Those years when I hung up and upgraded in the hospital

Chapter 118 Promise (please collect, please read)

Giant rotator cuff is a diagnosis in sports medicine. It does not mean that the rotator cuff is large, but it is a special type of rotator cuff injury, which is a relatively serious disease.

A giant rotator cuff tear is defined as a tear of the rotator cuff >5cm, or the definition from Gerber et al., who define a huge rotator cuff tear when there are two or more torn tendons.However, some scholars use a rotator cuff tear >2cm and involving more than two tendons as the diagnostic criteria for a giant rotator cuff.

There is currently no absolute unified definition standard.

But there is no doubt that such damage is relatively difficult to deal with.

After Fang Yun washed his hands again and came on stage, he stood at the first assistant operating station in a dignified manner. While helping Associate Professor Sun Xiaoliang hold the mirror, he slowly looked at the damage to the ligaments under the arthroscope.

Injury to this huge rotator cuff is relatively difficult to calculate. Not only are there injuries to two tendons in the rotator cuff, the supraspinatus and subscapularis, but also the retraction distance of each tendon. More than 5cm.

"Xiao Fang, do you know what shape this rotator cuff injury belongs to?" Sun Xiaoliang had just completed the cleaning of the subacromial space of the rotator cuff injury at this moment, which happened to expose the opening of the rotator cuff injury.

"The supraspinatus should be U-shaped, and the subscapularis injury should be crescent-shaped." As Fang Yun spoke, he carefully moved the arthroscope to observe the ends of the two broken ligaments.

The shapes of giant rotator cuff tears are often described as crescent, U-shaped, L-shaped, and reverse L-shaped, but may include other complex shapes.

In general, anatomically reducible crescent-shaped tears should be distinguished from retracted U-shaped tears, which converge only at the edges.If it is an L-shaped or reverse L-shaped tear, it can be trimmed and converted into a crescent-shaped tear to facilitate the suturing operation.

Sun Xiaoliang nodded when he heard this: "It is indeed quite lucky. We can reduce our operations a little. Raise the field of view a little higher and focus on the shoulder peak first."

Fang Yun immediately followed the instructions. Without Sun Xiaoliang's guidance, he only needed to give instructions, and Fang Yun maintained his vision at the position Sun Xiaoliang wanted.

After arriving, Fang Yun paused for a moment, then rotated the mirror's field of view slightly, choosing another field of view that might be more conducive to Associate Professor Sun Xiaoliang's operation.

Through Fang Yun's experience, Sun Xiaoliang knew that Fang Yun was not only skilled in the operation of arthroscopy, but also had certain understanding and attainments in the treatment of rotator cuff tears. Otherwise, Fang Yun would not have found someone more convenient for him. Operational vision.

An expert knows the way, and every move you make can let others see your level.

This kind of cooperation will make Associate Professor Sun Xiaoliang feel very comfortable. Fang Yun's proficiency in operating arthroscopy is only slightly lower than his. A bunch of attending doctors in the department, including the old attending, cannot reach it. to this level.

Then, Sun Xiaoliang asked Fang Yun to continue the operation, and after inserting the inner row of anchors, he also tried to have Fang Yun insert the outer row of subscapularis anchors. Fang Yun chose the position of the anchors and the method of rotation. Still very skilled.

At the end, Sun Xiaoliang simply asked Fang Yun to try the last knot.

It can be said that the key part of shoulder arthroscopy to treat rotator cuff tears is not suturing, but the application of knotting.

Because the knotting of shoulder arthroscopy is very complicated, it requires multiple methods to transfer the sutures from this sleeve to another sleeve in the sleeve.

Use a puncture needle or other tool to create an O-shaped suture as a lead, then pass one end of the suture on the anchor through the O-shape, pull it out of the sleeve, and then send it into the sleeve. Complete After one is covered, use the same technique to bring the sutures in and out.

To complete the coverage of the rotator cuff tear and sutures arranged in a diamond pattern.

Then there is the sliding knotting technique from the outside to the inside. Although there are tools, this knotting technique still requires practice.

However, Fang Yun's knotting technique has reached level 3, so there is no problem with such an operation.

And when this happened, Sun Xiaoliang felt that Fang Yun's whole person was different for a moment.

After poking down with an instrument and cutting off the suture stump, Sun Xiaoliang took Fang Yun directly off the stage and ordered: "You guys should do the follow-up operations. I told you a long time ago, practice more and watch more! If you guys If Dr. Fang is of this caliber, I would feel much more at ease."

The time when Sun Xiaoliang and Fang Yun stepped down was at [-]:[-] in the afternoon.

This surgery was not very time-consuming, mainly because the operations were a bit too much.In front of the sink, Sun Xiaoliang asked: "Doctor Fang should be the attending physician now, right? Can he be promoted to associate professor and get a provincial-level project?"

Fang Yun understood what Sun Xiaoliang meant.

At the deputy senior level, there are generally opportunities to enter prefecture-level hospitals or even places like Shashi No. [-] Hospital or Shashi No. [-] Hospital. However, in order to enter the Provincial People's Hospital, you must win a project or publish enough articles.

Fang Yun could only apologize: "Professor Sun, the subject is too high-end. I only have a bachelor's degree, so I am still fighting for it. The current focus of my work is only clinical practice and I am working hard in the direction of scientific research."

Sun Xiaoliang sighed deeply when he heard this: "Alas! The medical association's grading assessment is still not thorough enough."

"I really wish I could catch you right now. Although it's not kind, but it's okay for me to come forward for poaching people." Sun Xiaoliang grabbed Fang Yun's shoulder with reluctance.

Sun Xiaoliang is not mentally retarded. Fang Yun is only 30 years old now, and his proficiency in performing shoulder arthroscopy is no less than his. And he is already 37 years old.

If Fang Yun is given enough time, it is impossible to say whether there will be enough platforms for sports medicine in the province in the future, whether there will be two competing sports medicine companies or a three-legged alliance.

What the Third Affiliated Hospital of Xiangnan University has not accomplished, the Provincial People's Hospital has always wanted to accomplish.

Associate Professor Sun Xiaoliang would even be happy if the Provincial People's Hospital could complete surgical operations that even the Affiliated Hospital of Xiangnan University could not.

In Hunan Province, the resources of the Hunan Provincial Health Commission will not be tilted towards the several hospitals affiliated with Xiangnan University, because the others are former ministry-level units directly under the provincial government, the Provincial People's Hospital.

"Thank you Professor Sun for your kindness. It's because my background is so poor."

"Teacher Sun, if it's convenient, you can give me a good score. Thank you." Fang Yun still asked.

When necessary, it doesn't hurt to sell some good words.

Sun Xiaoliang nodded heavily: "Your current level is already very high. It is estimated that in the field of sports medicine, it will not be a problem to rank among the top [-] in the province."

"Don't worry, as long as I see it, I will mark the results for you."

"Would you like to study for a master's degree?" Sun Xiaoliang still refused to give up.

But after saying that, Sun Xiaoliang shook his head again: "I'm thirty, close to middle age. My proposal is a little late. Why do you think you did it?"

Sun Xiaoliang clenched his fists with both hands and hammered them, as if he was very sorry. If Fang Yun had a graduate degree, he might be able to poach him.

Fang Yun didn't reply and just laughed. Because of the bitterness of the past, there was no need to talk to him.

Fang Yun's grades were very good when he was an undergraduate. The reason why he did not choose the Affiliated Hospital of Shonan University was because he had no money. It was because the Affiliated Hospital of Shonan University could not join the rural doctor special plan, could not study for free, and had no living expenses.

Fang Yun still remembers that his college entrance examination score was 666.

Originally he planned to go to national defense, but Fang Yun failed the political examination and had a distant relative who was out of reach and was a bandit.

If it weren't for the political review, Fang Yun's family wouldn't even remember such a person.

Of course, only Xiangzhou can apply for such a special plan. If the geographical conditions are not good, you may not be allowed to apply.

　It has been confirmed that it will be released in the early morning tomorrow. There will be a small explosion by then. Make an initial reservation in advance, so I won’t post a special testimonial about the release.

　　
　
(End of this chapter)