godfather of surgery

Chapter 536 Cases Are Projects

Anyway, it was not the first time to be bullied by Xu Zhiliang, Zhang Lin has long been used to it.

The two belonged to the same medical team. Zhang Lin usually likes to pretend to be an uncle, and treats graduate students, trainees, interns, and even doctors who come from outside for advanced studies.

But Xu Zhiliang controlled him to death. Xu Zhiliang led him to make rounds. He was basically sweating profusely and trembling.

Xiao Wu had never seen this kind of disease before, so he couldn't say anything.

Song Zimo and Xu Zhiliang read a lot of books and dabbled in various periodicals every day. Although he was unfamiliar with this case, he could at least have a preliminary understanding.

"I have read the literature on this. The first case appeared in 1800, and then there were a few sporadic cases. In the cases recorded in the literature, although the knee joint is reflexed, there is no front-to-back reversal in the anatomical structure. Those cases are all Various reasons lead to ligament laxity, the knee joint evolves into excessive forward bending, and finally the patellofemoral joint and tibiofemoral joint are dislocated or subluxed, and the knee joint is stiff in a deformed position of reflexion. This knee joint is different, its reflexion It's not a lax ligament, it's a complete anatomical inversion, and you see, the patella is in the back."

"Is this an atavistic phenomenon? Mammals, such as dogs, have their knees facing backwards." Zhang Lin asked again. He didn't give up and wanted to show off, because he had recently read Professor Qin Sihe's article and tried to learn from Professor Qin. Use a higher perspective to look at some problems in orthopedics from the perspective of human evolution.

Teacher Zhang is awesome!
As soon as such high-end remarks were made, the graduate students and Gui Peisheng next to him cast admiring glances.

Seeing everyone's reactions, Zhang Lin immediately sat up straight, very scholarly.

It seems that if you want to pretend, you still need to read more books. The failure rate of pretending to be uneducated is too high. Even if you succeed, the grade is not high.

Xu Zhiliang took over the conversation: "Does your dog's knees face backwards? The knees of mammals are the same as humans, and they also face forward. The patella is in the front. In this case, the patella is in the back. How can it be a return to the ancestors? Strictly speaking, this kind of It is more appropriate to call the anterior and posterior anatomical reverse deformity of the knee joint in this case."

Zhang Lin pretended to fail again, but there was nothing he could do. This was a case discussion, and everyone expressed their opinions.The dog's knee joints are facing backwards. He also learned this knowledge from the Internet. It seems that the knowledge on the Internet is too unreliable, and he will have to read more academic journals in the future.

Song Zimo zoomed in on the picture and looked at it again: "Old Xu's formulation is very good, and it fits the actual situation of this disease. When writing the paper, we can name this disease the anterior-posterior anatomical reverse deformity syndrome of the knee joint. You Look at the severe dysplasia of the hip joint, which is in a deformed and dislocated state, and the ankle joint and foot are also varus deformed, professor! You don’t want to make her stand up through surgery, do you?”

Song Zimo looked at Yang Ping and felt that he was a half-human, half-god guy, full of crazy ideas in his head, and then he could always realize them.

Now Song Zimo really hopes that Yang Ping can lead a postdoctorate in the future, and follow him to get a postdoctorate himself.

Let's talk about surgery, how many seemingly impossible operations have been completed in his hands like a cow.

Let's talk about scientific research, the external fixation of the spine to treat scoliosis, such a complicated thing, this guy just did it in one step and succeeded.

Now they are planning to engage in the project of cultivating muscle with stem cells. If this project is completed, it will be at the Nobel Prize level.

Song Zimo has no doubts at this time, this guy can really do it.

Learning from this kind of person, Song Zimo was excited just thinking about it.

"After this patient came, we treated the whole process as a new topic. If this case is handled well, no matter how difficult the lower limb orthopedic surgery is, it will not be a problem in the future. This case uses almost all the knowledge of lower limb anatomy and biomechanics. If the treatment is done well, the postoperative effect will be very poor. If the postoperative effect is too poor, it will be counterproductive. Originally, others can crawl, but after the operation, they can neither walk nor climb, and end up in a wheelchair.” Yang Ping hoped that the team would pay attention to this case, Since I am a professor, I have the appearance of a professor.

Xiao Wu said with a smile: "If the operation is not done well, not only will you not be able to regain a new life, but you will also ruin your current job in the circus."

It is true!

"I went to contact Ruixing's laboratory for computer 3D modeling, then simulated osteotomy and soft tissue balance adjustment, found the best line of force, and then designed the hip and knee prostheses. Xiao Wu was in charge of patient reception. For work, Zhang Lin is responsible for collecting information, Lao Xu is responsible for checking information, and the relevant knowledge is compiled into a booklet for everyone to learn." Song Zimo divided the tasks for everyone on the spot.

After discussing the case, Yang Ping led everyone to round the room.

A patient asked Yang Ping to perform the operation by name, saying that he knew Yang Ping, and still held a small note written by Yang Ping in his hand.

Yang Ping felt strange, when did he write a small note to someone.

During the rounds, I saw this patient.

Yang Ping has a good memory and recognized this young man in his 20s at a glance.

When I went to the countryside in Nanqiao County, I saw a patient in the free clinic. His lower limbs were not equal in length. He fell from a tree when he was a child. There was no formal medical treatment. After a few strokes, the left leg was five centimeters shorter than the right leg, and the left ankle and left foot were also deformed, and they limped when walking.

Seeing Yang Ping, the young man immediately got up from the bed and held Yang Ping's hand: "Dr. Yang, I finally found you. Do you still remember me?"

"Why don't you remember, from Nanqiao County?" Yang Ping immediately thought of him.

The guy also said at the time that men with medical skills can now be turned into women, so his leg should be able to be adjusted.

"You have a really good memory. I thought you were a nobleman who forgot and didn't remember me. You see, Doctor Yang, I always carry the note you wrote to me at that time."

The young man carefully took out a notebook from his body, and there was a note in the notebook.

Yang Ping took it and saw that the note was plastic and well preserved, with the address, phone number and name written by Yang Ping on it.

"It's hard to find a doctor in a big hospital, so I didn't dare to throw away this note. I didn't dare to come to you until I saved enough money." The young man took the small note that Yang Ping returned to him, and put it back carefully.

"Doctor Yang, to tell you the truth, I want to walk normally and find a better wife." The young man did not hide anything, and revealed the ultimate goal of his operation.

Because of this leg, it is a bit difficult to find a better wife.

Yang Ping chatted with him a little, the young man's family is poor, he has no relatives and friends, he didn't graduate from junior high school and came out to work, moving bricks on the construction site.

He has more goals in life. He moved bricks for a few years, saved a little money, and went to a chef school to learn to be a chef. Later, he became a chef and his income was much higher.

The young man has a high spirit, and he also has standards in his heart when looking for a wife, not everyone wants it.

"What's your standard for a better wife?" Xiao Wu joked with him.

The young man said very seriously: "At least a junior high school education, you must be decent, have a clean history, be in good health, be over 1.6 meters tall, have a good figure, and be beautiful. I am also a skilled person, and I must marry a wife casually. You have to pick and choose, women marry carefully and choose carefully, and I also choose carefully to marry, men and women are equal."

This guy has a set of theories, and it involves equality between men and women. His outlook on the world and life is quite upright.

This standard is neither high nor low.

If this leg is not cured, it will be really difficult to achieve the goal.

"What do you mean by clean history?" Zhang Lin didn't understand, what time was he talking about clean history.

Xiao Wu pulled Zhang Lin's clothes: "The ward round is in progress, don't digress."

The young man’s name is Fang Faquan, and he has completed the admission examination. Song Zimo showed Yang Ping a full-length film of his lower limbs. Yang Ping took a closer look and found that the left tibia and fibula had an old fracture. At that time, there should have been shortening and overlapping, and then it healed malformedly. I was already twelve or thirteen years old when I was injured, and there was not much room for fracture shaping, so the tibia and fibula appeared varus and shortened deformity, which affected the whole body. In order to compensate, there were also problems in the hip joint, ankle joint and foot , the pelvis is tilted, and the spine has scoliosis.

However, this kind of orthopedic surgery is relatively difficult, because it is necessary to consider restoring function as much as possible.

Three levels of surgery: resection, repair and reconstruction.

Reconstruction is the highest state, but it is also very difficult.

Even a small operation, once it involves functional reconstruction, the difficulty will naturally increase.

If you do not master the core knowledge of surgery, the surgery may look very beautiful, but it will not achieve the desired function.

Just like a small factory can copy the appearance and interior of Porsche, it can be exactly the same, even more beautiful than Porsche, but it just can't make its core technology, such as engine and power, etc.

Therefore, reconstructive surgery tests the doctor's level the most.

"The purpose of your operation is to get a good wife?" Yang Ping asked him.

Fang Faquan didn't hide it: "Yes, Dr. Yang, if it wasn't for this, I wouldn't bother. Although I sway, I'm used to it, and it won't affect my current work."

"The goal is clear. Yes, there are two methods. One is relatively cheap and simple, and the other is relatively expensive and complicated. Of course, the latter is also risky. The former method shortens the normal long leg by five centimeters, and then shortens the left leg. Orthopedics. The latter method, while correcting the left leg, lengthens it by five centimeters, which one do you choose?" Yang Ping briefly told him the operation plan.

Fang Faquan did not hesitate: "The elongated one. If I shorten the long legs, I am only 1.6 meters tall. If I lengthen the short legs, I can be 1.6 meters five. I asked Dr. Zhang about the cost, and I have enough money. of."

"The latter is more risky!" Yang Ping added.

Fang Faquan said: "Don't be afraid, the big deal is that you will still be lame. In the end, the lame will be more serious. What is there to do without risk? Some people in our kitchen cut vegetables and cut off their fingers. Not long ago, an old lady who was washing dishes broke her bones while walking. Doctor Yang, help me stretch, it’s best to pull both sides at the same time, I read the introduction of your department, a patient stretched 1.8 centimeters in one leg, you help me stretch it to [-] meters.”

The more Fang Faquan talked, the more excited he became.

Yang Ping felt that this kid was really high-spirited: "Your condition is different from others. It would be good to let you walk normally after correction. Don't think about the 1.8-meter thing."

The boy's words made everyone laugh.

He not only has his own opinions, but also has his own outlook on life.

(End of this chapter)