medical simulator

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"It may cause oblique fractures to be shortened and shifted obliquely, and eventually lead to operation failure. This is also the step of internal fixation with small incision open reduction and internal fixation, which is more restrictive."

"When oblique fractures, be quite aware of this."

"But if we fix it horizontally first, we can avoid this from happening."

There is sliding in oblique row, and the tendency of sliding is great.

Zhou Cheng continued: "For oblique fractures, simple parallel fixation with Kirschner wires cannot achieve the fixation effect, so we'd better add internal fixation. The internal fixation device is square fixation. Together."

"At this moment, opening the internal fixation mushroom fixation device will no longer lead to the deviation of the fracture, and the preoperative manual reduction is excellent, so this belongs to compression fixation."

"This is borrowed from the principle of the compression screw."

As Zhou Cheng said, he opened the umbrella frame of the mushroom internal fixation device and pierced into the bone marrow cavity!

"This is the second fixation device, which prevents front-back, left-right, and left-right misalignment to a certain extent, because it is multi-axial fixation, and it can just fill the bone marrow cavity in a fully stretched state."

"But that's not enough. We also need to fix it with the steel wire of the coat to prevent lateral displacement. This is the idea of ​​using the steel wire of the patella fracture."

After speaking, in order to verify his theory, Zhou Chengcheng took another perspective.

After the fluoroscopy this time, Landscape Star heaved a long sigh: "Practice what you have learned and bring forth the new. Xiao Zhou did a good job in this surgery."

Blue out of blue is better than blue, and blue out of blue.

When everyone can understand and can find reference objects, and then use them together, this is to bring forth the new through the old.

With the internal fixation method that everyone is familiar with in the past as a reference analysis, everything is natural.

Are you familiar with compression screws, open reduction and Kirschner wires for patella fractures, and internal fixation with steel wires?It couldn't be more familiar, this is a classic technique, which has been verified many times in history.

"That's right, these techniques and theories are actually what we see every day. Xiao Zhou really has a thorough understanding of these things, so that he can quote from side to side."

"Xiao Zhou's mastery of the knowledge system has reached a certain level." Hu Xianhe also said the same.

Then, he said: "It is still the same for the upcoming project of our research group."

Speaking of this, Hu Xianhe stared at Zhou Cheng.

That stupid student of mine had no problem with his IQ, but Zhou Cheng was controlling him to death, which made him feel uncomfortable.

Zhou Cheng knew that he was suspected of taking advantage of Yu Heng, but he also had no regrets. It was Yu Heng's own suggestion, and he just gave a certain amount of help.

But after all, he still took advantage of it and did not act obediently: "Thank you, Mr. Hu, and thank you, Professor Jing, for your compliment."

"After this step in the operation, the surgery can actually be over. However, to be on the safe side, we still need to add an extra step, wire binding!"

Zhou Cheng then changed the subject: "What if the patient can rest after the operation? But if it is still necessary to get out of bed early, then it is necessary to fix it as much as possible."

After the operation, if you want to get up early for activities, you must be absolutely fixed, otherwise, the operation is no joke, how can you go to participate in any activities so quickly?

Upon hearing this, Director Zheng said, "Thank you, Doctor Zhou, if it wasn't for you, I really don't know what to do today."

"Each step, although it looks simple, is actually thrilling, and I'm afraid it can't be repeated."

Xue Xiude shook his head: "Director Zheng, it's better not to repeat this kind of operation."

Medicine does not allow showing off skills, whether it is Xue Xiude, Jingxing, or even Zhou Cheng, seeing this case for the first time, the preferred treatment plan is still a very safe traditional treatment method.

The pursuit of beauty is more important than the pursuit of quality, and the quality of medical treatment is undoubtedly more important.

If it wasn't for Director Zheng's secret assistance and the patient's own special requirements, this small incision open reduction and internal fixation should not be officially carried out.

Thinking of so many ways, don't you think it's a brain-consuming thing?

Director Zheng is also an old fritter, so he naturally understood Xue Xiude's meaning: "Professor Xue, this kind of thing will never happen again next time."

Although the idea of ​​this operation is borrowed from many previous operations, the operation is very difficult, and if you are not careful, it may fall short. Even if it is successful, the patient will have to bear various risks.

Although Director Zheng took the risk by himself, if something really happened to the old man, it would be a big obstacle to the promotion of small incision open reduction and internal fixation in the end.

In the current situation, I don’t know how many people hope to find out the limitations and defects of small incision open reduction and internal fixation, and then put them into the prison, so that they will never be reborn forever.

It's just that now, there are still curative effects, backing, and funds.

Zhou Cheng remained unmoved, and still cautiously added a third layer of steel wire binding.

I saw that Zhou Cheng tied the steel wire into a certain shape in advance, similar to a spring, and then sent the distal end into the opening.

Outside the periosteum, it is close to the muscles. What Zhou Cheng needs to do is to let the steel wire wrap around the bone. The difficulty of this step is also unimaginable.

Even in the cut state, the placement of the steel wire still requires the aid of formulas!

But I saw that Zhou Cheng fed the steel wire in as easily as turning a screw, and then took out the wire head very simply from the incision below.

Seeing this, including Professor Xue Xiude, the scalp was numb, and the muscles in the hands were extremely stiff.

This is the most difficult step in this operation, even more difficult than blind drilling into the hole of the internal fixation device. They thought that Zhou Cheng would spend a lot of time!

but?

It seems that this is not the case.

Several people were stunned for a moment, their tone was not calm, Landscape Star even grabbed Zhou Cheng's hand, looked carefully for a while, and said in a trembling tone: "Xiao Zhou?"

"This unscientific!"

Chapter 285 It's hard to live up to the reputation

Jingjingxing made a mistake that no intern dared to make. The most the interns would do was pick up the dropped equipment, but Jingjingxing grabbed Zhou Cheng's hand directly.

Fortunately, Zhou Cheng didn't have a knife in his hand, otherwise, the consequences would be disastrous.

But in fact, Zhou Cheng's operation made it difficult for him to understand.

Zhou Cheng's hand was very strong, and despite the landscape star's tight grip, it remained motionless!

Hu Xianhe stood next to the landscape star, although he was also inexplicably horrified, but he still silently grasped the wrist of the landscape star, and pulled it hard.

I thought to myself, Professor Jing, although you are the head of the trauma surgery group and a very prestigious professor of trauma surgery, but this is in an outer hospital, it is a bit inappropriate for you to lose your composure.

According to the strict calculation, if you directly grab the hand of the surgeon, it can be regarded as a medical malpractice.

Director Zheng and Xue Xiude also looked at Landscape Star.

Landscape star belatedly let go of his hand silently, but his eyes were still focused on Zhou Cheng.

Surgery is not a child's play, and the operation is not fantasy and magic, it must be reasonable.

There are various layers of muscle tissue around the femur. Even if you want to wind the steel wire during open reduction, you have to rely on the formula to assist, which is just a circle.

After you come down for many laps, you can directly rotate your head from top to bottom without any hindrance.

This must be unreasonable, what do you take the soft tissue around the bone as?

Zhou Cheng thought for a while, looked around expectantly, and explained in a low voice: "Professor Jing, I'm sorry, I can't answer this question right now."

"Eh!~" Landscape Star, who had already let go of his hand, blinked.

"Is it convenient to say?"

I didn't blame it, and I didn't dare to.

Today's Zhou Cheng is not just a simple graduate student, nor is he a simple little doctor. He is a doctor who can do research projects and is very strong. He can already be regarded as comparable to them.

Whether others can operate, you are optimistic, and then ask the bottom line, who gave you the courage?Sister Liang?

Whether or not to explain an operation, and how to explain it, are directly related to who the operator is.

If Zhou Chengruo is penniless, if he does an operation that others can't understand, he will have to explain a lot, because others can't understand, and the responsibility lies with others, so you need to know what your principle is.

But that was before.

Today, Zhou Cheng has not only won the approval of Gui Lao by relying on his own strength, but also single-handedly worked out a clinical project of small incision open reduction and internal fixation.

Even Hu Xian and the new subject over there are inextricably related to Zhou Cheng.

On such a basis, Zhou Cheng can naturally choose not to answer, or even block you with the confidentiality of the subject.

Zhou Chengcheng thought for a while and replied, "Professor Jing, it's not yet time. Let's continue with the operation."

Hu Xianhe also hurriedly said: "Professor Jing, the key point today is this operation, not the cause and effect and academic discussion, why don't we take some time to discuss this issue slowly."

"I still feel that Xiao Zhou's operation is extremely smooth, there is no doubt, and there is no need to waste time on topics that have nothing to do with the quality of the operation, right?"

Although Yu Heng was "sold" by Zhou Cheng and was still helping to count the money, one thing that is undeniable is that Zhou Cheng really helped Yu Heng in guiding the project ideas.

Moreover, objective auxiliary tools were given, that special sutures should be used, although in the end it would be to promote the sutures created by Zhou Cheng.

But the impact of this clinical topic is still huge.

Xue Xiude probably knew what Zhou Cheng was planning, so he chimed in: "Professor Jing, I probably know what Xiao Zhou wants to say. It's really too late now, so I can't explain it."

"After the surgery, we can talk in private."

"Sorry, I'm taking the liberty." Hu Xianhe's words, Landscape Star can ignore them, but Xue Xiude's words represent the Ninth Courtyard of the Demon City to a certain extent.

Zhou Cheng is currently in the Ninth Hospital of the Shanghai Metropolitan City. If he really wants to get to the bottom of it, it will not be conducive to the harmonious relationship between the two brother units.At least it is not conducive to the harmonious relationship maintained on the surface.

In fact, the operation has come to this point, and it is basically coming to an end!

Zhou Cheng passed the steel wire strings around, and there were Kirschner wires at both ends as auxiliary fixing points, which just formed a figure-eight-shaped binding and fixing, which was extra firm!

After tightening the two ends of the steel wire with the aid of pliers, X-ray was performed again.

It can be seen that the fracture line is tightly wound by the steel wire, and the front and side views show that there is no gap between the steel wire and the surface of the bone, which proves that there is no soft tissue clamped inside, resulting in dissolution and necrosis of the soft tissue.

Then I immediately brought a pair of powerful scissors, shortened the stump of the steel wire, bent the stump, and carefully put it into the soft tissue, and then cut off the end of the Kirschner wire——

At this point, I see through it again and observe the shrinking of the stump curve. Everything is just right, and this operation is not difficult anymore.

When he got here, Zhou Cheng took advantage of the patient's still anesthesia to shake the affected limb up and down, left and right.

When the fracture is broken, if the affected limb is shaken, there will be reflection, shaking, bone friction sound, bone friction feeling, etc.

The reason why strict fixation is required is to avoid this from happening.

In addition to observing the fracture line, this simple physical examination is also an important way to determine the stability of fracture fixation.

However, seeing Zhou Cheng playing around like this frightened everyone else enough.

But he still didn't dare to open his mouth. Just like before, Zhou Cheng was no longer an ordinary little doctor and subordinate. The reason why this operation could be carried out to this point was all due to Zhou Cheng.

Otherwise, we can only do traditional internal fixation, and the postoperative hospital stay will inevitably be prolonged.

Zhou Cheng has the authorization of Class IV surgery and new surgical methods, and Zhou Cheng is the first operator to obtain the authorization of new surgical methods. He is like this now, no problem.

After Zhou Cheng did this, he let out a sigh of relief, and said, "At present, the fixation of the fracture is quite satisfactory. Director Zheng, I am active and abnormal, and the fracture has not loosened. It can avoid the risk of internal fixation device loosening after operation to a certain extent.”

"Follow-up, getting out of bed the next day is still a bit risky, but a few days after the operation, it is no problem to get out of bed with the help of crutches."

"It would be the best if the patient can cancel the previously arranged meeting. Everything is about the body. The patient is already old."

"If you can't evade, then Director Zheng, you can contact the phone number I gave you. At that time, a special wheelchair will be sent over there. In fact, it can also be called a walking aid!"

"This is also a relatively good walking assist device. It is designed for walking rehabilitation after fractures and joint replacements. It is still in the trial stage, but because it is an external assist device, it is already in the clinical trial stage."

When Director Zheng heard this, he stepped off the stage immediately and took a few steps back.

It is natural for someone to clean up the wound.

At the same time, Jing Jingxing and the others retreated from the operating table one after another.

Director Zheng shook hands with Jingjingxing, Hu Xianhe, Xue Xiude and others successively, and then shook hands with Zhou Cheng solemnly, saying: "Little Doctor Zhou, I express my sincerity to you on behalf of myself, Mr. Lin and his family. thanks."

"You must go out with me and meet Mr. Lin's family members. This is what they specifically confessed."

Xue Xiude also urged after hearing the words: "Xiao Zhou, go follow Director Zheng, and see you."

Director Zheng was able to introduce Zhou Cheng to the old gentleman's family, which is a good thing. The old gentleman's connections are beyond what ordinary people can imagine. They have a good reputation and status in the political and business circles.

Zhou Cheng thought for a while, but still shook his head and refused: "Director Zheng, thank you for your kindness. I appreciate your kindness. But I am really inconvenient today. The junior I brought from Shashi is still waiting for me below."

"Today's operation, I still have to work hard for a few teachers. There are more important things on my junior brother's side, and I have to deal with them. Otherwise, my junior brother was brought to the magic capital by me and ignored. The teacher will scold me."

Naturally, Zhou Cheng wouldn't get so carried away that he forgot about himself just because he had performed an operation that no one like Jingxing Xing could do.

Relationships, contacts, everyone loves, but for him now, there is no need to focus on managing the redundant contacts, although he can't rely entirely on An Ruo and his teachers.

But they are all their established connections, and doing things is obviously more important than developing redundant connections.

Li Chongyue's ability is good, and now he is in the stage of swinging left and right. If he can accept him, he will have another person who can really do practical things with him.

"Your Teacher Cai?" Xue Xiude asked a little more.

"En." Zhou Cheng nodded.