The Godfather of Surgery

Hermès' surgery is scheduled for next week and needs to be discussed in the afternoon.

This is a very large operation, and most of the tibia must be amputated and discarded, except for the proximal and distal healthy parts, and all the infected bone tissue in the middle must be amputated.

Then, using the Irizalov technique, the healthy bone tissue at both ends was lengthened by using the external fixator, extending from the two ends to the middle, and finally joined.

In order to complete the task of bone lengthening, an external fixator should be installed on the calf. There are screws on the external fixator. When the screws are rotated, the external fixator will move with the bone tissue.

Two weeks after the operation, the extension began to extend by one millimeter a day. Hermes needs to be extended by more than 30 centimeters, which takes about a year.

This is only an ideal state. If there is abnormal bone formation in the middle, it is necessary to stop and prolong.

Yang Ping finished Luo Xiaohu's operation in the morning and had nothing to do in the afternoon. He slept in the duty room, entered the system space, read books for a long time, dissected dozens of experimental subjects, and trained his ability to compose pictures.

It also spent 5,000 cents to purchase 500 cases of external fixator special surgery for training.

Director Tian returned to the ward from the first floor. He had already translated Tan Boyun's opening speech into English and handed it to Zhang Lin.

Zhang Lin's posters were almost revised. Sitting in front of the computer, he went through them one by one and repeated them several times.

This is really a Japanese doctor? Are you sure you didn't steal the pictures? Xiao Wu sat next to Zhang Lin, still struggling with this question.

Zhang Lin ignored him, and Xiao Wu remembered that Director Tian was familiar with the guests and had been to Japan. He had a lot of knowledge. He asked him if he was right, and pointed to the photo on the computer: Is this really a Japanese doctor?

Director Tian smiled and said, Really, she is a guest at the meeting. A doctor at the Affiliated Hospital of the University of Tokyo Medical School, Fujiwara, is very good at sports medicine.

Have you seen her in person? Fatty Liang was also very interested.

When I was a visiting scholar there, I met her in person. Director Tian did meet her.

Am I so beautiful? Xiao Wu still didn't believe the photo.

Director Tian smiled: I am more beautiful than this one, do you know how tall she is?

How much? Zhang Lin asked, because the information provided would not have height.

One meter seven or eight! Director Tian reported the number.

So tall? As tall as me! Only Song Zimo can hold back, and senior brother can barely hold back! Zhang Lin was surprised.

Director Tian said so much and became impatient: Let me say, pour a glass of water, don't talk about it.

Xiao Wu immediately offered a glass of water with a smiling face, and Director Tian continued: This is nothing, and what surprises you even more, what is her part-time part-time job, do you want to know?

What? Everyone is very interested, this is expected, isn't it--

Island country! It always makes people imagine, who has never been young, and some people have two letters in their minds.

Director Tian took a sip of water: Fatty, take out your weight loss meal replacement and give me a little. It takes energy to speak, and ATP is seriously insufficient.

Fatty took out a few chocolate balls from the bag in pain and sent them over. Director Tian peeled one off and threw it into his mouth.

Everyone watched him eat eagerly, waiting for him to say what part-time was?

Director Tian took a sip and said: She is a part-time model, a famous Japanese model, and the top ten in the World Elite Model Competition. She has participated in the Victoria's Secret show in Paris.

Get such a person, don't open the academic meeting, just watch her on the catwalk. Fatty Liang said.

Zhang Lin sneered: Fatty, do you think everyone is as vulgar as you? Be more elegant.

Director Tian went on to say: She is a rookie in the Japanese sports medicine field. His brother is good at trauma orthopedics. This time it is estimated that he will come out with his brother. Although she is rare, it does happen. Nori Oga, Chairman of the Board of Directors of Sony Japan. , is also the conductor of the Tokyo Philharmonic Orchestra; Heidi Rama, the inventor of CDMA telecommunications technology in the United States, is a Hollywood movie star and the world's first naked actress; Bohr, everyone knows? Bohr's law, high He is not only a physicist, a Nobel Prize winner, but also a goalkeeper for the Danish national football team; I tell you, the serious occupation of several gold medalists in the history of the Olympic Games is a doctor! Treat me to dinner when you have time , I will tell you slowly.

Director Tian is knowledgeable and candid.

Beast man! Fatty Liang shook his head helplessly.

Fatty, so are you, an anesthesiologist, part-time chairman of the Sanbo Food Association. Zhang Lin said seriously.

Fatty Liang was not angry, but said aftertaste: The hero doesn't mention Ying Yong, let me tell you the truth, when I was in college, I really formed the school's association - the Gourmet Association, I was the first president of the association, and I did everything Pay the price, look at my current figure, that is the price.

The fat man gestured to his waistline.

Master! Zhang Lin Xiaowu gave the fat man a thumbs up.

Look, this is a photo of her Victoria's Secret show in Paris! Zhang Lin found the photo of the Japanese female doctor on the Internet.

Wow! Xiaowu and Fatty stretched their necks very long.

Keep your distance, don't spray the nosebleed on me. Zhang Lin sideways dodged.

This is not a retoucher, it's so beautiful, these legs can kneel down 90% of the men in the world! Fatty swallowed a mouthful of saliva.

Fujiwara's photo is on the catwalk, with a trench coat, short shorts, and sunglasses, and the stars are shining on the T stage.

Suddenly, Director Tian stopped talking and coughed a few times.

Someone slapped Zhang Lin's shoulder on Zhang Lin's shoulder. Zhang Lin didn't even think about it, and immediately switched the screen: Well, this patient is really troublesome.

Well, it's very troublesome! Xiao Wu touched his chin.

It's quite troublesome! Fatty Liang also nodded, frowning.

A group of drama elites who were delayed by studying medicine.

You guys are doing well today. Are you looking at Wang Changxin's medical records? Professor Zhang Zongshun walked in from the door.

Wang Changxin is the name of Hermes, and the name is so rich.

Well, familiarize yourself with it in advance! Zhang Lin stood up knowingly.

I don't know whose bloody paw touched the computer keyboard and actually brought up the picture of Fujiwara.

Professor Zhang looked through the gap in their bodies: What is this?

Zhang Lin turned around and saw that the picture jumped out. He said calmly, Screensaver, screensaver pattern.

Oh! Professor Zhang did not pursue it.

Where's Yang Ping?

Study in the duty room!

Actually sleeping in the duty room.

Where's Song Zimo?

Lab practice arthroscopy!

Really practicing arthroscopy.

Is everyone all together? Let's discuss Wang Changxin's medical records later. Professor Zhang nodded slightly.

Director Han is in the administration building and hasn't come back yet. Director Tian moved a chair for Professor Zhang to sit on.

It's okay, you all prepare first, wait for Director Han, this case discussion was raised a few days ago, have you all read the book?

I've seen it! Xiaowu Zhanglin said in unison.

Everyone went to the classroom to wait for Director Han. Director Tian called. Director Han was on his way back. Not long after, Director Han came back.

The discussion began. For the patients with Xiaowu tube, Xiaowu reported the medical records.

Xiao Wu, you guys have studied the medical records and read the book in advance. Please share your views on this case. Director Tian presided over.

Xiao Wu looked at the screen: There is no problem with the diagnosis of this patient. Chronic osteomyelitis of the right tibia is supported by imaging examination and bacterial culture. The best method is to completely remove the infected bone tissue of the tibia, and then use an external fixator to extend the tibia. , the defect was temporarily filled with vancomycin-containing calcium sulfate.

Yang Ping told them about it, and he was a little nervous.

The length of the tibia should be at least 30 centimeters. This length is very rare. Will there be neurovascular complications? Zhang Lin, tell me. Director Tian asked.

Well, this, that— Zhang Lin scratched his head.

Song Zimo took over and said: This is different from deformed shortened limb lengthening. There is no need to consider the lengthening limit of nerves and blood vessels, because only bone tissue is lengthened, blood vessels and nerves do not need to be lengthened. There are limits.

Song Zimo has solid knowledge and was once known as the problem terminator of the director's rounds.

There are two options for the extension device, external fixator and intramedullary nail. Of these two, the external fixator is more suitable for this patient. The reserved proximal and distal tibia can be placed with two sets of fixation pins. The external fixator is installed No problem. Director Tian added.

Most people only know that the external fixator can be extended, but they do not know that there is a special intramedullary nail that can also be extended.

What's Yang Ping's opinion? Professor Zhang called, and Yang Ping's speech was always not very positive.

Yang Ping calmed down and said: Everyone has said it in great detail, and there is nothing to say. When threading the needle, pay attention to the selection of needle insertion in the muscle space, so that during the extended period, the interference with muscle strength training is the least.

Song Zimo looked over, and pierced through the muscle gap. It was easy to say, but it was difficult to do it completely. Everything seemed easy to him.

Director Han collected everyone's opinions, made a teaching summary, and added the finishing touch: Ilizarov's theory of stretched tissue regeneration: the slow traction of biological tissue produces a certain tension, which can stimulate tissue regeneration and active growth, and its growth pattern is similar Fetal tissue has the same cell division. In layman's terms, slow and continuous traction is used to bring the tissue back to a state where it can grow in the fetal period. This technology is subversive to the traditional theory of compression fracture healing.

Yang Ping has great admiration for the founders of these medical theories. These people have big brains and rich imaginations.

Professor Zhang would like to talk about the origin of this theory: Irizalov was a village doctor in Siberia, the former Soviet Union in the 1950s and 1960s. This technique was produced by an accident. The original purpose of his design of the external fixator was to treat A patient with a fracture, by twisting the screws on the external fixator every day, makes the fracture end tightly pressurized to promote fracture healing. Once he was going on vacation, he told the nurse to adjust the screws on the external fixator every day. The nurse Seriously, he strictly followed his doctor's orders, but turned the screw in the opposite direction. When Irizalov came back, the patient's fractured end was separated, but he found that even though the fractured end was separated, callus still grew. Inspired by this phenomenon, he devoted a lot of time and energy to research, and finally proposed the principle of tensile stress, that is, the theory of stretched biological tissue regeneration. Later, the Soviet Union invested a lot of manpower and material resources in research and perfection of this theory, and only now has the mature theory. This theory is fully qualified to win the Nobel Prize, but at that time the US and the Soviet Union were in the Cold War and naturally could not win the prize. China began to develop this technology in the 1980s. There was a period of time when this technology was abused to increase the height of normal people and brought many complications. , skin necrosis, muscle weakness, bone non-union, nerve damage, etc. In October 2006, the Ministry of Health ordered the prohibition of the use of broken bones to increase the height of medical beauty projects, that is, they cannot be used for normal people's height increase, only use Bone defects and limb length disparities caused by congenital deformities, trauma, infections, tumors, etc., as well as limb deformities caused by diseases.”

Discussion can not only make the diagnosis and treatment plan of the patient more clear and perfect, but also is a good opportunity for young doctors to learn. Through the study of clinical cases and accumulation of experience, a typical case can master the knowledge of a type of disease.

After such a discussion, everyone has a basic understanding of the magical Ilizarov technology.

At the end of the meeting, Yang Ping received a WeChat message from Su Nanchen, asking Yang Ping to go to a consultation.

Go to the consultation? Or attach one!

Make no mistake!