Chapter 4151【240】Indispensable
"Seems to be-"
"should be-"
This is not mentioned in the textbooks.
Much of the latest knowledge in medicine comes from research papers published by peers. Dr. Chang Jiawei came back to his senses and realized who had said this, and insisted on the spot: "Yingying is absolutely right. She has read more papers than anyone else."
So you guys are really worse than Dr. Jiang. Doctor Xia Dongxian felt speechless anxiety in his heart.
Whether it is surgery or manual reduction, make the decision early rather than procrastinate. Procrastination by doctors is the worst thing for patients.
Orthopedic surgeons are aggrieved. If we look at the past, this case was not easy to perform reduction and surgery could be performed immediately without getting entangled.
Mainly due to the special status of the parties involved.
“I think the success rate of manual reduction is very low.” The second director of the Department of Orthopedics said sincerely.
Since the six-hour golden period is mentioned, let’s continue to demonstrate based on data.
“The biggest problem is the fracture fragments,” other orthopedic surgeons said.
“Do you know these questions?” Dr. Xia Dongxian asked Junior Sister Xie again. In short, Junior Sister Xie’s views were always different.
Dr. Xie Wanying said: "The anatomical structure of the hip joint makes it easy to miss small bone fragments in CT scans or radiographs. Even if the diagnosis is not missed, if the fragments cannot be returned to their original positions during reduction, surgery will be required to remove the fragments."
Generally speaking, if the fracture fragments are not left in the joint cavity, they can wait for the body to absorb them on their own, and the impact will be minimal and no surgery is needed to remove them.
In this case, the fracture fragments are on the contrary, and are easily left in the joint cavity, causing the huge impact described above.
The orthopedic surgeons nodded and expressed that Dr. Xie Wanying certainly understood. “So, in order to achieve correct reduction in complex cases like this, three-dimensional reconstruction must be done based on various examination results. But today, this issue is not the focus.” Dr. Xie Wanying continued to add.
It means that everyone has thought before that if orthopedic surgeons may not have time to perform three-dimensional reconstruction, Dr. Xie’s talent in this area should be able to make up for the technical gap.
This is indeed the case. This is not what orthopedic surgeons are rushing to discuss, because based on their rich clinical experience, they have inferred from the current films that there are fracture fragments in the patient's joint cavity.
The orthopedic surgeons on site are really a group of famous doctors.
It’s not that they lack Dr. Jiang’s courage, but based on their clinical experience and skills, they concluded that this patient would need surgery sooner or later, and it was better to have surgery sooner rather than later.
Hearing this, orthopedic surgeons finally understood.
Dr. Xia Dongxian said: "The problem is that they think they can't push the fracture fragment back to its original position."
Dr. Qi Donglai has said this before, he cannot do this kind of "blind" pushing that does not damage the nerves at all during the pushing process.
“You said it was a little less.” Dr. Tao Zhijie said to Dr. Xia.
Dr. Qi Donglai’s words have another profound meaning, which is now revealed through Dr. Xie’s addition.
The complexity, importance and terrible side effects of posterior hip dislocation combined with femoral head fracture prove that the difficulty of this "blind" push is to be further difficult: to remove the "blind" push that causes the fragment to damage the nerve and compress the nerve, but today's case broke the fragment The location is too tricky, making it extremely difficult.
No wonder the second director of the Department of Orthopedics thought Dr. Qi couldn't do it after he came.
From this point on, what Dr. Xie Wanying emphasized at the beginning: Sister Wen’s skills are indispensable.
What Dr. Xie said is Dr. Wen’s unique understanding of mechanics.
Xia Dongxian looked at Dr. Fu and wanted to ask again: Do you know?
(End of this chapter)
