The Godfather of Surgery
Chapter 55 Discussion
Let's eat some fruit cakes, drink some drinks, and take a break.
Song Zimo was on the podium, clapping his hands, Zhang Lin shouted, "Brothers, mute! Mute!"
The shouting was helpful, everyone stopped talking and went back to their places.
In the past, there were not many people and Zhang Lin, but now it is different, and his worth has risen along with Yang Ping and Song Zimo.
"Let's start the discussion?" Song Zimo asked Director Tian softly, mainly to show respect.
Director Tian nodded, and Song Zimo said, "It's time for discussion. If you ask questions, Dr. Yang will answer them. You're welcome, just ask them, and you'll be rewarded."
"What's the prize?" Someone shouted.
"Don't check your on-board medical records for a month." Song Zimo said.
This prize is enough, although it is not as good as not writing a medical record for a month.
After Song Zimo finished speaking, he sat down beside Yang Ping in the first row: "It's your turn."
Yang Ping stepped onto the podium, and everyone applauded, one wave after another.
The strength is here, and the aura is the internal and external release of strength.
A few directors are away, so everyone should relax a lot and speak boldly.
Director Tian is young, and everyone has no pressure on him.
These young people usually like to ask Director Tian for any questions. If they make any mistakes, they will secretly ask him for help.
Dr. Jin was the first to stand up: "Dr. Yang, I would like to ask, your stress shunting is indeed very subtle, but there is a question, how do you ensure that the bone blocks are not broken under stress, and the steel cables are constantly under stress?"
"Yeah, are you so confident in the steel cable? If it breaks, it will fall apart, the patient will have to enter the palace twice, and the family will run wild." A doctor whispered.
Yang Ping said:
"The tensile stress, compressive stress, stiffness, strength, elastic modulus, etc. that the bone tissue of the human body can withstand are all data. Different ages and different parts have different data. There is also data on the fatigue resistance of steel cables. Yes, there is also data on the number of steps the human body takes every day, as well as on the weight of the patient. By combining these data and calculating, you can know how long the cable can withstand, as long as the cable can hold on until the fracture heals.”
"Understood, we who study medicine have to worship Hippocrates, and now we have to worship Newton and Gauss." Dr. Jin joked.
A graduate student raised his hand and said, "If you go to the ground so early, if the fracture is displaced, the patient will file a lawsuit against you; if you go to the ground later, even if you don't recover well and cause bedridden complications, it is better than a lawsuit."
Yang Ping admired the young man's frankness and said: "If you have a hip fracture, you can go to the ground early, there is no doubt. Even if you can't fully bear the weight, you can bear some weight; if you can't even bear part of the weight, you can't lift up and walk with the weight. Continue after the operation. Lying down, I lost the advantages of surgery, and took all the disadvantages of surgery and conservative treatment. Horses can't run a horse, but they can't run a Mercedes-Benz. As for the lawsuit, I didn't compare the relevant data. There are a lot of lawsuits, so it’s better to go to the ground late.”
"Confidence depends on experience and data, not blindness." Yang Ping added.
The graduate students are very satisfied with the answer. Indeed, this is only what they take for granted. There is no saying that going to the ground late can avoid lawsuits.
"According to a multicenter retrospective study, there was no significant difference in average lifespan between those who fly and those who do not fly!"
A certain cow in the corner calmly threw out a sentence, with sugar in his mouth, and his words were not clear.
It turned out to be a doctor of spine surgery, and this is a high-end atmosphere. As soon as you speak, others will know that the degree must start with a master's degree.
"The sample has survivorship bias." In another corner, the voice recalled.
Everyone looked at Xu Jieba from the emergency department again.
"Mr. Yang!" A Gu Pearson asked shyly.
"It's how you pulled out the bone block that was inserted into the muscle. It seems to be very easy. In my impression, I encountered this kind of bone block several times, and it was irrelevant. "
The emphasis was on stress shunting, and Song Zimo remembered it after forgetting to talk about it.
"Just call me Dr. Yang or Senior Brother Yang. It is difficult for this bone block to be minimally invasively restored. First of all, you need to understand which muscle this bone block is inserted into and whether there are important nerves and blood vessels around it. Second, you need to understand the depth in the muscle, the bone Whether the block forms a barb and whether it can slide out smoothly, and finally, it is necessary to understand whether the bone block has muscles attached, and if so, what muscles are attached, and understand the different postures and movements of each muscle group. The pubic muscle is inserted into the block, and the iliopsoas muscle is attached to the bone block. During the abduction process of the bone block, the pubic muscle is highly tense, and the bone block is squeezed and spit out, and the iliopsoas muscle is relaxed. come out."
It turns out that pulling out a bone block requires such advanced anatomical knowledge.
"This operation is a bit brain-burning." A regulation Peisheng sighed.
Everyone followed the voice to look over, this guy looks old-fashioned, has bald, and has a lot of gray hair.
Looking at the hairstyle, it is obvious that he is already at the level of deputy chief physician, but his real identity is Gu Peisheng.
"Are there any questions?" Song Zimo asked everyone.
It's all figured out, and there seems to be no problem.
Director Tian saw that everyone was fine, and said, "Doctor Yang, last time you had a comminuted lower end fracture of the humerus, the reduction and fixation was amazing! I imitated your method and built a model with Kirschner wire. The model has self-stabilizing ability, and I simulate the flexion and extension of the elbow joint. During the movement, the model will have a certain self-tightening ability. What we usually do is loose structure, and yours is a complete dynamic stable structure.”
Thinking of the child who took the screws, Dr. Jin said, "The two screws have already been taken. If the symptoms are really relieved, I want to invite you to dinner and have a good chat."
"There's no problem, everyone can leave the meeting." Song Zimo announced.
Everyone saw that there were refreshments, and they all rushed to eat more, and chatted by the way.
"I have to go back and look at the anatomy, physiology, and pathology. Really, last time a patient had an infection, and he couldn't control it with antibiotics. He used the drug according to the drug sensitivity test. Later, the nephrology department was consulted, and they said that the drug that accelerated renal excretion was used, and the antibiotics were used in regular doses, which could not form a superimposed maintenance benefit, and always failed to reach the blood concentration of the treatment. Re-drug susceptibility test to select sensitive drugs, you say really, the infection will be controlled slowly in a few days."
"Yeah, you can do this in surgery. I don't know if I don't hear it today. It's an eye-opener."
Two graduate students and a few regular trainees chatted while eating.
Professor Zhang appeared at the door, the nurse followed, Tian Yuan, Yang Ping and Song Zimo got up together.
Originally, Professor Zhang planned to give everyone a few words before the meeting, but after seeing the animation demonstration on the screen, it was simple and clear, and he changed his mind.
Young people have their own language and methods, and it is purely superfluous to come to power, so they only listen at the door for a while.
"You can accumulate some more cases, do mechanical analysis of these internal fixation structures, and later you can publish a book - Orthopedic Internal Fixation Structures", which is devoted to the design of these stable structures.
Professor Zhang talked to Tian Yuan and Yang Ping. After speaking, he returned to the ward with a cane.
That's how Saturday went.
Su Yixuan sent a WeChat message and told Yang Ping that there were two pairs of slippers in his operating room shoe cabinet, and his slippers were cracked.
Sunday was also quieter. The system did not issue any tasks and was very quiet.
Yang Ping calculates the points. He is still 10,000 points away from purchasing pelvic fracture training. The gap is a bit big.
Only after completing the pelvic fracture training can you feel relieved.
Otherwise, if you suddenly let yourself have a pelvic fracture, you may not be able to handle it.
Although the basic skills of surgery have also entered the master level, the operation must be accumulated in quantity before it can be improved.
Pelvic fracture surgery must be done without delay.
Thanks for the reward of the mountain god who chased the dream. Thank you for your recommendation and collection. Once again, I am asking for recommended tickets and collections. During the current testing period, if the results are good, there will be follow-up recommendations. thank you all.
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