang Ziye's heart was pounding-

(End of chapter)