Three Hundred and One Is Not to Let You Sew

The genius remembers the address of this site in one second: [] The fastest update! No ads!

Zhang Fan slept really well this time, probably after one o'clock in the noon, and didn't even have time to fall asleep, so Zhang Fan fell into a deep sleep and slept until after eight o'clock in the evening. After waking up, Zhang Fan was dizzy . How should I put this matter? First of all, the amount of surgery is a bit too much, and the partner is a little girl and Xue Fei who is not worth it.

The orthopedic plate, jointing of bones, electric drilling, and screwing are all done by Zhang Fan alone. It really sounds like a carpenter making furniture. The workload is really not small, and he cannot move around freely, which consumes a lot of money. . Second, the hospital cafeteria is to be blamed. The lunch box at noon and the evening box lunch are simply boiled cabbage and potatoes. Not to mention meat, there is not even a little bit of oil. It is really a healthy diet in this era.

But for Zhang Fan and the others who do physical work, it’s not enough. This kind of diet without fat and protein will consume all the two steel plates. If there is a high-quality diet, Zhang Fan probably won’t be so tired, and the system can If the energy is converted quickly, the dean can be replaced, and the owner of the cafeteria of my mother can't be replaced, which is also a miracle!

Zhang Fan shook his head, and when he felt a little better, he got up and went out. Looking around, the old couple and Shao Hua were like puppets, sitting on the sofa, neither talking nor watching TV, just sitting there in a daze. "Why don't you watch TV!" Zhang Fan asked before going to the bathroom.

"Shao Hua is afraid of disturbing you!" The old man pouted, not to mention whether he was happy or not, just like a child complaining. After Shao Hua called, the old couple walked around the community all afternoon with the food they got from the farm, and it was not easy for Shao Hua to get off work.

As a result, when he got home, the old man said he was watching the news and kept his voice down, but Shao Hua disagreed. It's not that Shao Hua is unreasonable, Zhang Fan's state today really made Shao Hua feel distressed, so he directly rejected his father's request. When Zhang Fan got up, the old man complained.

After tidying up for a while, Zhang Fan came out of the bathroom, smiled and said to the old couple: "I'm a little tired today, and I can't hear anything when I fall asleep. From now on, I will go to sleep after the night shift. What should you do? Even singing at home makes you noisy." Not mine."

"If you don't watch TV, you won't lose a piece of meat. If you don't have a good rest, you can't do it. What you are doing is a matter of life and death. You must not be careless. Let's eat first, and be hungry. Today is big plate chicken and belt noodles. My favorite belt noodles. Local chicken, it tastes so good!" the old lady said after glancing at the old man.

"Really, I said why it is so fragrant. Oh! Someone gave me two bottles of Moutai, and my uncle will try it to see if it is real!"

"Tch! Zhongdute, he can tell the truth." The old lady said before leaving. The old man's best skills were despised and almost fainted.

"Why can't I taste it? Let me tell you, I've drank more wine than any water you've ever seen." The old man wanted to chase after him to bicker. Zhang Fan hurriedly took out the wine given by the medical representative at the department meeting a few days ago, "Uncle, show me, the packaging is okay!"

Old children, old children, this is how people get old, they have to be coaxed. The old man held the wine in a serious manner, looked at it several times over and over, "Hmm! It shouldn't be a big problem!"

"Pfft!" Shao Hua almost laughed, Zhang Fan gave Shao Hua a white look, Shao Hua covered his mouth, stood up holding back his smile, and said to the kitchen, "Mom, make some Pi Yazi too!" Then he hurried to the kitchen, The two of them secretly laughed in the kitchen.

"The hair is long but the knowledge is short." After the old man said something, he said to Zhang Fan: "You have a great future, so you can't make mistakes because of this thing. In fact, whatever I drink is the same, as long as you are healthy and safe, I Better than any wine."

"Well, don't worry uncle, it's okay."

"Okay, as long as it's okay, let's go to eat. Today is a native chicken. I went to the farm to buy it. It's a small native chicken that is less than a year old. It's very tender." The old man didn't say much, just mention it. The taste of Shaohua's family is a little bit of Jiangsu and Zhejiang, and their diet is sweet. Even the poached eggs are sweet and sugary. But Zhang Fan from the Northwest couldn't eat this sweet.

Once Shaohua's mother made sweet poached eggs, and Zhang Fan ate like medicine. Since then, the family seldom eats sweets, and pasta has taken up most of them. The two elders really took good care of Zhang Fan. At the beginning of the Chinese lanterns, the family sat together and had a lively meal of big plate chicken and belt noodles. Zhang Fan was really hungry, a plate of chicken, potatoes, and belt noodles, the other three people ate less than half of what Zhang Fan ate.

After eating and drinking, Zhang Fan and Shao Hua took a walk on the side of the road. This night market in the frontier is very distinctive. Haggis and mutton soup are the mainstream in winter. A warm bowl can drive away the cold in the whole body. When the weather gets a little hotter, roasted lamb takes the mainstream. There are also lamb heads, tendons, and cold hot and sour lamb belly. Their craftsmanship is really good, and the cold lamb is very tasty.

Although there are many ethnic groups in the frontier tea, this kind of night market is almost all Hui people's stalls, and they really have a way of cooking. The food of the Sanchuan people is good enough, but in the frontier, the world is divided into two with the Hui people. Definitely not like other provinces, Sanchuan Hot Pot can directly destroy the local catering industry.

In the early morning, after Zhang Fan got up, the old lady had already prepared Zhang Fan's breakfast and put it on the table. Let the old lady do it. But in this kitchen, he never interfered. After Zhang Fan came, he didn't let Zhang Fan interfere even if Shao Hua objected. What he said was: a big man who keeps groping in the kitchen will smooth out his fighting spirit! Zhang Fan can only respect the old man's opinion!

There is an operation today, and it is a relatively important operation, so Zhang Fan greeted the old lady in advance last night, not drinking milk, not eating soy products, pickled products, etc. Zhang Fan is afraid of diarrhea, this is the details, In matters of life and death, no detail can be overstated. Zhang Fan drank some porridge, ate an egg, and ate some steamed buns before going to work.

In the department, the doctors also came early. Xue Fei didn't go to play mahjong last night, and Zhang Fan was exhausted after being dragged on. He fell asleep when he got home, didn't eat dinner, and slept until dawn. His daughter-in-law was so happy. It is estimated that Xue Fei can quit Mahjong!

There is only one difficulty in this operation, which is to determine whether the broken ends of the fracture have reached the physiological position. There are not many people doing this kind of surgery now, the specific reason is difficult to say, anyway, there are not many people. The mainstream is still incision and fixation, which is just a rush of words. Lao Gao is willing to take the blame to carry out this operation method. If the director is changed, it is estimated that this will not happen for a while.

In blind typing, the feeling under the hand is very important. This feeling is not bragging, it is real. When the fracture line is well aligned, a doctor with extraordinary experience will feel it, but this experience is too difficult, too difficult. There are so many patients asking you to practice. Even if some patients are willing to let you practice, the department director and other doctors are not willing, anyway, it is a benefit.

There is a difference between the anatomical position and the physiological position of a fracture. The biggest advantage of incision and internal fixation is that it can achieve the anatomical position, that is to say, it can be perfectly stitched, just like there is no fracture. This is for the broken end of the fracture. But the damage is also quite huge, and the periosteum around the broken end is almost completely destroyed.

Physiological position means that although it is not the same as before, it does not affect the function and there is no deformity.

The ancestors of orthopedics in Huaguo are very good in this area. Liu style bone setting and Chen style bone setting. These doctors have been able to perform manual reduction of most fractures hundreds or even thousands of years ago, and then reach the physiological level. Anatomical location, but now that technology is more advanced, this kind of technique is becoming less and less common, where is it going? Who wants to know!

The patient had already been sent to the operating room. After the morning meeting, Lao Gao led a group of orthopedic doctors to the operating room in an orderly manner. Of course, Zhang Fan was at the end of the team at this time, so he had no choice but to have no hair on his mouth and no professional title on his head.

The first orthopedic department needs blind typing, or Zhang Fan needs blind typing, and many people in the three orthopedic departments know about it. There are people who are motivated, curious, and spectators. They are all very concerned. There are all kinds of people with different mentalities. If there are too many people, a sterile environment cannot be achieved.

But this is not a big problem. The operating room of the city hospital is divided into three floors, and there is an electronic classroom on the bottom floor, where you can watch the progress of the operation. "Director, let me go up and help lift a leg, let's disinfect it!" About to enter the operating room, Xu Xian hurriedly found Lao Gao.

Lao Gao looked at Xu Xian, and Xu Xian looked at the director with sincere and clear eyes. "Okay, you go on stage too, Sansuke. Hurry up and change your washclothes." Xu Xian hurried into the locker room upon hearing this. To be honest, he had never heard of this kind of operation, and the cases were all listed in the textbooks.

This operation is easy to say and looks very simple. It seems difficult without incision and internal fixation, but this operation pays too much attention to hand feeling and consciousness. A slight deflection is a huge loss, because the skin and soft tissue at the severed end will not be cut, and everything cannot be directly seen, which is difficult!

In the operating room, the anesthesiologist, itinerant nurse, and surgical nurse are all ready and waiting for the doctors to enter. In the electronic classroom, almost all the orthopedic doctors came. Although the second and third orthopedic departments were not notified, but Zhang Fan wanted to do blind typing, almost all the doctors who could come came, and even the medical office sent people. Although they don't understand the difficulty of this operation, as long as the operation is successful, there will be a colorful article in the hospital newspaper immediately.

Although Lao Gao said at the morning meeting that he would take Zhang Fan for surgery, Zhang Fan was still the chief surgeon. Two Zheng Gao, Lao Gao and Lao Chen, and two residents, Zhang Fan and Xu Xian. After the anesthetist finished anesthesia, he said to several doctors: "Start." Xu Xian brushed his hands quickly and began to disinfect. Before the operation, Zhang Fan went through the X-ray carefully one last time. Although the X-ray had been engraved in his mind, Zhang Fan still read it carefully.

Lao Gao and Lao Chen stood aside, quietly not speaking. There is too little that they can help with in this operation, and Lao Gao is also prepared. If the blind operation fails, he will immediately open and fix it. Washing hands and putting on surgical gowns, "It's okay, don't feel pressured, the big deal is incision and internal fixation, it's nothing." When Zhang Fan put on his clothes, put on his gloves, and picked up the sharp knife, Lao Gao said something.

"Hmm!" Zhang Fan is not good at this point. Once he has an operation, he will not talk if he can not talk, and he doesn't like others talking, so as long as it is Zhang Fan's operation, the air pressure in the operating room is quite low. Itinerant nurses dare not speak, this is a matter of personal temperament.

"Start." After Zhang Fan finished speaking, he began to prepare to cut the skin. What is the operation like? To put it bluntly, the femur is the human thigh, and then the thigh is broken from the middle, and the broken end does not move much. Zhang Fan is now going to open a small opening at the uppermost end of the femur, then use an electric drill to open the bone, and insert a long alloy rod through the opening. There are two holes in the lower end of the alloy rod and two holes in the upper end. , These are the holes for the screws. After the fixation is completed and the stumps are in good alignment, the four screws are then tightened, the OK fracture is fixed, and the operation is over.

It's that simple, a simple operation that 80 to 90 percent of orthopedic surgeons can't do. Don't talk about blind typing, just incision and fixation, a doctor with a lower level may not even be able to find the screw hole of this alloy! Zhang Fan made a small incision, and then used an electric knife to stop the bleeding. Before there was no electric knife, he used silk thread to ligate.

Zhang Fan performed the operation, Lao Gao smoked with a suction device, and Lao Chen gently opened the skin with a small retractor. Xu Xian was fine now, so he just stood and watched. The electric knife is actually very simple, just like a soldering iron. The human body has evolved so well that there are almost no large blood vessels in the superficial layer. When the skin and dermis are cut, the bleeding is not obvious, but only when the fat layer and muscle layer are reached, there are a little larger capillaries. The electric knife is directly electrocoagulated, nourishing! Nourish! Zi, no more bleeding.

The more it is time for the surgery, the more tormented it is, especially when the electric knife is used, the blood vessels are scalded while the fat is burned, and the fat smokes instantly. Although I wear a mask, the smell of barbecue comes directly, really. , When you are hungry, you can smell this smell, and your saliva will come down.

"Electric drill." Zhang Fan said after opening a small hole in the skin, separating the muscle and fascia layers with his bare hands, stopping the bleeding, and exposing the bone. The surgical nurse stood aside and installed the electric drill early on. After the adjustment was completed, she calmly handed over the electric drill to Zhang Fan.

"Squeak! Squeak! Squeak!" The hard bone, like tofu, unscrewed a mouthful. Bones, especially big bones, have been eaten by everyone. There is bone marrow in them, and there is red soft bone like a honeycomb. When the electric drill is drilled, how do you say the bones are like coffee with milk, white bone powder, dark red blood-colored milk-white bone marrow are stirred together, and then quickly mixed, and finally become a little whitish milk Same as soup.

The early methods of this kind of surgery were very cruel. When there were no electric drills or electric drills were not yet popular, this kind of surgery was like a butcher's stall, bone chisels, bone hammers, bang! Bang! Bang, smashed a hole in the bone abruptly. Moreover, the early intramedullary fixation was very troublesome. The femur was not a smooth cavity. There were spirals and various bone trabeculae inside. This shape can make the femur very hard and can also produce blood.

Therefore, when fixing, first use a small reamer, insert it into the femoral cavity, and smash it in with a hammer. How strong is this? If you stand behind the operating table, you can see the patient's number and the tied The whole body of the patient was shaken!

The reamer is very similar to some kind of triangular bayonet, but it is not so sharp, but very thick. Small size, medium size, large size, one at a time to expand the bone marrow cavity, expand smooth, you can imagine, you eat bone marrow with chopsticks, in fact, the principle is similar, but chopsticks can not make the cavity bigger It's just that the force to insert the chopsticks is a little less, and it's just that the heads of the chopsticks are not hit with a hammer!

When the hammer hits the reamer. Smash it, the blood is covered with bone marrow, and white and red blood spots are splashed everywhere. At this time, if there is blood flying into the doctor's eyes, and the patient has a blood-contagious disease, it will be very troublesome! With the development of science and technology, there are now instruments that do not require reaming, which also makes this kind of surgery more elegant.

Opening the medullary cavity, Zhang Fan gently inserted the intramedullary nail, slowly descending. In this operation, regardless of whether it is performed blindly or not, the length must be calculated by comparing it with the X-ray, and it cannot be long or short. Slowly descending, "The lower end of the femur is externally rotated ten degrees." Zhang Fan said to Lao Gao and Lao Chen, holding the intramedullary nail with one hand and pressing the upper end of the femur with the other.

Orthopedic surgeon, a good orthopedic surgeon must have a strong three-dimensional sense of space and a good knowledge of geometry. Back then, Lao Lu couldn't draw well, let alone geometry. Drawing a blood vessel made his head big. He was persuaded before he learned about bones. Return.

The various angles of orthopedics are really difficult to grasp. Not to mention the operating table, ordinary people have two chopsticks crossed, you don't need measuring tools, and if you place it at an angle of ten degrees, it is estimated that not many people can place it, let alone in such a situation where they cannot see directly.

"Stop! Internal rotation twice with pull-down, light pull-down." Zhang Fan commanded the assistant to reset. If the assistant can't do it at this time, Zhang Fan can't do it alone, so the team, the surgical team is very important. Lao Gao and Lao Chen spun slowly, Xu Xian grabbed his calf and slowly pulled it down.

The reason for pulling down is to slightly separate the broken ends of the fracture. The force should not be too large or too small. Too small to allow the broken ends to separate. Zhang Fan held the intramedullary nail and gently touched the stump, just like his hand, the change at the stump was clearly presented in his mind.

That's the feeling, that's how practice makes perfect. Lao Gao has never felt this way in his whole life, so one can imagine how crazy Zhang Fan is! Usually, I don't know how many surgeries have been performed in the system. "Crack!" There was a slight vibration, which was the sound of bone stubble reset.

"Okay, don't move, keep this position now." Fracture reduction changes during exercise, because it is an oblique fracture, there is an angle during reduction, and at this time the patient's lower limb on the affected side is suspended in the air, that is, an old lady. not heavy. If you are a big fat man, you can keep the three assistants in this position until the muscles are sore.

This holding is not simply done by lifting it up, it is necessary to maintain a fixed position. The three people need to have a little supporting strength. Simply put, if the chopsticks are broken, you want to tie them up. Do you have to align them, and then use one force to push them together to tie them together? There is a reason.

And this requires the cooperation of three people, Zhang Fan directs, five minutes, ten minutes, twenty minutes. It is really too labor-intensive to maintain a fixed position and continuously output a steady force. Although he is an old man, one lower limb is still a bit heavy.

Zhang Fan inserted, leaned slightly, slid down slowly, avoiding the stump, and slowly stuck to the bone. Don't be impatient at all, this is not something you can be impatient. Lao Gao and Lao Chen Dou Da's sweat has appeared. Tour, the head nurse sent another one for the original tour, and gently wiped the two old doctors.

"Director, why don't you turn down the temperature of the air conditioner?" The head nurse came in, and asked when she saw the two old men sweating profusely.

"No! No, no matter how low it is, the patient has a cold!" Lao Gao couldn't speak continuously, he was afraid that talking continuously would cause vibrations and cause the broken ends of the fractures to be displaced.

Entering, Zhang Fan turned the knob, "Reset. Knife!" The surgical nurse immediately pointed the handle of the knife to Zhang Fan, and the blade to herself, and handed it to Zhang Fan. Zhang Fan cut it open with a knife, and then drilled holes for screws. Here is also a difficulty, not to mention blind typing, sometimes, under the condition of incision and direct vision, doctors who are not skilled enough can't even find this screw hole.

"I made a hole, so it must be kept well." Zhang Fan said to the three assistants while holding an electric drill.

"Okay!" Xu Xian said.

Lao Gao and Lao Chen just nodded.

Opening the hole, "Crack!" Zhang Fan's positioning is too awesome. After drilling through the bone, the screw hole will be directly formed, and there is no need to adjust the position. This is the awesome feel and awesome technology. Xu Xian was dumbfounded. He reckoned that Zhang Fan had to adjust and find a position. After all, this was blind typing. Even if it wasn't blind typing, he hadn't seen many successful one-time positioning of this kind of positioning.

Screw on, "OK. Director, it's done!" After Zhang Fan finished speaking, he had already started to wash and was ready to suture. Lao Gao secretly rubbed his sore and numb hands, and said to Zhang Fan, "Why don't you take a look under the C-arm?"

"That's right, don't worry, it should be fine, but let's take a look, don't worry." Old Chen also said. This is Zhang Fan. If any other resident doctor would just say: push the C-arm! As for Zhang Fan, both of them spoke in a negotiating tone.

In the electronic classroom, a group of orthopedic surgeons were confused. This operation was nothing to watch at first, only two small incisions were made, and the whole process was performed by the surgeon's hand and feeling. But Zhang Fan, who was so alive, was like a dumb man once he had the operation, he would not speak if he could. Zhang Fan didn't explain his feelings, and only the other three doctors on the operating table felt a little bit.

And the doctor in the electronic classroom was entangled, "This is the end, Zhang Fan is too, no matter how fixed, no matter how confirmed, hey! It was useless, like a pantomime, and left to write medical records. "

"Hey, wait, look at the results of the C-arm!"

"Damn it, didn't you see that Zhang Fan was going to suture! Even if you saw the result, you would do it? Really, let's go!" A group of doctors left with a feeling in their hearts.

It's not that Zhang Fan doesn't say it, sometimes, this feeling, especially this mysterious and mysterious feeling, really can't be expressed in words, but can only be felt!

The little nurse came over pushing the C-arm, and the doctors and nurses all stood behind the lead plates next door to observe. Tap lightly, OK, the alignment of the broken ends on the display is very good.

"Nice! The angle judgment is too powerful." Lao Chen said to Zhang Fan with his thumb up.

"Mr. Zhang, how did you judge? In that situation, how did you judge that you need to rotate ten degrees." After Xu Xian was shocked, he began to ask for advice. This is a learning mentality.

"Yes, tell me." Lao Gao also said.

"Well, this, I feel it. Look at the original X-ray, although it has a slightly larger angle, but after the downward rotation, the internal rotation of the muscles corrects this angle a bit, and you can see the old man's The muscle strength has been relaxed, so the angle should be around ten to twelve degrees. When I used the probe to probe, I felt that it was at this point, and these two points were together!" Zhang Fan pointed out Said with the original film.

"Ugh!" Xu Xian broke out in a cold sweat, he could feel it. Just when Xu Xian was about to open his mouth to speak, the anesthesiologist said, "Hey! Why are you chatting? I can't sew any more. Let me tell you, the old lady is about to wake up."

"Haha, go down and talk, let's sew up. Lao Chen is leaving, let's perform the operation, let this kid give orders for a long time, his hands are sore, and leave the rest to them!"

"That's right, you guys should hurry up and take a break. Dr. Xu, go down too, and I'll do the rest." Zhang Fan said.

"It's okay, it's okay, go down and rest, and leave the rest to me."

Can Zhang Fan go down? No, so, Xu Xian didn't even mix up the stitches. Xu Xian got the needle holder and was about to sew, but Zhang Fan snatched it, "This incision, when I cut it, seemed to cut a small blood vessel. I sewed it, but you don't know where!"

"Why is this thing so lonely? It doesn't even let it be stitched. Besides, your sister, what kind of blood vessels are there!" Xu Xian's face was so cute!

The operation is over!

. m.