Great doctor starts with adding points

While Wu Xiezheng was talking with Guo Lixiang, someone was poking around at the door of the doctor's office. After finally seeing clearly that only Guo Lixiang and Wu Xie were sitting inside, a group of three people walked into the office.

The leader was an old man about sixty years old: "Doctor Wu, Doctor Guo, are you two here?"

"Uncle Fang, do you have anything to do?" Wu Xie and Guo Lixiang turned their heads and recognized the visitor.

Wu Xie, the leader, knew him. His surname was Fang, and he seemed to be an old man from Grandpa's village. The uncle I call him is older than my father and younger than my grandfather. There is no relationship between generations. It is said that he moved here in the 1990s.

The other two were a middle-aged man and a woman, Wu Xie felt a little strange.

After Fang Bo and the three filed in, the last middle-aged man closed the door of the doctor's office.

"Doctor Wu, I have something to ask you, that is, my grandson's fracture operation, can I call you to do it?"

"Yesterday, I heard from Dr. Guo that you went to participate in the competition. You are better than those big hospital doctors in Han City Union Medical College Hospital. You even won the special prize. Even Dr. Zhong said so."

When Fang Bo said this, he cupped his mouth and lowered his voice: "I think that if Dr. Luo or He Ling is to be operated on, it must be inferior to Dr. Wu."

Fang Hongqi spoke very formally, his eyes full of cunning.

Wu Xie quickly turned his head and glared at Guo Lixiang, this guy will definitely cause trouble for himself: "Uncle Fang, these are all rumors, how can I be better than the teachers in those big hospitals in Han City, look at me Senior brother, Doctor Long."

Fang Hongqi asked as if he knew the market very well: "That is, Dr. Wu, you admit that you are better than Dr. He and the others."

"That's not true, Uncle Fang, I don't think so either. You know Dr. He Ling. He has worked in Shazhen for so many years. Dr. Luo Wei is also a doctor at the County People's Hospital. He has rich experience and treats more patients than others. I've seen more than that."

"They." Wu Xie was about to explain.

Fang Hongqi withdrew his body, with a straight face: "Doctor Wu, don't be modest, you are going to be a doctor in a hospital in the state, so why doesn't Dr. He and Dr. Luo go?"

"That's right, Doctor Wu, you just agree!"

"We definitely believe in Dr. Long. We came here for Dr. Long, but we also trust Dr. Wu even more! What's so embarrassing, whoever has good skills, we would like to have someone operate on us."

"It depends on whether you are willing or not. Anyone with a discerning eye can see it." Fang Hongqi's expression was serious, and his tone was formal. He was not pretending, but really asked Wu Xie to be the chief surgeon.

"Uncle Fang, thank you for your trust, but Dr. Long and Director Lu have to arrange for whoever performs the operation, not just what I want to do." Wu Xie's mood gradually eased.

Indeed, from Fang Hongqi's point of view, he naturally wanted to choose a doctor with better skills. Longyuan came to teach him because he wanted to develop local surgical capabilities, so he must give up the opportunity.

However, in Fang Hongqi's vision, whoever is willing to use it as a teaching material should be the one. His grandson just wants to find someone with relatively good skills. Surgery is more reassuring.

"That's right. As long as Dr. Wu agrees, then I'll talk to Director Lu and give him my opinion." Fang Hongqi looked at the two people next to him after speaking.

"Aren't you right?"

"That's for sure. Dr. Wu has been a top student since he was a child. He has learned a lot and has good skills. This is obvious. We must find a doctor with better skills to perform the operation. Dr. Wu, it's not convenient for you to say, let's mention it. "

"Look, Qin Dahe, Lin Zhonghua, didn't they all do well with Dr. Wu, and Lin Zhonghua has already got out of bed and crutches, and his spirit is getting better and better..."

After the three of them got Wu Xie's consent, they left the office door, and they were still talking when they went out.

"Uncle Fang, you are still well-informed. I guess Dr. Wu is due to his low qualifications, so he wants to give Dr. He and Dr. Luo more opportunities."

"It's like this in the system. High ability does not necessarily match high qualifications. Look at Dr. Wu. In the provincial doctor competition, no one in Enzhou can win the special prize. This is strength."

"..."

When the three of them walked out like this, Wu Xie even had a feeling in his heart, whether his mother Xiang Mei went to be Bai Xiaosheng and got through similar news as a foreshadowing.

But considering that it was Guo Lixiang who said it, it couldn't be Xiang Mei.

No matter how stupid Xiang Mei was, she couldn't order Guo Lixiang to do things.

Wu Xie looked at Guo Lixiang: "Xiao Guo, we are brothers, you can't put me on the fire."

"Brother He Ling tried his best to help me when I first came here, and he also took care of us a lot. He has always been a big brother. If you tell patients like this, Brother He Ling will feel uncomfortable."

People have to know how to be grateful!

When Wu Xie first came to Shazhen, he didn't know anything, and even when he couldn't solve the problem with the debridement, it was He Ling who came to help him, not to mention hard work, but willing to heal himself.

It's a bit unreasonable to say that I have just started to improve, and I want to take the opportunity to take the lead from He Ling.

Guo Lixiang leaned over and put his chest almost close to the desk surface. He was originally small, but now he looked even smaller.

Explain in a low voice: "Mr. Long told me to say that."

"Yesterday afternoon. I made a special trip to the department." Guo Lixiang was probably afraid that Wu Xie would misunderstand, and he was also afraid that Wu Xie would tell Long Yuan that Long Yuan would misunderstand again, so he lowered his voice very low.

A lot of conjectures flooded into Wu Xie's mind, and finally all emotions slowly returned to reality.

Regardless of professional factors and professional titles, everyone is an ordinary person, whether it is Professor Qi Qiaowen or Duan Hong, plus Professor Zhou Xiaoning who is "reputable and established", there is another Longyuan not long ago.

Now, there should be another self.

Ordinary people will have good and evil likes and dislikes, and selfishness is also a basic characteristic of everyone, because everyone's vision and perspective are completely different.

Long Yuan didn't look exactly the same as Zhou Xiaoning before, just because there was no such necessity at the time, but when it was necessary, Long Yuan and Zhou Xiaoning were actually not different at all.

Wu Xie didn't even want to ask Long Yuan what news Guo Lixiang had spread.

In the normal course of the medical procedure, under the same surgeon authority and opportunity, the patient's right to make independent decisions is greater than preference and seniority. That is to say, the patient can ask who will be the surgeon and who will not be the surgeon.

He Ling used to focus on general surgery, so he was only the attending physician of general surgery. The authorization of surgery in related fields of orthopedics is almost at the same level as Wu Xie, and he needs temporary authorization from superior doctors or even as an assistant to operate!

From the very beginning, Wu Xie focused on the Minda Hospital. He never thought that the final result of this medical skills competition could be used in the same way in Xuan County Hospital of Traditional Chinese and Western Medicine.

But Longyuan thought of it, and he also used it——

This is an objective fact, because Wu Xie just won the special prize, and Wu Xie also performed teaching surgery there.

The patient may or may not be aware, but when the patient is aware, he requests that He Ling, who is the chief surgeon, be replaced by Wu Xie, which is reasonable, reasonable and compliant.

Because whether it is He Ling or Wu Xie, when the orthopedic fracture surgery is performed, either Lu Junyin is present or Long Yuan is present to authorize, which is essentially the same.

Wu Xie patted Guo Lixiang on the shoulder, keeping this incident firmly in his heart.

Sometimes, the maximum utilization of resources depends on how you use them! It doesn't have to be limited to where you concentrate.

...

When Wu Xie left the operating room, Guo Lixiang was still on duty.

In the department, he is the only junior medical assistant, and everyone else is a doctor or above. Therefore, Guo Lixiang will suffer a little when it comes to shift scheduling, but he also has some benefits.

The disadvantage is that there are not many opportunities to go to the operating room in Guoli Lane to observe Longyuan's surgery. The advantage is that Guoli Lane's schedule will never conflict with Longyuan's outpatient schedule. The bottom line of contact is to be tolerated.

Just like Wu Xie, one of Wu Xie's current bottom lines is not to schedule shifts on Saturdays and Sundays!

When Wu Xie went down to the operating room again, he saw the first operation in the operating room. It was He Ling who was the chief surgeon, and then Long Yuan who was in the first assistant position, and kept pointing out some details of He Ling's next operation. Operation module.

"Try reset again. Open reset should be of a high standard. It cannot be operated for the purpose of stepping down. At the very beginning, you must learn to discard almost three words." Long Yuan continued.

He Ling nodded and said yes, then turned his head to look at the shadowless lamp again, thinking about how to align the displacement of the fracture.

He already knows the principle clearly, but he is still at the stage of groping for the technique of control.

Operations and theory are separated...

Probably because he was afraid of He Ling's misunderstanding, Luo Wei explained: "Teacher Long has relatively high requirements, which is very good for our study. High requirements can produce high standards, and high standards can produce high quality."

He Ling smiled, regained his senses, and said in a relaxed tone, "Thank you, Teacher Long."

Wu Xie slowly adhered to the principle of not polluting the operating table, and kept approaching the field of vision on the operating table. Then Tang Yuewei, who was sitting in front of the anesthesia machine, pulled his hand, indicating that Wu Xie could stand on the anesthesia machine. side.

The position of the anesthesiologist is the head and face of the patient, which is one of the best views. When watching the operation, it is no less than in the main knife position and the first assistant position, but it is a sterile position, so it is not suitable for the operator to stand.

There were not many people in the department, Lu Junyin, He Ling, Luo Wei, Long Yuan, and Zhong Yusheng, there were only five people, and they could all be on the stage, so there were plenty of places to watch.

After Wu Xie stood still, he saw He Ling doing the second reset of the manipulation under direct vision, and Long Yuan doing the opposite resistance.

From Shuye, we can see that He Ling is now in a situation where he knows what to do and what to make, but when he does it himself, it is difficult to achieve his goal. This is still not very skilled in operation, but There is still a lack of theoretical reserves!

This should justify the learning route of medical surgery skills, first theory, then operation, and then theory!

However, Wu Xie didn't know how to make He Ling jump in the operational level for the time being. He was still only at the specialization level in terms of technique reset, and he was not even at the expert level.

This time I went to En City to participate in the competition. After observing so many expert-level skills, Wu Xie looked back at his trauma surgery skills and felt that he was in a mess and didn't know what to do.

This kind of self-criticism just confirmed what Long Yuan said just now, don't have surgery just to step down.

Being able to step down is just a lower limit of the operation, which means that you have completed the overall operation and can end this operation. However, there is no pursuit for the final quality of the operation. What you can achieve is what this type of operation can achieve. The lower limit of quality!

Similar to the final exam, failing to fail is the lower limit. You can only pass if you get 60 points in the test, and passing means that you have some understanding of this subject, but if you want to enter this subject, Just 60 points is definitely not enough, not even 100 points!

The ultimate service object of the operation is the patient. The patient does not know the quality of the operation, but as the chief surgeon, you should know it yourself.

Efforts to improve your lower and upper limits of surgery is your pursuit, and this is also the basis for you to be able to claim that your surgery is well done and your skills are good.

Now Wu Xie dare not say such a thing.

Of course, Wu Xie didn't dare to say anything, and neither did Long Yuan.

Now in the entire operating room, the upper limit of the restoration of the fractured hand is the specialization level. The specialization level is enough in application, but it is lacking in teaching.

Wu Xie's teaching to Long Yuan at that time was to demonstrate and take him to experience, and Long Yuan has done fracture-related operations for many years, so he already has experience, so he just needs to take him to experience.

And He Ling's current position is just getting started, understands the theory, knows how to do it, and knows what it looks like, but in the process of specific operation, there are deficiencies. Just practice it over and over again.

Some tricks can only increase the probability of successful reduction to a certain extent, and more depends on the hand feeling, the way of force and the classification of the fracture. Specific problems should be analyzed in detail!

...

The first operation did not progress quickly, but after more than 20 minutes, the reset was completed. It was not the best reset, but it was able to achieve a relatively good surgical quality.

Longyuan asked He Ling to proceed to the next step, that is, the fixing procedure of internal fixation with steel plates and screws!

The fixed procedure actually focuses on the proficiency of the instruments, and in this regard, He Ling has participated in many general surgery operations and has his own understanding, so he quickly caught up with the rhythm and worked steadily.

It was only after one hour and fifty minutes of the operation that the operation came to an end!

"Huh!~" He Ling breathed a sigh of relief after finishing the last step.

"Mr. Long, I usually see that you perform fracture surgery very easily, but when you do it yourself, you find that there are so many difficulties, and the operation is still too unskilled." He Ling asked Zhong Yusheng to apply plaster after the suture , Facing the image of the fixed fracture projected in the C-arm display screen, so to speak.

Accustomed to seeing the high-standard internal fixation images after Longyuan’s surgery, He Ling knew that his surgery was definitely enough according to conventional standards, but according to Longyuan’s average standard, it seemed a bit spicy. eyes out.

But this is his own operation alone, and Long Yuan is only assisting, which is already a good progress.

Lu Junyin said: "Yes, it looks simple, but it is difficult to do. Most things are like this."

"It's okay, after all, it's the first time." Lu Junyin said so, and looked at Wu Xie with a slightly complicated gaze: "Xiao Wu, what do you think?"

Just during the operation, before Wu Xie got out of the operating room, he received a call from the person on duty in the operating room, saying that a surgical patient was looking for him.

After Lu Junyin asked what happened, he was very troubled now.

"Brother He Ling has done a very good job." Wu Xie nodded, not acknowledging the implication in Lu Junyin's words.

I won a special prize. This kind of strength should not be the normal technical level that a town hospital should have, because this is a level that even young doctors in the state people's hospital can't reach.

Lu Junyin couldn't believe it even if he said that he wouldn't leave after ten thousand.

And Lu Junyin was even embarrassed to ask Wu Xie if he wanted to stay any longer. If Wu Xie cooked a little better, he could give Wu Xie a few choices for Wu Xie to choose!

Because if the level is similar, it is actually better to stay in the town hospital, after all, it is up to oneself.

But Wu Xie's current level can easily become bigger and stronger in the state, and the level of the platform is different, how can you say it?

However, now knowing that Wu Xie is leaving, the patient's family members strongly demand that Wu Xie come to be the surgeon. It is equivalent to using the patient resources and surgical resources in the department to train Wu Xie during the period before Wu Xie is about to leave.

Lu Junyin is not a saint either, and he still feels a little uncomfortable in his heart.

He had given Wu Xie so much trust before, but he didn't keep Wu Xie in the end. Now that he knew Wu Xie was leaving, he had to feed him.

Lu Junyin smiled: "You will be the chief surgeon for the next operation, and watch your performance for the grand prize. The patient's family members immediately demanded it strongly after hearing this."

Lu Junyin glanced at Long Yuan's expression from the corner of his eye.

Long Yuan's expression remained the same, but Luo Wei helped to speak: "Director Lu, Xiao Wu's level is still quite high."

"I also didn't participate in our trauma surgery competition, but in hand surgery, the young doctor Zhao Runfa from Union Medical College Hospital, Zhang Tianwen from Provincial People's Hospital and other doctors can be regarded as experts."

"Huang Yaolong, deputy chief physician of Minda Hospital, is relatively low in the overall ranking this time."

Luo Wei is also the one who does not open the pot, but he has such an identity to carry it.

Luo Wei is from the County People's Hospital. He is an outsider who came to support him. What you said is also an objective fact, how can you make him not speak?

Although Lu Junyin was not on the field, he had already received countless poaching calls, which was also one of the reasons why he was quite depressed.

So many directors and professors came to him to recruit people, so they didn't regard him as a human being, thinking that Lu Junyin would definitely not be able to keep Wu Xie, nor did he have the capital to keep Wu Xie!

Not to mention, Huang Yaolong, deputy chief physician, is equal to Lu Junyin in terms of professional title, and is still young with high development potential, still behind Wu Xie.

Wu Xie's ranking is based on his strength, that is, he can speak, and he does not rely on relationships.

Can Huang Yaolong willingly serve as Wu Xie's supporting green leaf?

"Director Lu, I will try my best! I dare not be a performer."

"The performance is outside the operating room." Wu Xie replied so solemnly, not joking.

Lu Junyin, He Ling and the others all smiled, and then walked towards the operating room with Luo Wei and Longyuan while chatting and laughing.

Wu Xie didn't follow him. He was the chief surgeon for the next operation, and he had to follow the turnaround of the operation, so that he could perform operations such as disinfection and draping as soon as possible.

And even if he is not the chief surgeon, as a resident doctor, he will cooperate with Zhong Yusheng to complete the preparations before the operation.

After Zhong Yusheng sent the previous surgery patient back to the ward, Tang Yuewei and Dong Chun were still under anesthesia, Zhong Yusheng and Wu Xie sat on the stool under the timing panel in the operating room.

"Brother Crab, congratulations!" Zhong Yusheng stroked his eyebrows as he spoke.

"I invite you and Xiao Guo to have dinner together tomorrow night!" Wu Xie smiled and nodded to Zhong Yusheng.

"Yusheng, where's Dr. Zheng? It seems like you didn't see him during the surgery just now?"

Zheng Yingshan, who was new to the department before, obviously came down to the operating room with Lu Junyin.

"Dr. Zheng had something to do and left before you left the operating room, but he didn't say what it was!" Zhong Yusheng explained, putting down his hand, and then he checked the time on his phone. It was already ten twenty.

The operation time of He Ling's previous operation was relatively slow.

"Oh. That's it." Wu Xie expressed her understanding.

Zheng Yingshan is only here for a trial job. Although he is in charge and has no competitors, in principle he will not leave early or be late at will.

"Yu Sheng, do you know why the Zhang Xuehua who came to try the job before didn't come? Wasn't he still with you when you were in Enshi?" Wu Xie asked curiously.

"I don't know about this either. Zhang Xuehua told Director Lu on Saturday that he has already booked another place. Maybe it's because the treatment or the platform is better." Zhong Yusheng replied.

Then Zhong Yusheng lowered his voice and asked, "Brother Xie, when are you going to leave?"

When Zhong Yusheng said this, there was envy in his eyes.

When he and Lu Junyin went to the competition venue, most of Lu Junyin was laughing with a group of directors, while Wu Xie easily wandered among professors and senior doctors, talking and laughing, and more harmonious Professor Qi Qiaowen from the hospital said to his face that Wu Xie was his student.

This kind of treatment is really different for the same age, which makes Zhong Yusheng very envious.

But Zhong Yusheng felt that he could no longer follow Wu Xie's path. Now that his job was stable and his salary was okay, he just let it go.

"It should be a while. Huake usually starts interviews from February to March. After the interviews are over and the list is announced, I should resign." Wu Xie said.

"Actually, I didn't agree to director Lu's participation in the county TV station's interview today because of this. I will still be able to leave if I have a notification letter to go to higher education."

The country's laws stipulate that no unit shall use contracts to suppress the normal admission to domestic universities. Even if you are a civil servant, you can resign if you want to get a master's degree, especially if you are a private unit.

Even if the contract is not written, it is considered illegal, and the contract cannot be used as an argument.

"Director Lu actually wanted you to stay. The surgery department of our hospital can develop well. When we move to the new inpatient building, we will separate the general surgery department and the orthopedics department!"

"However, in the past two days, Director Lu said that you are out of talent for staying here. You should have more surgeries and get in touch with more difficult diseases so that you can give full play to your advantages, instead of making trouble here. .” Zhong Yusheng’s tone was slightly sour.

"It's not a small fight, Yu Sheng."

"Our hospital is the most core provider of medical resources in a town. If you keep a peaceful place, how can you make a small fuss?"

"It's just that the mission positioning is slightly different." Wu Xie told Zhong Yusheng this way.

The town hospital has the meaning of the existence of the town hospital. There is no need to make the people in the town to toss too much. Being able to deal with some routine diseases will save a lot of money and trouble for the uncles, aunts, grandparents here.

"Anyway, they're all bastards!" Zhong Yusheng smiled irresistibly, and looked at Wu Xie, with longing in his eyes, but helpless.

He has already completed the regular training, and at this age, basically the future has been finalized. If there is a breakthrough, at most he will be like Liu Chengshan, who will run to the county after he becomes a senior attending.

Now at his age, it is not suitable for him to go to school, and if he does not study, the upper limit is very limited.

Wu Xie didn't continue to discuss this topic with Zhong Yusheng in depth. After Tang Yuewei and Dong Chun finished the anesthesia, the two of them cooperated very skillfully to finish the operation of disinfecting and spreading the towels.

And when it was about to end, Chen Chen, the itinerant nurse, dialed Lu Junyin's phone number, and Fan Qingqing stepped onto the stage quickly and prepared all the surgical equipment.

After Wu Xie and Zhong Yusheng put on sterile surgical gowns and gloves, they stood on both sides of the operating table, waiting for Lu Junyin or Long Yuan to arrive.

When Zhong Yusheng left the operating room to go to the ward, Wu Xie had already completed the film reading and the overall design and planning of the operation.

This is a patient with a comminuted fracture of the middle femur. Conservative treatment + plaster external fixation cannot achieve the effect of fixation. Internal fixation must be used to achieve the degree of fixation.

Therefore, the need for subpatellar intramedullary nail tibial fracture internal fixation.

Only tibial fractures, no fibula fractures, the operation is relatively simple.

It was originally a surgical operation for He Ling to practice, but the family members of the patient strongly urged Wu Xie to come on stage as the chief surgeon, so Wu Xie was naturally given the opportunity to be authorized to do secondary and tertiary surgeries in hand surgery and trauma surgery. Prepare.

Soon Lu Junyin and Longyuan Luowei came to the stage, while He Ling knew that he didn't have many opportunities, so he stood on the sidelines and watched the whole process.

He Ling is not jealous of Wu Xie being the surgeon advocated by the patient's family. He just wants to see where and why Wu Xie did a good job, and whether it can help his own improvement.

Because Lu Junyin's plan is to separate the surgery department in the next step, if Lu Junyin doesn't want to take over the orthopedics department, he can only take over the orthopedics department himself in the end, or the main direction in the future will be the infection surgery of the orthopedics department.

It's a plan!

"It's all ready, let's start the stage?"

"Chen Chen, the surgery is starting!" Lu Junyin yelled at Chen Chen, telling her to start timing the surgery so that the opening time of the surgery can be unified later.

The start of the operation must be consistent with the three time points of the operation record, anesthesia record, and operating room instrument use record.

"Five minutes past eleven, the operation begins!" After Wu Xie said so calmly, he made an incision under the patella without hesitation, exposing the upper part of the tibia with a specialized incision!

The whole process was very dry. I just used the electric knife to touch the small mutant blood vessels that were cut a few times. There was almost no blood leakage. The pale yellow fat and muscles were not stained with blood. In addition, a tourniquet was applied before. The wound surface is even more refreshing.

A clear wound surface means a good surgical field of view, and a good surgical field of vision means a relatively wide operating field.

After exposing the proximal end of the tibia, Wu Xie immediately said to Long Yuan: "Brother, let's reset it first, and then make an intramedullary opening after C-arm fluoroscopy."

The fixed position of the intramedullary nail is fixed in the bone marrow cavity, and the bone marrow cavity needs to be opened with a special opener, and then flared!

"Okay!" Long Yuan stood in the first aid position, and without a traction frame, pressed the middle of the femur for reverse traction and fixation.

Wu Xie pinched the patient's ankle, and after pulling the fracture slowly, he changed the axial position of the bone and aligned it. After a little effort, it can be seen that the proximal and distal ends of the fracture have fit together .

If the deformity is visible to the naked eye, it can be seen that the deformity disappears, which is a visual sign of successful fracture reduction. If it is closed reduction, then the operation is over at this step.

But this is surgery, so it must be done with rigor.

"Teacher on tour, please push the C-arm machine." Wu Xie was in a serious mood, so the address was changed.

With the help of He Ling, the itinerant nurse Chen Chen pushed the C-arm machine covered with a sterile C-arm machine cover to the top of the operating table.

After everyone went out, Wu Xie stepped on the foot controller for shooting, and the reset image was displayed on the C-arm display.

After taking a few serious glances, Wu Xie looked at Longyuan's expression again, and found no disgust or other changes, so he said: "The current reset situation is okay, you can open your mouth! Sister Qingqing, please prepare the mouthpiece .”

After Wu Xie finished speaking, he entered the operating room with Longyuan and Lu Junyin, but Luo Wei did not come in together, but continued to be with He Ling in front of the C-arm monitor for a long time as if unable to let go.

"Brother Wei, how do you think Xiao Wu can achieve the same reset effect as Teacher Long?" He Ling only dared to tilt his head, but did not dare to move, for fear of bumping into Luo Wei who was wearing a surgical gown.

Luo Wei should have said, "Didn't Xiao Wu teach Brother Yuan's technique reset? You should say that Brother Yuan's technique reset can achieve Xiao Wu's effect!"

"However, when making the incision, it can still be seen that although Xiao Wu's incision is better than ours, it is still a bit worse than Teacher Long's."

"In contrast, there is still a depth of effort."

He Ling looked at Luo Wei, and felt that what Luo Wei said made sense, so he slowly let go of it a lot.

...

The mouth gag is similar to an awl, but the common household awl is conical, but the medical gag awl is mostly a four-sided rhombus. After breaking the opening into the bone marrow cavity, start to use the expander to go deep into the bone marrow cavity until it completely breaks through the bone marrow cavity Until the guide wire can penetrate the bone marrow cavity!

Wu Xie did it slowly and steadily step by step.

My current opportunity to be the chief surgeon comes from the trust of patients. The original purpose of patients is to get better medical resources and provide them with better surgeries. This is not a competition.

You don't need fancy operations, you just need to be the best in the world every step of the way, but you have to do your own limit, and this is the relative best.

Not comparable to Longyuan, but comparable to others, even Luo Wei!

The difficulty in the operation of intramedullary nail fixation is that the guide wire passes through the broken end of the fracture line, because there is displacement between the broken ends, so the guide wire can easily exit the bone marrow cavity from the displacement port and reach the soft tissue during the process of shuttling. !

The more the displacement is not corrected, the greater the chance of this.

However, after Wu Xie performed manual reduction, the broken ends of the fracture were almost strictly aligned, so there was no such dislocation hole. Without the dislocation hole, the guide pin would not be biased!

Therefore, reduction is still an important operation node in intramedullary nailing, which determines that the difficulty of your operation will be reduced, and the quality of your operation will be improved!

The guide needle made two beeps, confirming that it could reach the blind end of the bone marrow cavity, and Wu Xie said, "Reamer, starting on the 6th..."

Fracture reduction is a reserve operation in the early stage of the operation. After the preparatory work is done, the next step is the proficiency in the use of the corresponding orthopedic instruments.

Reaming, mold trial, placing the real intramedullary nail internal fixation device, and then fixing the intramedullary nail through the formula. This operation is very procedural!

At least in Wu Xie's current understanding, these operations are all programmed.

However, it is obvious that Wu Xie's current understanding is a bit biased. Long Yuan explained: "Slow down, the quality control node of intramedullary nail internal fixation is the effect of reset. The second is the process of internal fixation. In the middle, reduce the fretting!"

"The effect of reset lies in your control and alignment of reset."

"The reduction of fretting during the operation is to avoid the friction of the fracture ends, resulting in postoperative bone healing scars, and the impact of fretting on the final alignment!"

"A few more key points are that you have to learn to understand the fixation principle of the internal fixation device, as well as the compression principle between the screw and the thread, so as to reduce fretting."

"The second is that you need to temporarily fix it through certain techniques to avoid fretting and displacement during the reset process."

"The better the alignment and the stricter the fixation, the more reassuring you will be to let the patient recover as soon as possible after the operation. Reliable internal fixation is the absolute guideline for exercise rehabilitation after the operation or even after the anesthesia ends!"

When Wu Xie heard this, his eyes flashed.

I don't know if it's because he has many expert-level skills, so his ability to capture and calculate some key elements of expert-level skills has been improved.

So in the process of Long Yuan giving him such instructions, Wu Xie suddenly realized a lot.

"Knowledge point +14!" With just a few words, Wu Xie's knowledge point increased by 14 points.

This is the essence, but also an understanding and concept!

However, with only experience, it is still impossible to obtain essential improvement, but Wu Xie is not in a hurry, and continues to complete this operation step by step.

After the important operation of the operation was over, Wu Xie voluntarily withdrew, because the chief surgeon of this operation still had to write Long Yuan, so it was best not to complete all the operations by himself, and leave the end cap of the final intramedullary nail to Long Yuan. As well as the stitching operation, you will still be the chief surgeon.

I am just an assistant, but an assistant who has completed the reset and most of the fixes, not the complete surgeon.

Assistants have the right to help superior doctors complete some operations, which is written into the law to avoid medical disputes.

After the important operation was completed, the C-arm fluoroscopy results came out, and everyone felt that it was perfect, so Lu Junyin and others stepped down, leaving only Wu Xie, Long Yuan, and Zhong Yusheng on the stage.

Wu Xie asked: "Brother, in the final fixing process just now, is there still something lacking?"

"right!"

"In the operation of internal fixation instruments, the physical helical principle should be used to the greatest extent, not the principle of top rotation."

"In the process of top rotation, although it will reduce the difficulty of your operation, it will increase the fretting and friction between the broken ends, and will slow down the healing time of the patient to a certain extent. Although there is no specific statistics, it is not easy to count. , but can be deduced from experience.

"This deeper concept is related to the healing process of fractures. You can go back and read the relevant modules carefully, although it is the foundation for getting started in orthopedics." Long Yuan gave Wu Xie instructions in this way, in-depth and simple.

Then he noticed that Zhong Yusheng was at a loss, and Long Yuan simply explained: "Yusheng, the guy who makes aluminum alloy window frames in the town, do you know him at home?"

"If there is, you can come and help for two days, which can help you improve your understanding of the operation of the internal fixation device fixation process. When I passed by several times, I thought it was pretty good."

"It's a good practice material."

"Huh? Teacher Long, aluminum alloy?" Zhong Yusheng was astonished.

Isn't that for doors and windows?

"You don't want it? When aluminum alloy is fixed with screws, there is no thread formula to assist. Don't use the electric screwdriver they use to screw in the screws one by one by hand, if you can do it without slipping the teeth. "

"You guys will definitely have a deeper understanding. I was interested last time and tried a few times. The boss said that I am a carpenter who works on doors and windows in a big place." Long Yuan is really good at teaching. , so you can find very unpretentious teaching material!

"Okay! Teacher Long." Zhong Yusheng was dubious.

But Wu Xie kept this matter in mind!

Every skill is down-to-earth, so that you can know it well and be able to handle it with ease. In the process of performing surgery and treating patients, you will have a spectrum and know where the lower limit and upper limit are.

He has already fixed his lower limit, and his roots are very stable. It's time to constantly strive for the upper limit!