I don’t know about other industries, but as far as the medical field is concerned, the difficulty is to formulate a postoperative follow-up visit and expected big data, but the human body is too complex. There is no large-volume trial base, and I want to figure out the estimates.

The possibility is too slim. But this matter is too expensive, and there is no substantial economic benefit, so!

Moreover, the payback period in this industry is too long. When you are the youngest and most short of money, you have to endure it. Most industries also need to endure it, but the time to endure it in this industry is a bit too long. It takes five years to get an undergraduate degree and three years to transfer.

Department, five years of hospitalization, this is still the smoothest. It is considered a bit of a foundation after being treated as an attending doctor. However, during this period, a lot of people have passed away as long as they endured it.

Then a large number of medical students flooded into the civil service, and some medical students worked as pharmaceutical agents and other industries. No matter how much they hate or hate this industry, when the night is quiet, they will definitely miss the man Zeng Jin in white.

He in the big coat!

The sense of accomplishment between life and death is so beautiful! Every time I rescue, the adrenaline surges like a roller coaster. It’s like snatching a person back alive from the hands of death. What a feeling, it’s really hearty, and this feeling is addictive.

of.

"Director, prepare for bone grafting." Zhang Fan split the spinous process and turned to Lao Gao and said. For a small bone defect, osteoblasts will slowly fill it up. If it is such a large defect, it is

There is no way to fill it.

"Okay!" After Lao Gao placed the automatic retractor, he went to the sterile table next to the instrument nurse to start preparing the allogeneic bone needed for bone grafting.

For bone grafting, the best bone quality is actually the patient's own bone, but Bart is too small and cannot be removed, so allogeneic bone can only be placed.

"Doctor Zhang, let me wipe the blood for you." Although Zhang Fan's chop was very accurate and gentle, a lot of blood still splashed on Zhang Fan's face and eyelids.

This kind of surgery is slightly better. If you do a knee replacement surgery, it will be all flesh and blood. Generally, when doing a knee replacement surgery, the surgeon must wear glasses like windproof glasses. Because the femur, the thickest bone in the human body, needs to be cut.

When the cutting machine cuts, bone marrow, blood, and a small amount of soft tissue splash out directly with the cutting machine.

The roving nurse dipped the chlormethionine solution in her hands and gently wiped off the blood on Zhang Fan's face, "Okay, Doctor Zhang."

"Yeah!" Zhang Fan said without even bothering to thank him. This kind of surgery would cause too much damage and he needed to hurry up.

How is this surgery performed? It is actually very simple. It is to separate the deformed bone fragments that are connected up and down.

Then, adjust the position and place fixed alloy instruments from the upper and lower bone fragments. Then, the deformed spine is slowly corrected through this alloy instrument.

"Vertebral hook." Zhang Fan said to the surgical nurse after cleaning up the bone fragments in the surgical area.

At this point in the operation, two hours have passed. Now it is time to place the titanium alloy instruments. Everything done at this time must be confirmed three times.

Because at this time, once the device is implanted, there is no way to modify it. If a mistake is made at this time, the operation will directly fail. There is no way to make up for it. The human spine is only such a big place. Once a mistake is made, if you want to start over,

What a dream.

The upper and lower spine, several curved spines, began to place corrective equipment. What does it mean? In layman's terms, it is quite simple, such as a curved sapling.

To correct it, first drill a hole in a relatively straight place and put in a nut with a hole. This nut is the root hook. Then drill a nut with a hole in the middle, lower end and bottom of the sapling, or directly

The only thing is to drill a hole in the ground.

Then use an iron rod to pass through the hole on the upper end of the nut from the uppermost end until it reaches the ground, and then tighten the nut. In this way, as the sapling grows, the curvature becomes smaller and smaller, and finally becomes

Straight.

"Director Wang, help me support you." Zhang Fan took the vertebral hook and placed it on Bart's pedicle. The vertebral hook is actually like a screw with a spiral, just like any expansion screw commonly used in daily life, and then

There is a buckle attached to the top of the screw. It looks like a question mark buckle.

The tool for placing this buckle is like a corkscrew for red wine, but this one is not for pulling out, but for drilling in. "Doctor Zhang, let's get started." After Lao Wang grabbed the nailer, he gave it to Zhang Fan

Confirmed.

"Okay, I'm starting." One, two, and three times. The thickness of the bone is different, and the number of turns is different. This is not wood or bricks. It cannot be turned casually. Once it is turned, the spinal cord is inside.

One lumbar vertebrae, two lumbar vertebrae, three lumbar vertebrae, seven in total. One such screw costs thousands of imported ones. It is made of titanium alloy, because this metal has relatively stable properties and is not prone to electrolysis in the body.

Not easy to get infected.

Installing the screws is not a very laborious task, but just like that, Zhang Fan's sweat has soaked through the washcloth. If the surgical gown hadn't been extremely thick, it would have been soaked through.

Now comes the most laborious task. The orthopedic implant rod. The implant rod is a straight titanium alloy rod. I don’t know how hard it is, but it is probably the hardest metal Zhang Fan has ever seen.

Because the spine is inherently curved, now the implant rod must be corrected to a certain curvature, a specific curvature, a curvature that allows the spine to develop toward a normal physiological curvature. Why are there so many other female surgeons?

There are indeed very few orthopedic surgeries, because there are so many tasks in orthopedic surgery, not to mention women, even men with weak bodies and weak strength can't do it.

Orthotics are not fancy things, especially this kind of metal orthosis. They are very simple. They are three fixed circular iron pillars in a triangular shape placed on an iron lump.

"Dr. Zhang, I'll do the early correction, and you'll do the fine-tuning later. You've already had more than two hours of surgery." Xu Xian spoke.

"It's okay. I'll come!" On the operating table, Zhang Fan was too alone. At this time, let alone Xu Xian, even if he was Lao Gao, Zhang Fan was not at ease.

"Don't worry about it. He doesn't trust anyone right now." Lao Wang understood Zhang Fan. Doctors are like this. He can only feel at ease if he does it himself.

Zhang Fan took a titanium alloy rod about ten centimeters long and put it into the orthosis. Xu Xian grasped the orthosis with his hands. Zhang Fan used a rongeur on his left hand and a rongeur on his right hand to clamp the two ends of the titanium alloy.

"Have you caught it yet?" Zhang Fan asked Xu Xian.

"alright."

"Hey!" As Zhang Fan made a dull sound from his nasal cavity, the titanium alloy rod began to bend visibly to the naked eye. It was really bent alive.

This kind of correction is particularly laborious. It must first be corrected to a certain arc. Once the expected arc is not reached the first time, fine-tuning in the later stages will be even more laborious.

If you use too much force, the bend will be too bent. If you use too little force, the person will not move at all. And the number of corrections cannot be too many, because metal has a fatigue level. Repeated violent corrections, although it cannot be seen with the naked eye, in fact, the metal is no longer good.

, after installing it, it didn’t take long and it broke!

Therefore, one-time molding is best, which requires a good familiarity with force control and understanding of this material. Zhang Fan suppressed his blush and bent the titanium alloy rod in one breath, and the bend was very beautiful, in line with

expected arc.

Zhang Fan took a slightly hot titanium alloy rod and gestured on his lumbar spine. Although it felt suitable to the naked eye, he still had to gesture. At this time, the sticks that were directly inserted without gestures were all sticks, but if it was a stick, I guess this surgery would not be possible.

Made.

Zhang Fan was gesticulating, and Xu Xian was stunned. "This guy is not very strong, why is he so strong? He is really a beast! Such a thick stick can be corrected in one go. It seems that I will have to go to the gym to lift irons in the future.

.”

Lao Wang and Lao Gao were both used to it. They looked at Xu Xian a little stunned. Lao Wang smiled evilly and then asked: "Xiao Xu, do you have a partner?"

"Oh! We have a director."

"Look at Zhang Fan. He's a young boy with great firepower!"

"Uh!" Xu Xian sweated. The operation went well. Lao Wang couldn't help but want to talk. Zhang Fan was so annoying that he almost didn't talk during the operation. It was so difficult.

Zhang Fan glanced at Lao Wang and said nothing. The old man was very sullen. The head nurse was a little excited today, otherwise an old man paired with a young woman would be annoying to death.

"Zhang Fan, see if it fits." Lao Gao handed the repaired allograft bone to Zhang Fan. Zhang Fan looked at it and said, "Just right." Normally, Zhang Fan would definitely praise him, but as soon as he got it,

During the surgery, Zhang Fan seemed to have changed into a posture of not letting strangers in.

Zhang Fan took the allogeneic bone and gently shook it one screw after another. Although he installed it himself, this final check must be indispensable. If you forget this step, well, just do the surgery.

It's a time of torture.

It could take as little as a week or as long as a month, and I would probably have nightmares about screws falling off every day.

"Add the implant rod and fix it." Zhang Fan said this, and several people involuntarily straightened their bodies. This is the most critical step in the operation. Zhang Fan gently clicked the orthopedic screw from the first fixing nut.

The good implant rod is stuck all the way to the last nut, and the correction is very successful, as if it was tailor-made for Bart.

Then gently and steadily turn the nut driver counterclockwise until you feel that the nut is in place, and then tighten it clockwise. This is to prevent the nut from slipping. Tighten one by one, and finally you must use extra force to remove the implant.

The stick snaps into the top of the hook.

OK, the placement of the implant rod is completed. Is the operation completed? No, this is only half done. If you want to pull the deformed spine over, you must insert such instruments on both sides.

This is just like a curved small tree. Pulling on one side can pull the curvature over, but there is also a risk of breaking the small tree. The best thing is to put one on the opposite side to resist the pulling force.

.

After installing the screws, Zhang Fan confirmed it again, and then said to Lao Wang: "Come on, Director Wang, let's change positions." On the operating table, especially for this kind of flat surgery, usually one assistant stands on the operator's side.

opposite.

Now he wants to do another side, so Zhang Fan wants to change places with Lao Wang. When Lao Wang saw that Zhang Fan had already decided the position, he originally wanted to say: Let me do it, but he looked at Zhang Fan and refused to recognize his relatives, like a wolf

He looked at her and said nothing.

After all, he was a director, so he opened his mouth and was rejected by Zhang Fan. Wasn't he ashamed? So he didn't say much and started to change places with Zhang Fan.

For doctors themselves, this sterile area is actually defined as follows: below the neck and above the laces of the surgical gown is the sterile area, and the hands to the shoulders are sterile. Once you undergo surgery, no matter whether you are contaminated or not, the rest of the area is sterile.

are considered polluted areas.

What does a surgical gown look like? It is actually made of a very thick fabric in the same shape as a raincoat. When worn, it is the opposite of the raincoat, that is, the buttoned side of the raincoat is on the doctor's back. However, there are no buttons on the surgical gown.

, all fixed with cloth straps.

Generally speaking, it is best not to move around during surgery. If you have to change positions, it is not done at will. The two people must change positions back to back when they meet. Novice doctors are often scolded by the nurses in the operating room.

Because of violation of aseptic practices.

The position was fixed, and the fixation on this side was much faster. Repeating the above steps, the operation was finally completed four hours later. Zhang Fan looked at the spine fixed by the titanium alloy, and gently

Smiled.

Because he seemed to have seen Bart grow up. He was as strong as a mountain and his back was straight!

"Rinse!" Xu Xian took over Lao Wang's place and helped Zhang Fan rinse. With the experience last time, Xu Xian no longer asked for sutures.
To be continued...