Chapter 399 Can you show some respect?

The road of medical students is very long, and every step is accumulated over time.

From being an ordinary high school student, one has to go through four long years of study and occasionally spend half a semester in clinical practice.

After another year and a half of internship and successful graduation, they have only initially touched the threshold of medicine. Many people are even still waiting outside the doctor's door.

Even if you go to graduate school, regardless of the differences between special departments such as internal medicine and pediatrics, dentistry, and ear, nose and throat,

Even within the same department and between different subspecialties, there are blind spots in understanding. This is something that cannot be avoided. A person's life is only so long. Even if he spends his whole life, he can only blame one subspecialty.

If you study slowly, you will rarely have free time to master and become familiar with the operations and knowledge of other sub-specialties.

Because each subspecialty is deep enough.

Not to mention the vast scope of orthopedics, just talk about neurosurgery, which can be divided into stroke, hemangioma, malignant tumors...

If orthopedics is to be truly subdivided, the current classification of Hunan University Second Hospital is far from being a true subspecialty.

Microsurgery of the hand, trauma, tumors, bone diseases, spine, joints, sports medicine; are these categories really enough?

No, it's not enough. If you really want to subdivide it, you can still divide it.

Foot and ankle, orthopedics, chronic injuries, nerve transplantation, sports rehabilitation...

Each subject is enough for a doctor to study for a lifetime.

There are not that few diseases in medicine, and each disease is not that simple, nor is it as typical as written in textbooks.

In fact, the more Lu Cheng learned, the more scared he became, and he felt more and more confused.

Although his confusion is much better than that of Pang Lin, he still feels small compared to the vastness of medicine.

Compared with the complexity of human beings, his current thinking is still too simple.

Therefore, Lu Cheng can understand Pang Lin's current feeling of powerlessness.

Lu Cheng was definitely not qualified to blame Pang Lin for not seizing the opportunity, and said: "It's a bit strange to speak like this. Pang Lin, it's the first time for everyone. If you haven't met before, just take your time to meet each other. Today we are together

Fight, and you will know how to do it next time you encounter it."

"For this kind of tibial shaft fracture, a ring-shaped external fixator can be used, or two crossed triangular brackets can be used."

"We're going to install a tripod today."

"You can let go of your hand and help me find the external fixator together."

Lu Cheng said it very euphemistically. He had never had an external fixator before, so he might not even be able to recognize the things used in an external fixator.

Pang Lin was confused and confused for a while, then he regained his energy and followed Lu Cheng to study seriously.

He still felt that he didn't work hard enough. He still had a lot of time to stay at home and watch live broadcasts and play games. This was not okay. If he passed the doctoral stage like this, he might never be this good again in the rest of his life.

So many learning opportunities and such leisurely study time.

It doesn't matter if you don't know how to do it, everyone starts from not knowing or not understanding.

Start learning, learn slowly, learn one, get one, understand one, and get one more.

I, Pang Lin, was admitted to the undergraduate program in 1985, and graduate and doctoral students from nationally renowned medical schools were also admitted. Is there anything else that can stump me?

After correcting his mentality, Pang Lin felt much more relaxed and relaxed in an instant. He carefully watched Lu Cheng find a set of external fixation devices and remembered them one by one.

Bone fixation nails, connecting rods, connecting rod fixing caps.

Lu Cheng only took one bone fixation and fixation cap. As he walked back, he said, "Pang Lin, please bring seven more."

"We need to insert three fixing nails at the proximal and distal ends of the fracture at the same time, and then form a triangle and insert two fixing nails,"

"After connecting with two connecting rods, two stable incomplete triangles are formed, which can achieve the best fixing position."

Pang Lin nodded frequently and quickly obtained the two connecting rods and the remaining seven fixing nails and fixing caps.

Lu Cheng had already connected the fixing nails to the electric drill, and had used a sharp knife to make the holes where the nails needed to be driven. He said, "Pang Lin, I'll drive the upper and lower nails first, and then I'll give you the rest."

Come and fight!"

"Okay!" Pang Lin took a deep breath and stopped saying thank you.

Now Lu Cheng has become his teacher instead of his classmate.

"When inserting the fixation nail, be sure to insert the needle perpendicularly to the bone cortex, and choose the position in the anterior tibial area, from front to back. This can best avoid hitting nerves and blood vessels, but be careful not to hit the outside of the tibialis anterior muscle.

, because this is where the anterior tibial artery takes its shape.”

Pang Lin still remembered the basic anatomy very clearly.

Watch Lu Cheng accurately deliver the nails into the bone. After two breakthroughs, he immediately stopped driving the nails, and then used a special handle to completely bury the threads of the fixation nails under the skin. At this time, the best results were achieved.

fixed effect.

Pang Lin became a little more proactive this time: "Brother Xiaocheng, I've seen everything clearly, it should be fine."

Lu Cheng explained in detail again: "Well, you can first drive the remaining two nails on the distal end of the tibia. Remember to make them in a straight line with the nail I drove, and leave the position of the final fixation cap open.

.And because we have to make two semi-open triangles, the position of the fixed cap must be reserved on the inside of the fixed rod."

Pang Lin smiled and said, "I still know this."

After saying that, Pang Lin picked up the sharp knife and broke the skin with his hand steadily. Then he used curved forceps to bluntly separate the subcutaneous tissue to the bone surface, and then accurately inserted the fixing nail with an electric drill.

The squeaking sound of the fixation nail rubbing against the bone kept making a constant sound, but Pang Lin's hands did not shake at all, and he concentrated on the changes in the sound.

After two breakthroughs, he immediately stopped, and then used the handle to push the fixing nail into the tightest position.

After doing this, he breathed a sigh of relief. In fact, it is not that difficult to install the external fixator.

With the first nail, the second nail was easy. He carefully looked at the X-ray again. After determining the location of the fracture, he took about 3cm below the fracture line and broke the skin again...

Six minutes later, Pang Lin completed the six fixation nails in the front area of ​​the tibia.

Lu Chengcheng said: "We first put up the fixing cap and the connecting rod. Fix one side, and then drive in the remaining two fixings from a direction about 45-90 degrees to the side of the connecting rod.

Nail it and then fix the connecting rod."

"Okay! This fixed cap looks very good. Let's do it together. This can also save the patient's operation time." Pang Lin said.

Although he is practicing, his first principle is to reduce the patient's operation time.

The most critical part of applying an external fixator is to choose the location of these nails. He has already done it, and there is no need to make the patient suffer more, prolong the operation time and cause more bleeding.

Although it takes a longer time and the extra tens of milliliters of blood has no impact on the patient, it is unnecessary time.

Lu Cheng was quite pleased to hear this. He was also a little worried that Pang Lin would completely ignore the surgery he was doing in order to practice his skills. The operating object was a patient. No matter how minor the injury he suffered, he was still the same as himself.

Living people.

After the two people quickly installed all the external fixators, they started debridement again.

The debridement operation was quite simple. The two people basically operated in separate areas at the same time. Although Lu Cheng gave Pang Lin a sweep of his tail in the end, it also saved the operation time again to a certain extent.

It wasn't until the VAC was connected to the negative pressure suction and the patient was transferred to the gurney and sent directly to the department that Pang Lin smiled heartily and said, "Brother Xiaocheng, this feels so good."

"Oh? Is it okay?" Lu Cheng looked at Pang Lin. What he saw in him was the temperament of an ordinary medical student.

The excitement and happiness at this moment could not be concealed at all.

This should be the first surgery in which he actively participated in the most critical operation.

And he also noticed that Pang Lin's operational ability and talent were not bad at all, but the opportunities he usually got were probably too few;

Perhaps in the second ward of the Department of Orthopedics, he could already cut simple cysts independently under his own teaching teacher, but compared with this kind of third-category open fracture surgery, the sense of accomplishment was completely incomparable.

Pang Lin's hands are also very steady, basically not shaking much. Such a surgeon has a strong psychological quality. After he works in the future,

He is definitely a very good surgeon.

If I didn't have the help of a plug-in, I would only be slightly better than him by an almost negligible amount at most, and definitely not much more.

Just a slightly better ordinary person.

"Yes, no wonder my master always says that only emergency surgery can train a person the most. Only after being tempered by emergency surgery can we better carry out other elective surgeries. I was hesitant before, but now I finally understand

I feel it.”

"But I'm still a little tired." Pang Linhan smiled and wiped the sweat from his head.

It was the first time I had an external fixator installed. If I wasn't nervous, I must be pretending. In fact, my forehead was already covered with fine sweat.

"It's okay, take your time." Lu Cheng led Pang Lin toward the sink outside the operating room, and then said: "Pang Lin, we are classmates, and we got along well before. There is no need to be too restrictive in the future.

.”

"We can get along more naturally. Are you willing to run hard with me?"

"You happen to be studying for a Ph.D. now. If you want, I will call my master to send you to me, and you can also tell your master." Lu Cheng thought to himself, he is really busy now, if he can have an old classmate as a

If you follow the boss, you will kill two birds with one stone.

Of course, Pang Lin's own consent and the consent of Pang Lin's teacher are required.

"Of course I am, Brother Lu. You don't know, in fact, my teacher has mentioned your clinical ability more than once. I thought it wasn't you before, and we don't have any photos of you in our ward."

"If I had known it was you earlier, I would have come to find you during the fucking re-examination."
To be continued...