Chapter 308: Just won't let you sew

Chapter 308: Don't Let You Sew
Zhang Fan's sleep was so solid. It was estimated that he slept more at noon, even without sleep time, Zhang Fan went into deep sleep, and slept until more than eight in the evening. Zhang Fan was dizzy and dizzy after getting up. . How does this matter? First of all, the amount of surgery is a little bit, and the partner is a little girl and Xue Fei who is not in trouble.
Orthopedic steel plates, even bone pieces, electric drill holes, and screws are almost all done by Zhang Fan. It sounds like a carpenter is making furniture. The amount of labor is really not small, and he ca n’t move freely. . Secondly, the hospital canteen is to blame. The box lunch at noon is the boiled cabbage in white water and the potatoes stewed in white water, not to mention the meat. There is not much oil in it, which is a healthy diet in this era.
But for Zhang Fan, they ca n’t do physical work. This type of fat-free and protein-free diet consumes two orthopedic plates. If there is a high-quality diet, Zhang Fan is not expected to be so tired. The system can Quickly change the energy, the dean can change, and the mother of a cafeteria owner can't change it, it is also amazing!
Zhang Fan shook his head and felt slightly better, then got up and went out. Looking at the probe, the old couple and Shao Hua, like puppets, were sitting on the couch, not talking or watching TV, and sitting idly. "I didn't watch TV!" Zhang Fan asked before going to the bathroom.
"Shao Hua is afraid of making noise for you!" The old man pursed his lips, not willing or unwilling, just like a child complaining. After Shao Hua made a phone call, the old couple wandered around the community with the food from the farm for an afternoon, and it was easy for Shao Hua to get off work.
As a result, when he returned home, the old man said that he would watch the news and put a small voice, Shao Hua did not agree. It's not that Shao Hua didn't make sense. Today, Zhang Fan's condition really distressed Shao Hua, so he directly refused Dad's request. Zhang Fan got up, and the old man sued.
Zhang Fan cleaned up and went out of the bathroom. He smiled and said to the old couple: "I'm a bit tired today, I can't hear anything after falling asleep, and I will go to work at night after work. What should you do, just sing at home? Not mine. "
"If you do n’t watch TV, you wo n’t lose a piece of meat. If you have a bad rest, you ca n’t do it. It ’s a matter of life and death. You ca n’t take care of yourself. Let ’s eat first. Hungry. My favorite belt noodles. Chicken is so delicious! "The old lady said after glancing at the old man.
"Really, I said how so fragrant. Oh! Someone gave me two bottles of Moutai, and my uncle gave them a taste to see if it was true!"
"Well! Moderate, he can taste true and false." The old woman said before leaving, the old man's best skills made people despise, almost dizzy.
"Why can't I taste it? I'll tell you that I've had more wine than you've ever seen." The old man chased and stirred. Zhang Fan hurriedly took out the wine delivered by the medical representative when the department had a meal a few days ago, "Uncle, show it, this packaging is OK!"
Old children, old children, people are just like this, they have to coax. The old man held the wine in earnest, and watched it several times, "Well! It shouldn't be a problem!"
"Huh!" Shao Hua almost laughed, Zhang Fan gave Shao Hua a glance, Shao Hua covered her mouth, stood up with a smile, and said to the kitchen, "Mom, make a little bit of skin!" Then went to the kitchen quickly, The girls laughed secretly in the kitchen.
"The hair is long and the sight is short." After the old man said something, he said to Zhang Fan: "You have a great future, but you can't make mistakes for this thing. In fact, I drink everything the same. As long as you are healthy and healthy, I am safe. Better than any wine. "
"Well, rest assured, okay."
"Okay, it's okay. Let's eat. Today is a local chicken. I bought it at the farm. The young chicken is less than one year old. It's tender." The old man didn't say much, just mention it. The Shao Hua family has a taste of Jiangsu and Zhejiang, and their diet is sweet. Even poached eggs are sweet and sugary. But Zhang Fan from the northwest can't eat this sweet.
Once the sweet poached eggs made by Shaohua's mother, Zhang Fan ate like a medicine. Since then, the family has rarely eaten sweets, and pasta accounts for most of them. The two old men really took care of Zhang Fan. At the beginning of the Chinese lantern festival, the family sat together and ate a large plate of chicken and belt noodles. Zhang Fan was really hungry. A plate of chicken with potatoes and belt noodles did not eat more than half of Zhang Fan's.
After eating and drinking, Zhang Fan and Shao Hua took a walk along the road. This night market on the border is very special. Sheep are chopped in winter, mutton soup is the mainstream, and a hot bowl can drive away the cold of the whole body. As soon as the weather is slightly hot, roast lamb has become the mainstream, as well as lamb's head, hooves, and hot and sour lamb belly, which smells pretty good. Their craftsmanship is really good, the cold lamb is very flavorful.
Although there are many ethnic groups in frontier tea, this kind of night market is almost all returning to the stalls. There is really a set of food for others. The food of the Sanchuan people is good enough, but in the frontier, that is, two points with the world. Unlike other provinces, Sanchuan Hot Pot can directly destroy the local restaurant industry.
In the morning, after Zhang Fan got up, the old lady had already prepared Zhang Fan's breakfast on the table. Although the old man was very nice to the old lady, the relationship between the two was good. He had heavy things and heavier physical work. The old man definitely did not Will make the old lady dry. But in this kitchen, he never intervened. When Zhang Fan came, he didn't let Zhang Fan intervene, and Shao Hua didn't object. His words were: a big man, always struggling in the kitchen will smooth out the spirit of hard work! Zhang Fan can only respect the opinions of the elderly!
There is surgery today, and it is still a relatively important surgery, so Zhang Fan greeted the old lady in advance last night, not drinking milk, eating soy products, pickled products and other food. Zhang Fan is afraid of diarrhea. This is the details. No matter how small the details of human life are, it's not too much. Zhang Fan drank some porridge, ate an egg, and went to work after eating a little bun.
The doctors also came early in the department. Xue Fei didn't go to play mahjong last night, so Zhang Fan dragged it into a tired dog, went home and fell asleep, didn't eat dinner directly, and slept until daybreak, his wife was happy. If this is half a year in a row, It is estimated that Xue Fei's Mahjong will be quit!
There is only one difficulty in this operation, to determine whether the fracture ends are docked to reach the physiological position. There are not many people doing this kind of surgery now, the specific reason is hard to say, anyway, there are not many people. The mainstream is still open and fixed. This is also a matter of rushing. Lao Gao is willing to carry out this operation method. If you change the director, it is estimated that this will not happen.
Blind touch, the feeling under the hand is very important. This feeling is not bragging, it is true. When the alignment of the fracture line is good, an experienced doctor will feel it, but this experience is too difficult and difficult. There are so many patients asking you to practice your hands. Some patients are willing to let you practice your hands, and other doctors in the department are not willing to do so.
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 reach the anatomical position, that is to say, it can be closed tightly, as if there is no fracture. But the damage was also quite huge, and almost all the periosteum around the stump was destroyed.
The physiological position means that although it is not the same as the original, it does not affect the function and there is no deformity.
The ancestors of the orthopedic department of Huaguo are very cattle, willow orthodontic bone, and Chen orthopedic bone. These doctors have been able to reset most of the fractures with bare hands and have reached the physiology. The anatomical position is that the more developed the technology is now, the more and more rare this method is, where is it going? Who wants to know!
The patient had 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, there was no way, no hair on his mouth, no title on his head.
Orthopedics is blind, or Zhang Fan is blind. Many people know about three orthopedics. Those who are self-motivated, curious, and lively, are very concerned. There are all kinds of people with any mentality, but the operating room is the operating room. The only ones who can enter are a few surgeons, plus a maximum of one or two observation doctors. If there are too many people, a sterile environment cannot be achieved.
However, this problem is not big. The operating room of the city hospital is divided into three floors. There is an electric classroom on the bottom floor, which can be used to watch the progress of the surgery. "Director, let me go up and help raise my leg and get rid of the poison!" It was time to enter the operating room. Xu Xian quickly found Lao Gao. This is a motivated person, or a dignified graduate student, is there no face!
Lao Gao looked at Xu Xian, Xu Xian Chen looked at the director earnestly and clearly. "Okay, you go to the table, Sansuke. Go and change your clothes." When Xu Xian heard it, she quickly entered the locker room. This operation, to be honest, he has never seen it before, the case is all on the textbook.
This operation is simple to say, and it seems very simple. It has not been difficult to open the internal fixation, but this operation is too particular about feel and consciousness. Slightly deflected, it is absolutely inaccurate for thousands of miles, because the skin and soft tissue at the stump will not be cut open, and everything can not be directly visualized. Difficult!
In the operating room, anesthesiologists, itinerant nurses, and surgical nurses are all ready, waiting for doctors to enter. In the video classroom, almost all orthopedic doctors came. Although the second orthopedics department and the third orthopaedics department were not notified, Zhang Fan wanted to hit the blind. Almost all the people who could come came, and even the medical department sent someone. Although they didn't understand the difficulty of this operation, as soon as the operation was successful, a lot of colorful articles appeared in the hospital newspaper immediately.
Although Lao Gao said at the morning meeting that he took Zhang Fan for surgery, the main knife was still Zhang Fan. Two Zheng Gao, Lao Gao and Lao Chen, two residents, Zhang Fan and Xu Xian. After the anesthesiologist finished anesthesia, he said to several doctors, "Begin." Xu Xianliso brushed his hands and started disinfecting. Before going to the surgery, Zhang Fan finally carefully read the X-rays. Although the X-rays had been engraved in his mind, Zhang Fan still carefully read it again.
Lao Gao and Lao Chen stood aside, silently speaking. There are too few places they can help with this operation, and Lao Gao is also ready. Once the blind hit fails, the internal fixation is immediately cut. Washing hands and wearing surgical gowns, "It's okay, don't be under pressure. It's a big deal to cut the internal fixation. It's nothing." When Zhang Fan was dressed, gloves, and a sharp knife, Lao Gao said.
"Hmm!" Zhang Fan is not good at this point. Once he has surgery, he can't speak without talking, and others don't like it. So as long as Zhang Fan's operation, the air pressure in the operating room is quite low. The itinerant nurses dare not speak, which is a matter of personal temperament.
"Begin." After Zhang Fan said, he began to prepare the skin. What is the operation? Probably, the femur is the human thigh, and then the thigh is broken from the middle, and there is not much displacement of the broken end. Zhang Fan is now going to the upper end of the femur, open a small mouth, then use an electric drill to open the bone, and insert a long alloy rod from this mouth. The lower end of the alloy rod has two holes and the upper end has two holes. These are holes for screwing. After the fixation, the broken ends are well aligned, then the four screws are tightened, the OK fracture is fixed, and the operation is over.
It's that simple. Eighty to ninety percent of orthopedic surgeons can't do simple surgery. Not to mention blind typing, just cut and fix it. The doctors who are a little bit level can't even find the screw holes of this alloy! Zhang Fan opened a small mouth, and then used an electric knife to stop bleeding. When there was no electric knife before, he was ligated with silk thread.
Master Zhang Fan, Lao Gao held the suction device to smoke, Lao Chen gently opened the skin with a small hook, and Xu Xian was fine now, just stood and watched. The electric knife is actually very simple, just like an electric soldering iron. The human body has evolved so much that there are few large blood vessels in the superficial layer. When the skin and dermis are cut open, the bleeding is not obvious. It is only when the fat and muscle layers are reached that there are larger capillaries. The electric knife is directly coagulated. Zi! No, no bleeding.
The more you go to the surgery for the meal, the more you suffer. Especially when you use the electric knife, you are also scalding the blood vessels while burning the fat, and the fat instantly smokes. When you are hungry, when you smell this smell, you can drool.
"Electric drill." After opening a small opening in the skin, separating the muscles and fascia layers with his bare hands to stop bleeding and exposing bone, Zhang Fan said. The surgical nurse stood on the side and installed the electric drill early. After the commissioning was completed, the electric drill was calmly handed over to Zhang Fan.
"Squeak! Squeak! Squeak!" The hard bones opened like a tofu. Bone, especially large bones, has been eaten by everyone. It contains bone marrow and red soft bone like honeycomb. When the electric drill is drilled, what do the bones say, just like coffee with milk, white bone powder, dark red blood-colored milk-white marrow are stirred together, then quickly mixed, and finally become a little white milk Like soup.
The early method of this operation was very cruel. When electric drills were not available or when electric drills were not yet popular, this operation was like a meat stall, osteotome, bone hammer, hoe! Huh! Alas, smashed the bone open. And the early intramedullary fixation was very troublesome. The femur was not a smooth cavity. It had spirals and various bone trabeculae. This shape made the femur very hard and made blood.
Therefore, when fixing, you must first use a small reamer, insert it into the femoral cavity, and smash it into it with a hammer. How strong is this? If you stand behind the operating table, you can see the disease number, tied The patient was shaken all over!
Reamers are very similar to any kind of triangular bayonet, but they are not sharp, but very thick. Small, medium, large, open the bone marrow cavity in one click to make it open. You can imagine that the way you eat bone marrow with chopsticks is actually similar, but the chopsticks cannot make the cavity bigger. It ’s just that the power of inserting chopsticks is a little bit smaller than that of chopstick heads!
When the hammer hits the reamer. Smashed, the blood carried the bone marrow, and the white red blood spots were scattered. At this time, if there is blood flying into the doctor's eyes, and the patient has a blood-borne disease, it is very troublesome! With the development of science and technology, there are now instruments that do not require medullation, which also makes this surgery elegant.
Open the medullary cavity, Zhang Fan gently inserted the intramedullary nail and slowly descended. This operation, whether it is blind or not, will be compared with X-rays to calculate the length, which cannot be long or short. Slowly descending, "the lower end of the femur is rotated ten degrees outwards." Zhang Fan held the intramedullary nail with one hand and pressed the upper end of the femur with one hand, and said to Lao Gao and Lao Chen.
Orthopedist, a good orthopaedic surgeon has a strong three-dimensional sense of space, and good knowledge of geometry. Old Lu could n’t paint, geometry could n’t even be made. He had a big head when he drew a blood vessel. Before he learned the bone, he was persuaded. Return.
The various angles of orthopedics are really difficult to grasp. Don't talk about the operating table. Normally, two chopsticks are crossed. You don't need a measuring tool to put it at an angle of ten degrees. It is estimated that not many people can put it out, let alone such a situation that cannot be seen directly.
"Stop! The internal rotation is pulled down twice, with a slight pull down." Zhang Fan instructed the assistant to reset. At this time, if the assistant failed, Zhang Fan could not get it alone, so the team and the surgical team were very important. Lao Gao and Lao Chen slowly rotated, Xu Xian grasped his calf, and slowly pulled down.
The reason why it needs to be pulled down is to make the fracture stump slightly separated. The intensity cannot be too large or too small, and it may be pulled and displaced. Too small to allow the broken ends to separate. Zhang Fan held the intramedullary nail and gently touched the broken end, just like his hand, and the change at the broken end appeared clearly in his mind.
This is feeling, this is the feeling of practice. Lao Gao hasn't felt this way in his whole life, but imagine that Zhang Fan has so much liver! I don't know how many operations were performed in the system. "Ka!" A slight vibration came over, and this was the sound of bone stubble reset.
"Okay, don't move, keep this position now." The fracture reduction is changed during exercise, because it is an oblique fracture, there is an angle at the time of reduction, and the affected side of the patient's lower limb is suspended, that is, an old lady, thigh not heavy. If you are a big fat man, this position can keep the three assistants until the muscles become sour.
This maintenance is not simply lifted up and done. Keep a fixed position. It also requires three people to have a slightly strong force. Simply put, the chopsticks are broken, and you have to tie them up, do you have to align them, and then push them together with a force to tie them, a reason.
And this requires the cooperation of three people, commanded by Zhang Fan, five minutes, ten minutes, twenty minutes. It's really expensive to keep a fixed position and continue to output a steady power. Although he is an old man, a lower limb is also a bit heavy.
Zhang Fan inserted, slightly deflected, slowly slid down, avoiding the broken end, and slowly pressed against the bone, he couldn't be impatient at all, this thing was not impatient. The sweat of Lao Gao and Lao Chen Dou has already appeared. During the tour, the head nurse sent another one to gently wipe the two old doctors.
"Director, please lower the temperature of the air conditioner." The head nurse came in and saw the old man sweating, and asked.
"No! No, no matter how low, patient, cold!" Lao Gao was inconvenient to speak continuously. He was afraid that the continuous vibration of the speech caused the displacement of the fractured end of the reset.
Entered, Zhang Fan turned a knob, "Reset. Knife!" The surgeon immediately put the handle on Zhang Fan and the blade on himself, and handed it to Zhang Fan. Zhang Fan cut it with a knife, and then made a hole to prepare the screw. Here is also a difficult point, not to mention blind typing, sometimes, when the incision is straight, the doctors who are not technically in place cannot find this screw hole.
"I made a hole, I must keep it well." Zhang Fan said to the three assistants with a drill.
"Okay!" Xu Xian said.
Lao Gao and Lao Chen just nodded.
Opening the hole, "click!" Zhang Fan's positioning is too great. After drilling the bone, it is a screw hole, and there is no need to adjust the position. This is the feel of Niubi, the technique of Niubi. Xu Xian looked dumbfounded. He estimated that Zhang Fan had to adjust and find a position. After all, this was a blind hit. Even if it was not a blind hit, this positioning was a one-time success. He hadn't seen much.
Put on the screws, "OK. Director, all right!" Zhang Fan said, he had started flushing and was ready to sew. Lao Gao secretly rubbed his sour and numb hands and said to Zhang Fan, "Would you like to see it under the C-arm?"
"That is, don't worry, it should be fine, but let's take a look and rest assured." Lao Chen also said. This is Zhang Fan, if other resident doctors, it is directly: push the C-arm! In contrast to Zhang Fan, they both talked with each other.
In the classroom, a group of orthopaedic surgeons looked at the mist in the water. The operation was originally nothing to see. Two small openings were made, and the whole process was done by the doctor's hand. But Zhang Fan, who was so immortal, went to surgery and, like dumb, could not speak, he wouldn't say it. Zhang Fan did not explain the feelings, and only the other three doctors on the operating table felt a little.
And the doctor in the classroom was tangled. "This is over. Zhang Fan is also, how to fix it, and how to confirm it. I do n’t say a word, hey! Look at it like a mime, go, write a medical record. "
"Hey, wait, look at the results of the C-arm!"
"Look at the fart, haven't you seen Zhang Fan are ready to sew! Even if you see the results, you will do it? Really, let's go!" A bunch of doctors left in their hearts.
It's not that Zhang Fan didn't say it. Sometimes, this feeling, especially this mysterious and mysterious feel, really can't be expressed in words, it can only be realized!
The little nurse pushed the C-arm and the doctors and nurses all stood behind the lead plate to observe. Tap lightly, OK, the alignment of the fracture end on the display is very good.
"Bull! The angle is too great." Lao Chen said to Zhang Fan with his thumb.
"Mr. Zhang, how did you judge? At that time, how did you judge that you need to rotate ten degrees?" Xu Xian began to ask for advice after being shocked. This is a learning mentality.
"Yes, tell me." Lao Gao also said.
"Well, this, feel it. You see this original X film, although the angle is slightly larger, but after turning down and pulling, the internal rotation of the muscles corrects this angle a bit, and you see this old man The muscle strength is already relaxed, so this angle should be about ten to twelve degrees. When I touched it with a probe, I felt at this point, these two points are together! "Zhang Fanzhi Said in the original film.
"Eh!" Xu Xian's cold sweats all came down, which could be felt. As Xu Xian opened her mouth to speak, the anesthesiologist said, "Hey! Why are you talking and can't sew? I can tell you, the old lady is waking up soon."
"Haha, go ahead and go to the suture. Lao Chen left, let's go to the operation and let the boy give instructions for a long time, his hands are sore, the rest is left to them!"
"That is, you can take a rest. Hurry up, Dr. Xu, and leave the rest to me." 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, Xu Xian didn't even mix the stitches. Xu Xian got the needle holder to sew, but Zhang Fan robbed it. "This knife edge seems to cut a small blood vessel when I cut. I sew, you don't know where!"
"Why is this thing so unique? You won't even let the sutures, besides, your sister, what blood vessels are there!" Xu Xian looked dumbfounded!
The operation is over!
Sang Xin!
But the bird is still OK!
bird?
bird?
Haha!
(End of this chapter)