Doctor's Life Simulator

Chapter 104 Surprise, comprehend the advanced technique of fracture reduction and fixation (Add more chapters for the big brother)
Qin Lang controlled the scalpel and accurately cut the tendon sheath about 0.5cm away from the distal end.

".OK, next I will use the Tsuge suture method, also known as the Tsuge method. In order to strengthen the tension of the tendon end, I will use the double sleeve method"

In order to let the twin sisters see more clearly, Qin Lang intentionally slowed down his movements.

".Choose No. 5 looper loop thread, 0.5cm away from the end of the tendon, suture the locking position, penetrate into the tendon and exit from the end of the tendon"

The twin sisters were moved, watching Qin Lang's operation carefully, and listening to his gentle and clear instructions.

".The needle penetrates into the contralateral tendon and exits 0.5cm away from the tendon"

".An additional knotted suture is sutured from the exit needle, with interrupted sutures, to strengthen the tendon end tension"

After Qin Lang finished stitching on one side, he did the same thing on the other side again.

After making sure that the twins understood it, they continued to the next step, and quickly completed a section of tendon suture.

"The incision in the next section of the patient is a straightened and flexed injured finger, which fully exposes the tendon sheath on the palmar side, using the Bruner incision"

The so-called Bruner incision is a small technique to save flap pulling. This incision is a serrated incision, which can expose the lesion in a large range and facilitate the operation.

After all, the twin sisters Hua are senior surgeons in the field of hand surgery, so they naturally know something about this technique, but they are still a little startled when they see Qin Lang's proper use and such a clean handling method.

"Doctor Qin's clinical talent has also become stronger. The same incision is like magic in his hands."

When the twins were feeling emotional, Qin Lang had already gently pulled out the proximal end of the deep flexor tendon from the tendon sheath wound and started to fix it.

".Pay attention to my next movements. In order to be able to perform functional exercises early, it is necessary to improve the suture method. The Bunnell suture method and the Kessler method are more commonly used, but neither is the best method."

Hearing Qin Lang's introduction, Yang Yi and Yang Yue were shocked. Doctor Qin's small class was about to start.

The two quickly concentrated their energy and listened carefully:
"The Bunnell suture method is firm and reliable, which is conducive to early functional exercise after surgery, but because the sutures interweave and travel inside the tendon many times, it affects the blood supply of the tendon, which is not conducive to the healing of the tendon"

".The traditional Kessler suture has no effect on the blood supply of the tendon, which is beneficial to the healing of the tendon, but only two 7-0 to 8-0 microscopic sutures connect the tendon, which bears a large pulling force and is prone to rupture. "

".So I used the modified Kessler suture method to anastomose the tendon, which does not affect the blood supply of the tendon and provides conditions for functional exercise."

Seeing Qin Lang's next operation, the twin sisters were very pleasantly surprised. This kind of stitching method was obviously not mastered by Director Tian Hua.

"It turns out it can still be like this!"

"Amazing!"

Yang Yi and Yang Yue stared wide-eyed, even if someone came to chase them away now, it was impossible for them to leave Dr. Qin.

A few minutes later, the two watched Dr. Qin's next operation with endless interest.

".5-0 Nylon Noninvasive Needlework"

Yang Yi and Yang Yue admired Qin Lang for several specifications of needles and threads and different techniques within a few minutes.

"This is how much experience and physical strength is required to be able to play so many tricks."

This is simply a luxurious hand surgery tendon suture show.

Soon, under Qin Lang's meticulous micro-manipulation, the sutured part of the tendon was naturally retracted into the intact sheath at the proximal end.

After suturing these most critical tendons, the next step is to reduce and fix the fracture of the scaphoid.

Although Qin Lang obtained the technique of fracture reduction and fixation through missions, it was still only an entry-level technique, so he was going to learn the technique of the two doctors Yang.

"Doctor Yang, the tendon suture has been completed, and I will leave it to you."

Qin Lang gave up the position of the chief surgeon in a timely manner, and gave up the part of the fracture reduction and fixation to the two of them.

Yang Yi and Yang Yue, looking at Qin Lang's sincere tone and humble attitude, her affection increased greatly.

Moreover, this is also the value of their coming to the treatment center of the city's first hospital.

They are still very skilled and proficient in the treatment of scaphoid fractures.

"Doctor Qin, then we'll make a fool of ourselves."

The two also intend to show their level in front of Qin Lang, so that this little man can't be underestimated.

The sisters looked at each other, and they both saw the high fighting spirit in their eyes.

After the wrist joint, frontal and lateral X-ray films, axial film of the scaphoid and CT of the wrist joint, they already know the patient's condition well.

"Kirschner wire, hollow screw, small C-arm X-ray machine, non-sterile balloon tourniquet."

Soon, the standard hand surgery instruments and equipment were ready. This is also a new product purchased by the treatment center this time, basically relying on the list carefully selected by Director Tian Bo.

Yang Yi started to make oblique incisions on the dorsal side of the patient's wrist, and began to separate the subcutaneous tissue, while Yang Yue stretched the extensor hallucis longus and extensor digitorum tendons to both sides with a tacit understanding, exposing the fracture.

Seeing the tacit cooperation of the twin sisters, Qin Lang also nodded frequently. It has to be said that the two are still very capable in the basic skills of hand surgery.

Whether it is incision, separation, or exposure, at least he has six successes. As an attending physician, he is already very remarkable.

"Ruzi can be taught!"

When Qin Lang evaluated the two, he was also learning their subtle skills.

Yang Yue quickly completed the reduction of the fracture by inserting a Kirschner wire perpendicular to the fracture line from the distal end to the proximal end to help reduce the fracture and serve as a guide wire for implanting hollow screws.

A cannulated screw was implanted through a guide wire, and pressure was applied to anatomically reduce the fracture.

Here, the control of strength is very particular. Therefore, orthopedic doctors basically have very strong hands.

Although Yang Yi and Yang Yue are girls, they are also burdened with strange powers.

Yang Yi claimed to be breaking apples with bare hands, and Yang Yue practiced spinning two iron balls with one hand for an hour a day.

Qin Lang carefully watched the operation of the two of them. Since his fracture reduction and fixation skills are entry-level, it is most suitable to watch Yang Yi and Yang Yue's level now.

Qin Lang looked at it, just like Yang Yi and Yang Yue just now, and asked for advice:
"Doctor Yang, I only have a superficial understanding of orthopedic manipulation and fixation. What are the details in this process?"

Hearing Qin Lang's request for advice, the two young ladies naturally knew everything.

Yang Yi can't wait to dig out her heart and lungs:

"Doctor Qin, according to my personal understanding, in the operation, when the first incision is made, the dorsal incision is used, so attention should be paid to avoiding the superficial branch of the radial nerve, as it is easy for novices to injure it."

Yang Yue also immediately replied:
"Exposure is also very particular. The degree of exposure of the fracture must be precisely controlled, otherwise too much free will easily damage the blood supply of the scaphoid bone and cause bone nonunion."

Under the teaching of Yang Yi and Yang Yue, Qin Lang quickly absorbed nourishment.

[Ding, thanks to the nuanced teaching of the twin sisters, the host Fuzhi's spiritual skills are stimulated.You have upgraded the fracture reduction and fixation technique to an advanced level! 】

Hearing this voice, Qin Lang was overjoyed, this is an advanced orthopedic reduction and fixation technique.

PS: Oh, thank you for your rewards. I became 100 coins, 100 coins for the small blood bottle, 20191111162755243 coins for the book friend 500, 100 coins for the bloody knife, 500 coins for the purple muscle, and the big brother cauliflower Uncle's four little dots of 5000 coins.Thanks boss~Happy~
This chapter will be updated. In the afternoon and evening, there will be ~ Chong Chong Chong ~
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