medical simulator

The muscle strength of the lower limbs is not small, so the stretch is very tight.

And you can't use violence, otherwise, the fracture fragments that were originally separated may break when you use brute force, so what's the point of doing surgery?

If the reduction of the fracture is the key point of the whole fracture operation, then how to get the fracture displacement of this kind of muscle traction is the key point of the fracture reduction.

At this time, it is necessary to use a clever way to resist the pulling of the muscles!

Cai Dongfan continued to poke for a while, but the pulled fracture fragments were still not very obedient.

He raised his head and said, "Luo Yun, take another bone and peel it off for me!"

What Cai Dongfan wanted was to press down on the broken ends of the fracture fragments so that the fracture fragments would not be displaced under the pull of the muscles.

Luo Yun frowned slightly, and said, "Director Cai, this fracture is not big, it might break if you press it backwards."

Although this was a rejection of Cai Dongfan's opinion, Luo Yun still said that the entire operation does not belong to Cai Dongfan alone. If there is an accident during the operation, it is the entire team that will increase the workload!

"En!" Cai Dongfan pondered for a while, and took a few deep breaths.

"It would be great if it could be fixed with a Kirschner wire first, so that the whole bone will be stressed." Cai Dongfan said to himself.

This is a kind of temporary fixation during the operation. A variety of fracture operations will be applied to the temporary fixation of the Kirschner wire during the operation.

This is also the reason why Zhou Cheng also acquired the skills of fracture reduction and Kirschner wire internal fixation (perfect) after obtaining perfect fracture open reduction and internal fixation!

This is a whole and belongs to the downstream skills.

"Xuan, give me two Kirschner wires for a try." Cai Dongfan still thinks it's better to be on the safe side, otherwise, after the fractured fragment fractures again, the workload will be much greater than it is now!

Cai Dongfan called for the itinerant nurse.

For an operation, the most complete configuration in a tertiary first-class hospital is that itinerant nurses are responsible for prescribing various new instruments or consumables during the operation under the stage.

Nurses wash their hands and pass instruments to surgeons.

An anesthesiologist, responsible for anesthesia.

Then there is the team of surgeons, who do the surgery.There are also some workers who are responsible for cleaning the operating room, delivering surgical kits for the next operation, etc., and performing their own duties, so that the connection between a patient's operation and the operation stage can be smoother!

"Okay, Director Cai." The itinerant nurse naturally respected the chief surgeon's opinion.

She knew some orthopedics, but she certainly wasn't good enough to give advice on Cai Dongfan's surgery.Moreover, temporary Kirschner wire fixation in fractures is a normalized operation!

Just when Cai Dongfan got the Kirschner needle and was about to inject it, he suddenly said, "Yan Jun, change positions with you, Zhou Cheng, and I will first inject the Kirschner needle in the direction from the inside down to the outside up."

"You need to fix the insertion point of the Kirschner wire for me."

During the operation, the temporary fixation of the Kirschner wire generally requires two Kirschner wires, crossed.

What is being done now is a medial fracture. The first Kirschner wire is best to be nailed to the large tibia along the direction of the tibial plateau fracture from the inside down to the outside.

In the process of inserting the Kirschner wire, a person needs to develop the needle entry point, and it is best to assist in fixing it.

This is a good opportunity to operate.

Cai Dongfan still gave it to his student, Du Yanjun.

Zhou Cheng was also very obedient, first he asked Du Yanjun to take over the hook he pulled, and then walked around from behind Du Yanjun back to back to above Du Yanjun, and then Du Yanjun went to Zhou Cheng's previous position move!

Zhou Cheng can't go wrong with the aseptic small details in this kind of surgery.

Every surgical operation requires a strict concept of asepsis, otherwise it is killing yourself and causing trouble.

After Zhou Cheng came to the place where Du Yanjun was standing before, he sighed slightly in his heart, covered himself with a mask, smiled wryly, and then decided to help Cai Dongfan.

Because if according to Cai Dongfan's way, he forcefully nailed the Kirschner wire to the larger tibia in the state of leaving the air, in fact, it is no different from when he asked Luo Yun to hold it down.

In fact, the best way now is to find a suitable point and relieve the tension of the inner muscle group whose insertion point is on the inner side of the tibia.

Muscles are like rubber bands, but if the rubber band is not being stretched, there is no pulling power.

Before, Zhou Cheng stood under the operation site, while the inner muscles started from the ischium and ended on the inside of the tibia, and the muscles were shaped above the operation site. Even if Zhou Cheng wanted to help, he was powerless.But now that he is in this position, it is natural to help.

So, while pulling the hook with his right hand, Zhou Cheng silently placed his left hand on a very clever position on the inside of the patient's thigh, and then pressed it down, then slid down slightly.

In an instant, the increased friction brought about by Zhou Cheng's pressing down on the fingers of his left hand smoothed out the patient's muscles that originally pulled the fractured fragments.

Follow the shape of the muscles and stroke like this.

A miraculous scene appeared, the tip of the fracture, which had been pried very high, retracted its 'tail' very docilely at this moment, and joined the big army of the tibia steadily.

Seeing this scene, Cai Dongfan immediately shrank his pupils, without having time to think about why this happened.

It's just that this is very conducive to the progress of the operation, and he shouted almost without thinking: "Don't move, keep this posture, I will inject a Kirschner wire first. Don't move."

Opportunity for surgery is fleeting.

Therefore, Cai Dongfan didn't have time to ask Du Yanjun to reveal the needle insertion point to him, so he directly drilled the Kirschner wire in with an electric drill.

Du Yanjun was very embarrassed at the time, holding a vascular forceps in his hand, and opening it in the air, it was almost lonely...

I was at a loss: Master, did you ask me to fix the needle insertion point for you?

After the first Kirschner wire nailed the fracture fragments in the direction from the inside down to the outside up, the three heads and six eyes all looked in the same direction as Zhou Cheng...

Chapter 13 feels threatened!

Obviously, such a silky and safe operation timing was created by Zhou Cheng.

After all, Du Yanjun stood in Zhou Cheng's position for so long before, without any help, and Zhou Cheng stepped up, so the perfect time for surgery came.

The front and the back formed a stark contrast. How could it be possible to prevent the three of them from focusing on Zhou Cheng?

Cai Dongfan remained silent, but blinked his eyes, thinking in his mind.

Was Zhou Cheng's tendon unloading action just done by accident or on purpose?

Strictly speaking, Zhou Cheng is also Cai Dongfan's student, and has been training with him for two years.Staying in the same group is the superior and the subordinate, who manage the bed with dignity, and get along with each other day and night. Even animals have certain feelings, but the unfamiliarity of the feelings is different.

Du Yanjun is his real graduate student, in ancient times he was his apprentice, and Zhou Cheng was at most a registered disciple.

Zhou Cheng and Cai Dongfan definitely knew each other and were familiar with each other. After two years of getting along, Zhou Cheng didn't have any outstanding performances, but there were no flaws either.

In Cai Dongfan's impression, Zhou Cheng only had two words, one is ordinary, which cannot be more ordinary, and he is just one of many ordinary regular trainees in Shashi Eighth Hospital.

If there is one thing about Zhou Cheng that is different from others, it is that Zhou Cheng is extremely reliable and basically did not cause any trouble to his superiors.

If it doesn't cause any trouble, then it's reliable. What else can you expect Gui Peisheng to do?Compared with some other Gui Peisheng who want the superior doctor to wipe their buttocks, it is not easy for Zhou Cheng, a Gui Peisheng who does not cause trouble and does not cause trouble.

However, in Cai Dongfan's impression, Zhou Cheng was really ordinary, with average qualifications and basically no outstanding performances.Otherwise, how could he fail to discover Zhou Cheng's bright spot after spending such a long time together in the past two years?

However, one possibility is not ruled out that the time he really paid attention to Zhou Cheng was actually very short. Since Du Yanjun came to the department and became his student, he has focused most of his attention on Zhou Cheng. Du Yanjun's body, but ignored Zhou Cheng...

Moreover, in Zhou Cheng's first year, he just came to the department, and he was learning the rules. When he was integrated into the team, he didn't pay much attention to him.

……

Luo Yun wanted to touch the back of his head very much at this moment, because he couldn't figure it out!

Zhou Cheng, Luo Yun and Zhou Cheng's contact and time together can be said to be the deepest.

Luo Yun participated in all operations, big and small, and was Zhou Cheng's immediate superior, who also supervised Pearson.And before Du Yanjun came to the department, Zhou Cheng was a newcomer, and the rules and basics that Zhou Cheng learned now were all taught by Luo Yun.

In other words, all the skills in Zhou Cheng's hands were brought up by Luo Yun.

Where did he teach Zhou Cheng this?

He himself will not.

I haven't taught it before, Zhou Cheng hid it really deep enough that time, I'm afraid it was blown out by the quota of staying in the hospital this time.Otherwise, Zhou Cheng would not be bothered to express himself.

Zhou Cheng is usually very low-key and hardworking. He completes the writing of the medical records on time, and Luo Yun doesn't have to worry about the admissions and discharges since Zhou Cheng has just entered the department for two months.Later, Zhou Cheng was on duty alone, and Luo Yun didn't need to pay attention to simple fractures and plaster casts.

Therefore, Luo Yun seldom paid attention to what Zhou Cheng was doing. Anyway, for simple operations, Luo Yun had only recently been promoted to attending doctor at that time, so he needed to practice by himself, so naturally he would not give Zhou Cheng many opportunities.

Later, when Du Yanjun came, with Cai Dongfan's order, Luo Yun would naturally give Du Yanjun more opportunities.

And the other Zhang Zhengquan, who came more often than Zhou Cheng, would occasionally treat him to food and drink, so for yesterday's emergency surgery, although both Zhou Cheng and Zhang Zhengquan were free, Luo Yun called Zhang Zhengquan.

At the same time, Luo Yun also found a very good reason for himself.

Well, Zhou Cheng has just finished his shift, so he needs to rest!

From this point of view, it seems that I don't pay enough attention to Zhou Cheng.

……

Du Yanjun was a little confused at this moment, as if he had returned to the time when he first arrived in the department, Zhou Cheng was already mature enough to be on duty, but he was still an "apprentice", learning basic skills with Zhou Cheng, and following Zhou Cheng's on-duty staff day.

At that time, he felt that he was a graduate student, that is, he had a solid basic knowledge, and he was just a graduate student.

The real clinical skills are his undergraduates, which are still far behind Zhou Cheng.

But later, after Du Yanjun gradually became familiar with him, and he was on duty alone, he felt, well, I am a graduate student, so I can learn things quite quickly, and I have to start writing articles. This is the gap with Zhou Cheng.

But now it seems that he is still too young.

……

Zhou Cheng looked into the three pairs of eyes, organized his words in his mind, and said, "Mr. Cai, why don't we inject the other Kirschner wire first, and I don't dare to relax now."

"It's quite strenuous to press like this."

Hearing this, Cai Dongfan immediately reacted.

Immediately ordered the roving nurse to install another Kirschner wire on the electric drill, and then found the correct position.

Sternly said to Du Yanjun: "Yan Jun, be smart, don't be in a daze, fix the needle insertion point for me."

"Didn't you see how hard it is for Zhou Cheng to remove the muscles?"

Now that you are undergoing surgery, do things first. This is the first principle on the operating table.

In the hospital, the patient's condition is the first priority.Even more so in the operating room!

Cai Dongfan stood at the chief surgeon position and was responsible for the quality of the patient's operation. All the assistants assisted him in the operation, so it was a matter of later to study how Zhou Cheng did this.

Because Cai Dongfan, as the chief physician, heard many powerful professors say that in the process of dealing with fracture displacement, he should be smooth, not brute force.Muscles are sometimes very cute, we have to use their shapes and characteristics skillfully!

It’s just that Cai Dongfan didn’t know how to complete the movement and mastery of smoothing the hair. He tried it a few times before giving up. It’s a bit advanced!

After completing the cross fixation of the two Kirschner wires, the operation on the inside becomes quite simple.

Three principles of fracture.

Reset, immobilize, recover.

Now that the reduction and temporary immobilization have been completed, it is only necessary to do firm immobilization.

I chose a T-shaped steel plate dedicated to the medial tibial fixation, click, click, click.

It was very smooth, with the help of Du Yanjun's first help and Luo Yun's second help, Cai Dongfan nailed the steel plate. Now, he is no longer afraid of the inner fracture being displaced again. The treatment of the inner platform is complete!

Then do the outside.

Zhou Cheng still has to go to the opposite position of the third assistant!

But Cai Dongfan pulled Zhou Cheng back, and said, "Zhou Cheng, you stand at my starting position. Luo Yun, if you are dealing with the outside, you can pull the hook."

Luo Yun nodded, but felt a little bitter in his heart.

Director Cai, I am your first 'student', even earlier than your first graduate student. Are you giving up on me now because I am old?

Du Yanjun stood in the first assistant's seat, looked at Zhou Cheng, feeling a little apprehensive.

There is a sense of status being threatened.

Chapter 14 There are high and low levels

Cai Dongfan's position as chief surgeon remained unchanged, and Du Yanjun's position as first assistant remained unchanged, but Zhou Cheng was obviously moved from the position of secondary assistant to second assistant.

That is, Cai Dongfan's starting side, here, has a better surgical vision.

In fact, Luo Yun doesn't care. He can also perform open reduction of tibial plateau fractures, but the level is not good. If Cai Dongfan didn't perform this operation, he can also do it, but it may take a long time, and the operation The quality is not as good as Cai Dongfan.

In fact, Luo Yun was already familiar with the procedure of the operation, and having followed Cai Dongfan for so many years, he also knew the root of Cai Dongfan's surgical habits.

What he lacks now is the heat. It is not to see how Cai Dongfan performs surgery, but to figure out how to improve the quality of his surgery. This is the key.

Seeing one more operation and one less operation is not much different.

So Luo Yun was just complaining in his heart.

For Zhou Cheng and Du Yanjun, it is very important to watch the complete operation process and operation techniques up close.To personally teach Du Yanjun is also the purpose of Cai Dongfan taking over the operation today.