Those years when I hung up and upgraded in the hospital

Chapter 86 Playing off? (Please collect and read)
Wei Zhaoliang has long known about Fang Yun's abilities. Through the previous operations, everyone knows that Fang Yun has solid basic skills and is a relatively professional sports medicine doctor.

Wei Zhaoliang has recognized Fang Yun as one of his own, so he will naturally tell Fang Yun in private about the true intentions of Hu Jun, the leading brother.

Indeed, perhaps from a surgical perspective, shoulder joint release is so simple.

It only needs to be released, but in fact, shoulder joint release or shoulder joint adhesion release is actually much more difficult than rotator cuff suturing, because there are many places that need to be operated.

If all adhesions need to be released under arthroscopy, it may not be possible to remove them for two or three hours, and a thorough exploration is required.

"Okay, thank you Brother Liang for the reminder." Fang Yun felt moved in his heart when he heard this and quickly thanked him.

If Wei Zhaoliang regarded himself as an outsider, he could just watch the joke from the sidelines.

"Director Hu has such a temperament. He likes to dig pits for people unintentionally and make you jump out of them. But his intentions are not bad. He just hopes that we can make progress and improve our understanding, not only of the difficulty of the disease, but also of our own abilities. ." Wei Zhaoliang explained this way.

"I know this."

"By the way, Brother Liang, in terms of sports medicine, how is the development of the city hospital?" Fang Yun asked.

In Ji City, Xiangzhou People's Hospital and Municipal People's Hospital are two old rivals.

"We won't ask too much about the situation in the brother hospital. We are responsible for the patients by performing our own operations." Wei Zhaoliang replied.

Fang Yun nodded and stopped gossiping.

……

Half an hour later, Fang Yun and Wei Zhaoliang were already standing on the operating table fully armed.But he did not start the operation immediately. Instead, he waited for the two big brothers, Director Hu Jun and Chai Junye, to eat and return to the operating room one by one before starting the operation.

Various tools for arthroscopy have been installed!

"Sharp knife! Tour teacher, record the start time of the operation." Fang Yun said, taking the bending plate, and then started to do the arthroscopic observation scope passage.

The sharp knife is used to break open the joint capsule, and then the blunt puncture tool is used to penetrate the joint capsule, and the arthroscopic cannula is inserted into the arthroscopic field.

After adjusting the field of view angle of the arthroscope.

The field of view of the arthroscope was temporarily controlled in the subacromial space.

On the display screen, the humeral head is clearly visible and slightly white, but inside the joint cavity, after running water and cleaning, it can be seen that it is rough and the synovial pannus has proliferated, blocking most of the field of vision.

Hu Jun and Chai Junye had already washed their hands and dressed before going on stage. Fang Yun smiled and asked, "Director Hu, can I clean up a little first?"

"It's okay, you continue to operate." Hu Jun stood opposite Fang Yun and took the initiative to help hold the mirror first.

Fang Yun once again skillfully made an operating hole on the front of the patient's hanging upper arm.

After inserting the plasma electric knife, he smiled and took the arthroscope held by Hu Jun.

He smiled and said: "Director Hu will correct me later. This patient's joint cavity is too rough, with severe adhesions and synovial hyperplasia."

Hu Jun nodded and said, "It's very difficult." Chai Junye raised his toes slightly and said, "This should be a medical condition that lasts for several years."

Fang Yun stopped talking and first used electrocoagulation to clean up part of the synovial pannus. After slightly opening up his field of vision, he put down the plasma electrosurgery.

Fang Yun then conducted a relatively detailed investigation according to his own ideas——

The arthroscope has an inlet pipe and an outlet pipe. After the water is released, the structure inside becomes clear.

The glenohumeral space, that is, the shoulder joint space, was still rough, but there was a part of the field of vision where Fang Yun quickly and clearly slid around the joint cavity.

Next, you can find the position of the biceps tendon more skillfully and observe the upper part of the shoulder joint or the articular cartilage part of the biceps tendon and shoulder glenoid.No visible problems with the biceps tendon and articular cartilage.

After Fang Yun started taking pictures, he explained: "The shape of the biceps tendon can be seen, but the glenoid cartilage is blocked by the synovial pannus. It needs to be cleaned to have an exploratory field of view. Let's take pictures later after Director Hu's surgery."

Then the camera moved forward to observe the humeral head and the cartilage part of the shoulder glenoid; it was not a big problem at the moment.

Fang Yun then said to Chai Junye, who was now standing in the position of assistant: "Brother Jun, please help me rotate the shoulder internally and externally, so that I can fully observe the cartilage of the humeral head and shoulder glenoid."

"Then we move the camera forward and look at the upper and lower surfaces of the biceps tendon, the biceps tendon attachment point and the superior labrum for partial tears."

"But this patient's tendons were all intact and smooth."

At this time, Fang Yun himself automatically pressed the photo button on the operating handle. The display flashed a few times, and the negatives were left. These photos were used for a clear diagnosis.

The gold standard for diagnosing rotator cuff injury is not MRI, but arthroscopy!
Fang Fang Yun added: "At this time, we can use the antegrade surgical technique from outside to inside to open the opening and insert the front probe."

"Explore the biceps labral complex and assess the extent of the injury. Normally, the cord-like middle glenohumeral ligament crosses the subscapularis tendon and attaches to the scapular neck at the fourteen o'clock position."

"When mutated, this ligament will directly insert into the biceps tendon, causing part of the area above the labrum to lose its labral coverage and become a bare area, called the Buford complex."

"Then we move the arthroscope further down to examine the anterior portion of the inferior glenohumeral ligament and the middle glenohumeral ligament. Normally, the anterior portion of the inferior glenohumeral ligament attaches to the glenoid neck between two and four o'clock. The anterior joint capsule contains 3 separate ligaments with different attachment points."

When Fang Yun said this, Chai Junye and Wei Zhaoliang, who were standing next to them, were immediately confused, because this area was an area that they had never been to before, and it was a wild area!
Moreover, not only were they confused, Director Hu Jun was also a little confused, as if he hadn't kept up with Fang Yun's rhythm.

For shoulder arthroscopy, there is a common area and a wild area.

"Wait a moment, stop a moment, where do you think this is?" Hu Jun asked aloud.

"Middle glenohumeral ligament and inferior glenohumeral ligament?" Fang Yun asked doubtfully.

Is there any problem with this investigation?
However, what Fang Yun didn't know was that the area he was exploring was called a wild area because it was rarely accessible and difficult to reach!
"Slow down, your vision is not very clear." Hu Jun felt that he was completely out of control for a moment.

Because he couldn't even do such a probing technique.When he usually conducts investigations, he would not be so detailed.

Hearing this, Fang Yun operated slowly and said slowly: "At this time, we enter the arthroscope into the inferior recess and rotate the arthroscope toward the top of the scapular glenoid to inspect the glenohumeral ligament and labrum."

(End of this chapter)