Chapter 49 The strongest patient arrives
After the examination, the old man was pushed to the orthopedic trauma ward, and Director Xiong personally went to the window to help him handle the hospitalization procedures.
As soon as Professor Zhang arrived, the ward was like a dark cloud. From the interns to the professors leading the team, everyone who was still in the ward and not off work panicked.
Everyone stopped what they were doing, and the first thing was to quickly check the buttons on their white coats. If there were any missing buttons, go to the head nurse.
"What are you doing at ordinary times? At this time, you are mending buttons and stuffing chicken drumsticks into your mouth before you remember to fill your teeth." Yao Ling scolded several graduate students and trainees, but she was a sharp-tongued person.
It was too late to go to the linen room for this matter, so I wanted to call a nurse to take care of it. Discard this idea immediately. These little girls usually take injections and infusions smoothly, and sew clothes and mend buttons. Don't even think about it.
Yao Ling found the sewing box and buttons from the department warehouse and sat down in the doctor's office: "Come one by one."
Several young men were queuing up to button up, and someone was standing guard at the door to warn of any trouble.
"Quick, quick, old Zhang has a fracture and will be hospitalized immediately." Someone came to the duty room to report the news.
A few guys took advantage of their free time to play a few games of King. When they heard the shouts, they couldn't hold their mobile phones steady. They closed the game and forced quit. Then they picked up a book and read it, pretending to be cool.
"Where is the fracture?" someone asked.
"Femoral intertrochanteric space!" the messenger replied.
Oh - take a long breath, no need to pretend, put down the book in your hand, I will definitely not dare to play the game again.
Gurgling, the sound of wheels grinding against the ground, the beep of the emergency elevator opening its door.
Professor Zhang was pushed to the ward by a flat car. Yao Ling personally guarded the door with her most capable nurse Cai Qiaojun, but Cai Qiaojun was obviously a little nervous.
Not to mention the nurses, no one in the entire hospital except Dean Xia and Director Han should be nervous in front of him.
Professor Zhang criticized people without using a single curse word or saying an angry word. When criticizing, the words are clear and logical. Which book is on which page, who published the paper, and the latest guideline consensus are all at your fingertips. They are word for word. You can't accept it.
Yang Ping pulled his injured leg and everyone worked together to cross the bed. Xiaowu brought the skin traction equipment. Since it was an emergency surgery, there was no need for bone traction and skin traction was maintained for a while.
The wrist identification band is fastened to the wrist, a pre-operative patient sign is hung on the bedside, and food and water fasting begins immediately. Blood was drawn and a bedside electrocardiogram was done. I had no respiratory symptoms such as coughing recently. I had a chest CT for my annual physical examination, so I didn’t need a chest X-ray.
Everyone helped Professor Zhang adjust his posture to the best position, straighten out the ropes for skin traction, and rock the head of the bed to 45 degrees so that he could lean on it comfortably. He didn't want to lie down.
After applying a rubber tourniquet, Cai Qiaojun quickly punctured the back of Professor Zhang's hand, preparing to place an indwelling needle.
But I don’t know if I’m nervous or because Professor Zhang’s blood vessels are really hard to find, and even after one puncture, no blood returned.
Cai Qiaojun is a benchmark among orthopedic nurses and has won awards in the city's nursing skills competition. If he had failed once, if it had been any other patient, he would have calmly punctured again without changing his expression or heartbeat.
But Professor Zhang is lying now. How could she not be nervous? Sweat can be seen on her forehead. Professor Zhang put his right hand beside him to prick the needle and turned slightly sideways.
Stretched out his left hand and said: "Give it to me!"
The tone was very kind, and the kinder it was, the more nervous everyone became. He took the puncture needle to draw blood and asked to perform venipuncture himself.
"Look, first 45 degrees, shorten the puncture path. The layers the puncture needle passes through must be clear, skin, subcutaneous, and then vein. If you can feel it under your hands after each layer it passes through, you are still not skilled." Professor Zhang was operating. Explain patiently.
He turned the needle over with his left hand, pushed it in casually, and returned blood, hitting the nail on the head.
"After inserting the needle, lower the puncture angle and keep it consistent with the course of the blood vessel. As long as the blood vessel is thicker than the needle, it can be inserted. There is no such thing as nervousness. Nervousness is due to lack of skill. No matter how nervous you are, you can answer that one plus one equals two. "Professor Zhang continued, Yao Ling and Cai Qiaojun's faces turned red.
Professor Zhang let go, Cai Qiaojun pulled out the needle, left the hose inside, fixed it, connected the balance solution, and started the infusion.
It was just a legend in the past, but now in close contact, the nurse dared to refute the old man's technique of injecting himself, so he could only listen to the lecture obediently. Director Han came in with a briefcase: "Teacher Zhang, I have to catch a flight, so you can stay here with peace of mind. I also said hello to Tianyuan, and then Xiao Yang, Xiao Song, and Tianyuan will all come on stage."
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"Okay, I know what I'm doing. You're busy with your work. The institute's affairs must be taken care of without delay." Professor Zhang was fiddling with the remote control and wanted to watch TV.
Director Han exchanged a few pleasantries and left in a hurry.
The head nurse offered to help adjust the TV, but he refused: "What are so many people doing around me? You are busy with your business. Just handle it as usual."
I turned on the TV and flipped through the old movie "Assault on the White Tigers" about the War to Resist U.S. Aggression and Aid Korea.
"You all go and get busy. There are so many patients. Don't worry about me. Please help me hire an escort. Male, the urinary catheter will not be inserted before the operation. Don't embarrass you. Asking the urology department to use a metal probe may not necessarily lead to smooth entry. Also. There are three meals a day after the surgery. There are no contraindications. You can go ahead and stay." Seeing that everyone had no intention of leaving, he started to chase people away and named Yang Ping to stay.
Seeing that nothing was wrong, the head nurse said a few words of relief and led everyone out of the ward, leaving Yang Ping behind.
"Sit, why are you standing? You didn't make a mistake." The old man asked Yang Ping to sit down.
Yang Ping moved the accompanying chair over and sat down beside the bed. Professor Zhang paused the TV and said, "These movies are still good to watch. At that time, I was a teenager, and my father was one of the earliest Western orthopedists. After returning from studying in the United States, he When the 1950s War broke out, he volunteered to go to the battlefield. During the Battle of Changjin Lake, there was still a piece of shrapnel left in his body. The old man still insisted on going to the outpatient clinic at the age of 90. He closed his eyes on the office chair in the outpatient clinic. ”
Yang Ping listened silently and couldn't help but be in awe. Professor Zhang suddenly stopped and said: "Bring the film over and let's discuss it."
Yang Ping took out the X-rays and CT films from the bag beside the bed. Professor Zhang put on his reading glasses, pointed at the films with natural light and said: "The biggest difference between the lower limbs and the upper limbs is that the lower limbs need to bear weight. Any fracture of the lower limbs requires In the early stage of ambulation, there must be bone support, which means the pressure becomes tighter. The implant is only an auxiliary, not a substitute. The simplest interlocking intramedullary nail fixation of tibial transverse fractures was done by Germans in the morning, and they could walk in the afternoon. When we went back, we were too scared to speak. It took six to eight weeks before we dared to bear partial weight, and it took 3 months after the operation to fully bear weight. At first, we thought it was a material problem, but later we discovered that the main problem was not the material, but the bone support. Theoretically, their interlocking intramedullary nails use longitudinal sliding holes, which are locked laterally and slid longitudinally, so that the fracture end is automatically pressurized, and load-bearing becomes a favorable factor, and the longer the fracture is healed, the faster it will heal.”
Yang Ping listened carefully, and Professor Zhang continued:
"This bone piece needs to be pulled out, and these pieces must be anatomically reset. This piece needs steel wires and steel cables. Nowadays, when steel wires are used in fracture surgery, it is considered backward. Without steel wires, it becomes taller. Surgery is not to follow the fashion trend. You have to have your own thinking, and medicine needs to advance, but new things are not necessarily the best and need time to test. Your last comminuted fracture of the lower end of the humerus was done very well using steel pins and wires, and the entire reduction and fixation sequence was arranged. , it must have taken a lot of thought.”
"I think the sequence of fracture reduction and fixation is too profound. It is by no means a simple process. It is like building a house. It is not a simple accumulation of bricks. There should be a complete set of theories." Yang Ping expressed his feelings.
"Well, it's good to be able to realize this. I have been thinking about this issue. Many things seem very simple on the surface, but after studying it, I find that they are very profound and complicated. Just like a Rubik's Cube, looking at the surface, it seems that it can be broken apart. Go, actually how to restore and arrange the sequence is a big question." Professor Zhang put down the film.
Yang Ping put away the film, and Professor Zhang said: "Surgeons, especially orthopedic surgeons, must have an important ability - spatial imagination. They must have a three-dimensional anatomical construction in their minds. This construction must be accurate and specific. Next Chess players can play blind chess, but we surgeons must be able to close our eyes and go through the surgery in our minds.”
Yang Ping pushed the mobile table over, put it on the bed, placed it in front of Professor Zhang, and locked it securely. Then take out the white paper and gel pen from the drawer of the bedside table.
The old man put a gel pen on the white paper and began to sketch it. In less than three minutes, a hip joint image appeared on the paper, and his own fracture was completely drawn. Then draw a picture of the reset and fixation on another piece of paper. The images are extremely realistic and detailed, and the three-dimensional effect gives people a strong visual impact.
"At that time, we had to master the technique of drawing. Today's doctors can't find anyone who can draw. If you need it, I have some drawing manuscripts. Take a look." Professor Zhang put down his pen.
Yang Ping was shocked by him, no wonder the whole hospital was afraid of him. It's not that he likes to curse, but that everyone really can't meet his requirements. When Yang Ping picked up the two pictures on the table, they were not inferior to the works of Western realist painters. They were jaw-droppingly realistic and delicate. This painting is not flat, but three-dimensional. Just a black gel pen can actually express the three-dimensional effect so perfectly. This level is completely worthy of performing three-dimensional paintings on the streets.
"Are you surprised? If it were in color, you would think that there are joint models and steel plates and screws on the paper. A simple combination of lines can achieve such a state, why can't medicine? After I taught myself modern 3D painting, combined with medical drawing, I There is this kind of 3D painting technology," Professor Zhang laughed.
Yang Ping became very interested in Professor Zhang's drawings. He had never had this concept before. He put away the two pieces of paper and said, "Can you give these two pieces of paper to me?"
"It was originally painted for you. You should use it to study the operation process. You are a little thirsty and the combination of rehydration is not right." Professor Zhang said.
Yang Ping quickly poured a glass of water. There was a cotton swab on the bedside table. Soak the cotton swab and smear it on Professor Zhang's lips.
"After the operation, you can get a tablet and connect it to the video system in the operating room. I will watch the whole process by myself," Professor Zhang warned.
Yang Ping said: "I will make people prepare now."
"You go and get ready, I'll take a rest. I've been operating on others all my life, and now it's my turn."
"Remember, I will go to the ground tomorrow."
When Yang Ping walked to the door, Professor Zhang did not forget to remind him.
(End of chapter)