Those years when I hung up and upgraded in the hospital

Chapter 66: Beautiful First Battle (Please collect and read)
In fact, it seems that Fang Yun is already a quite excellent orthopedic surgeon.

Fracture treatment is the main theme of trauma surgery. As long as this operation can be done well, Fang Yun will not be short of food. At worst, after five years, he will go to a hospital in SZ City in the south to specialize in fractures. The salary No less.

"Sterile cotton pad." Fang Yun asked Fan Youhua again and took a clean cotton pad.

Long Quan couldn't stand it anymore: "The wound is clean enough, but when a mosquito comes, I have to cry for three minutes."

"There is also liquefied fat, Director Long. I'm not very proficient in operating it, so it's better to play it slowly and steadily." Fang Yun smiled back.

Although the open reduction and internal fixation of fractures has reached level 3, there is still a slight gap between the fracture treatment performed by Director Chen Shengwu, and perhaps the same as that of Director Long Quan, but Fang Yun still hopes to make good preliminary preparations.

Sharpening knives does not miss woodcutters.

After using a sharp knife to break open a small opening in the lifted deep fascia, Fang Yun used a hemostat to poke in, bluntly tearing the deep fascia layer up and down. The deep fascia immediately swam to an unknown place, freeing his field of vision.

Under the periosteum, there were blood clumps and small fracture fragments left after the fracture. Fang Yun carefully made a hole with a sharp knife, and then used a hemostat to open it, but the hole did not enlarge.

In the limited surgical field, foreign bodies were removed.

Blood clots are foreign objects at this moment. Naturally, some useless small fracture fragments and fracture fragments must also be cleaned up.

"Bah Liu, Bah Liu!"

When the negative pressure suction device sucks out the blood clot, it makes a vibration sound of compressed air. However, after such operation, the blood clot gradually fades out of sight, leaving behind liquid blood residue.

Although the blood clot is a foreign body, it also has a certain hemostatic function. After the blood clot is sucked out, it will naturally ooze blood again.

But there won't be a lot of bleeding.

The fracture was not complicated, it was an oblique fracture, and there were not many fracture fragments.

Fang Yun picked up the three fractured fragments like pebbles and put them behind the bending plate. He clamped the remaining fragments onto dry gauze and planned to discard them.

Not every fracture fragment is useful.

The stump was cleared within four to five minutes.

Then Fang Yun put the two stumps of the fracture together, and there was shortening and displacement visible to the naked eye.

This is also the patient’s indication for surgery.

But Fang Yun just gave Qin Chaowen a look, and Qin Chaowen took the initiative to fix the fracture and fix it manually.

Manual traction requires both traction and fixation forces to separate the shortening and displacement of the fracture. Only after the shortening and displacement is restored can reduction be achieved.

Fang Yun was not nervous at this moment. With the excellent surgical field, he could just reset it under direct vision.

The patient's anesthesia was supplemented with muscle relaxation, so Fang Yun just exerted a little force, and the broken ends of the fracture began to separate. Fang Yun's left hand just moved a little, and the oblique broken ends of the fracture closed together, leaving a residual gap. .

It was the gap where the broken bones were broken.

"Director Long, help me temporarily fix it with Kirschner needles!" Fang Yun greeted quickly.

Long Quan had already held the Kirschner wire with the electric drill in his hand, slightly gestured with the angle, and then decisively used the Kirschner wire to cross the fracture line diagonally.

"Remove the force and take a look?" Long Quan ordered after temporarily fixing it.

Fang Yun released his strength and saw that the broken ends of the fracture were not separated, so he said: "The angle Director Long found is still good."

Seeing that Fang Yun was on the right track, Long Quan turned around and said, "Why don't you say your posture is good?"

"Director Long also teaches well." Fang Yun shot back, but his rank was obviously a little behind Long Quan.

After Fang Yun and Qin Chaowen relieved themselves, they asked the roving nurse to help push the C-arm machine and perform a X-ray examination to avoid the misalignment of the bleeding blind area.

It's also a guarantee.

After being satisfied with the C-arm fluoroscopy, Fang Yun and others returned to the operating table.Neither Long Quan nor Qin Chaowen pressed, but Fang Yun just rotated the broken pieces a few times before finding a suitable position for them, stuffing them in, and filling the holes.

This skillful operation did not give Long Quan a chance to do anything or give instructions. Of course he could only drive: "Chaowen, can Xiaofang stuff it just right now?"

Qin Chaowen quickly shook his head: "Director Long, I have never been stuffed."

Long Quan then turned to look at the equipment nurse and the patrol, who had already started to pick up the phone: "I'll tell the head nurse and ask the teacher from the nursing department to take you, Director Long, to the nursing department class."

Long Quan's expression changed suddenly when he heard this: "No, this is all a misunderstanding."

The traveling nurse didn't really want to make a snitch, but she just felt that Longquan was getting more and more derailed.

Fang Yun had already picked up the locked seven-hole steel plate and made a gesture and found that it was too short.

Because it is an oblique fracture, the fracture line is a bit long.The fixation principle of open reduction and internal fixation of fractures is that it must span the upper and lower parts of the fracture line and have at least three screws in place.

So I changed it to a nine-hole one.

"It's better to be longer, okay?" Long Quan had just suffered a loss and was feeling depressed, but he didn't dare to speak frankly, and he didn't want to have nothing to do and could only use metaphors.

"Actually, it's better to be longer." Fang Yun laughed.

The steel plate was expertly placed into the anteromedial space without touching the intertibiofibular membrane. Then a hole at the upper edge of the fracture line was selected, and the hole was opened using the screw formula. The depth sounder measured: " 4.5.”

The depth finder is actually used to measure the required length of the screw. It must be correctly matched. Otherwise, if it is too long, it will poke into the soft tissue, and if it is too short, the fixation effect will not be achieved.

The instrument nurse skillfully took a 4.5cm screw and temporarily continued to measure the length to prevent the instrument supplier from making mistakes when installing the instrument.

Fang Yun skillfully drove the first screw in and completed the fixation of one end.

Moreover, after Fang Yun had completely tightened it, he twisted it back a little, so that he wouldn't have to spend too much effort when removing the internal fixation later. This is foresight and a kind of character.

Some orthopedic surgeons just don't care about such things at all. They feel that the patient will never remove the screws from their own place in the future, and they will tie the screws and steel plates tightly. When removing the internal fixation, they cannot be screwed at all, and the screws will simply break.

This is also the main reason why basically all trauma surgeons are unwilling to perform internal fixation on others.

Basically, hospitals with disease-related diseases do not remove the internal fixation device for others. I don’t bother to take it out where it was done.

All subsequent operations are very natural.Fixation, C-arm machine fluoroscopy, flushing, removal of temporarily fixed Kirschner wires...

Although the suturing operation can be left to Fan Youhua, after all, it is the first operation performed by surgeon Fang Yun alone, and it still needs to be completed from beginning to end.

The suture is divided into four layers.

Periosteal layer, deep fascia layer, subcutaneous layer and skin layer.

After suturing one by one, Fang Yun also added a pair of sterile gloves to use as a drainage piece, and then applied a sterile dressing to cover the wound.

"Director Long, can you step down?" Fang Yun asked the superior doctor for his opinion again.

"Beautiful." Long Quan gave Fang Yun a thumbs up without hesitation.

Qin Chaowen also followed closely: "Nice (nice, beautiful, Naiko)."

Fang Yun pretended not to understand and watched Qin Chaowen and Long Quan step off the stage first. He took Fan Youhua to start the plaster external fixation.

Fan Youhua then said: "Brother Yun, how does it feel like being the first surgeon?"

"It's okay, I don't feel anything special." Fang Yun's heart was actually somewhat beautiful, and he had an elusive sense of accomplishment.

……

(End of this chapter)