The level of a doctor can be seen from the first face he sees a patient!


    After seeing the patient''s situation, an Yanjun''s brain immediately began to run at high speed and kept thinking about the best treatment plan.


    For the patient''s situation, I soon learned a lot.


    Now the first thing to do is to reset the story.


    The patient''s condition is mainly the dislocation between metacarpophalangeal joints and phalangeal fracture.


    Tan Zhonglin is good at handling this kind of joint, and an Yanjun is also not bad.


    But


    At this time, they involuntarily staggered the position of the main knife and silently prepared to take auxiliary equipment.


    Tan Zhonglin looked at Chen Cang: "Xiao Chen, come on!"


    Chen Cang was silly and said awkwardly, "come on, director. I''m not very good at orthopedics."


    Tan Zhonglin was stunned. What a good young man. He gave me face, but he sighed: "Xiao Chen, this is not a time for humility. You come!"


    Chen Cang was stunned: "director, I really don''t know much."


    This time, even tan Zhonglin and an Yanjun were foolish.


    And Chen Cang won''t?


    Tan Zhonglin glanced at Chen Cang and saw that Chen Cang was not joking. He asked again: "really? You don''t have to take care of our face. We''re not outsiders!"


    Chen Cang cried and laughed: "really, director, I really won''t. You reset the fracture. I''ll deal with the tendons, nerves and blood vessels. Let''s have a clear division of labor, okay?"


    When Tan Zhonglin heard Chen Cang''s words, he was relieved and couldn''t help breathing.


    That''s right!


    You''re only 27, okay? No matter how good your talent is, there must be a limit.


    How can you do everything?


    Thinking of this, Tan Zhonglin thought of his first idea and couldn''t help laughing.


    Everyone is human, how can there be such a big gap!


    It can only be said that the technology industry has a specialty!


    Besides, the orthopedics department needs long-term work experience and surgical accumulation. Xiao Chen is good at tendon and vascular suture, which may be because he has been in the front line for a long time and has more contact with trauma patients.


    Suddenly, Tan Zhonglin felt much more relaxed.


    "Director an, come on, let''s come."


    While talking, Chen Cang observed carefully. Clinical work needs no short study. If you don''t study, how can you make progress.


    If there is no displacement of phalangeal fracture, it is generally mainly manual reduction. Chen Cang will.


    Now Chen Cangcai suddenly feels how powerful the reset technique he learned from director Wang Xiangjun at that time!


    However, this kind of open fracture needs to be cut and fixed internally. For example, Tan Zhonglin''s Kirschner wire fixation at this time is firm and reliable. It is also commonly used in clinic.


    Chen Cang handed over the instruments, but he could see clearly!


    Tan Zhonglin watched Chen Cang study hard, but also had a little pride in his heart!


    Young people should learn more!


    After all, the fixation of open phalangeal fractures is the surgery that hand surgery often needs to do. Lao Tan has done this kind of surgery for half a life. He is experienced and skilled. Occasionally, he can go to the annual meeting to try his hands and feet and win applause.


    Therefore, Tan Zhonglin is quite confident.


    In fact, surgery is the same as playing ball and singing. We need to have a state. The doctor''s mental outlook is good, and the surgery is not bad.


    Tan Zhonglin found that Chen Cang was too confident when he was an audience.


    Thinking of this, Tan Zhonglin couldn''t help showing an operation, which made an Yanjun''s eyelids jump. When he looked at Tan Zhonglin in his eyes, he took some respect. He is worthy of being Director Tan!


    fierce!


    Chen Cang also has to admit that Jiang Hao is old and spicy. Director Tan''s phalangeal surgery is really good!


    [Ding! Congratulations, the title attribute''s 5% cheating skill trigger: obtain Tan Zhonglin skill: phalanx fracture surgery: Master level.]


    [phalangeal fracture surgery: including phalangeal reduction and phalangeal fixation, master level; special effects: 1. Accurate reduction; 2. Firm fixation;]


    Chen Cang looked happy!


    I''ll be good.


    The task of stealing teachers has not been triggered for a long time. Finally, it came.


    At the thought of this, Chen Cang couldn''t help but feel happy, and the two special effects, one is accurate and the other is firm, are very effective.


    Because the treatment of phalangeal fracture should not only achieve accurate reduction, but also achieve firm fixation, but also carry out functional exercise as early as possible to restore the flexible activity function of fingers.


    The surgical effect can be controlled, which is basically accurate reduction and firm fixation!


    The fracture operation was soon over. Tan Zhonglin couldn''t help but breathe a sigh of relief and was finally able to show in front of Chen Cang.


    Since I met Chen Cang, I have been refreshed by Chen Cang again and again. I almost forget that I am the director of hand surgery of the provincial people''s government.


    Thinking of this, Tan Zhonglin glanced at Chen Cang.


    An Yanjun flattered: "Director Tan did a good job in the operation of phalangeal fracture! I saw it at the annual meeting last year and didn''t expect to make progress again!"


    Tan Zhonglin looked at Chen Cang and said seriously, "I''m in good shape today, Xiao Chen. I''ll give it to you next."


    Chen Cang nodded. He understood that the next work was the top priority!


    Orthopaedic surgery only takes a little time and will not affect the neurovascular surgery of the hand.


    Tan Zhonglin and an Yanjun both looked worried at the back of Guo Zhiyong''s hand. At this time, even after debridement, the situation is not good!


    Because the ulnar artery and radial artery have been completely broken!


    This is not a simple thing.


    Even if all the effective data reported in clinical reports show that the survival rate of hand can still reach about 13 in patients with complete rupture of ulnar artery and radial artery.


    But... Is it a third high?


    Maybe some people think it''s high, in other words, you don''t think so.


    The probability of surgical failure is as high as two-thirds.


    The artery was ligated before the operation. Now all we have to do is anastomose the damaged blood vessel.


    This is also due to the ruptured artery injury of the hand. If it is elsewhere, the probability of recovery may not be even 10%.


    Because the blood supply of the hand is very rich, the main sources are radial artery and ulnar artery. In addition, there are anterior interosseous artery and posterior interosseous artery.


    Of course, there are some so-called gifted people who look different from others, that is, the so-called "bone wonder, martial arts wizards". In the blood supply of their hands, 3.7% of the individuals have the median artery.


    In fact, medical statistics are really only for most people. There are too many people with strange shapes. They are really gifted. One of Chen Cang''s deepest impressions is a patient with cerebral infarction.


    Generally, after cerebral infarction, it means that the back brain tissue is necrotic due to ischemia and hypoxia. However, when discharged from the hospital, it is found that there is collateral circulation in the original infarct, and the compensatory blood vessels restore the blood supply to the infarct area!


    Chen Cang was stupid at that time!


    This is really the so-called medical miracle.


    Therefore, since then, Chen Cang was full of awe for the human body. When he saw those who jumped from the building, he had to go around. What if someone''s bone was abnormal and jumped down and ran away? Maybe people really dislike the trouble of climbing stairs!


    The blood vessels in the hand form arterial network or arterial arch to form a smooth channel for traffic, so as to ensure that the hand has strong adaptability to blood supply in a variety of functional positions of pinch, hold, grasp and grasp.


    It is precisely because of the abundant anastomosis between the above blood vessels and good compensation ability that the hand can recover more than 30% even if the radial artery and ulnar artery are broken.


    Chen Cang found that his eyes were really good when dealing with these elaborate operations.


    Looking at the name written on it, Chen Cang knew that he couldn''t find the wrong blood vessel!


    [distal end of ruptured radial artery] + [proximal end of ruptured radial artery] = intact radial artery.


    Well, it''s that simple, just like splicing toys at school.


    Of course, suture is the top priority of surgery.


    Because the suture of peripheral blood vessels is relatively thin, it is hard to operate and difficult to operate.