When doctors have a simulated operating room

The old lady was in pain, but she still tried very hard to lift her leg.

The family member said:

"Rheumatism? It's been many years, maybe... ten years?"

Han Dongliang understood and said to the old lady on the bed:

"Auntie, can you lift your leg? Can you use force?"

Although the old lady was in pain, she still cooperated and tried very hard to lift her leg.

Of course, despite her efforts, she still couldn't lift her leg high.

"Okay, okay, like this, bend your knees, put your hands down, and put your legs in a 4 shape."

Han Dongliang continued.

The physical examination of femoral necrosis includes a '4' test of hip joint mobility.

That is, bend the knee and flex the hip joint to abduct and rotate it to form a ‘4’ shape and place it on the other straight lower limb.

Then press the iliac crest on the opposite side with one hand, and place the other hand on the inner side of the knee, and then press down with both hands at the same time.

If the entire buttocks and hip joints are painful, it is positive.

That is to say, damage to the hip joint and femoral head cannot be ruled out.

Considering the use of this ‘4’ test, it means that Han Dongliang also thought of femoral head necrosis.

In fact, the 4-character test is to lie on your back, straighten one leg, lift the other leg and place it on the knee of the straight leg, bend it and press it down to observe whether there is pain in the iliac joint on the same side.

The result is obvious.

The old lady was already screaming in pain just after the movement and before she started to press down.

Seeing the old lady in so much pain, Han Dongliang turned to look at the family members and said:

"Let's do the check-up directly. We need to do CT and MRI, and draw blood to see if the rheumatoid factor is high."

"Are you her family member? Her husband?"

The old man nodded: "Yes, I am his wife."

"Okay, let's go for the check-up first."

After that, the emergency nurse helped push the bed to the check-up directly.

After the patient left, Han Dongliang said:

"It is suspected to be femoral head necrosis, but it is not sure what stage it is. It seems that surgery should be considered."

After that, he turned his head and looked at Zhang Yi:

"Assistant Zhang, if it is really femoral head necrosis, will you follow me to perform this operation?"

Han Dongliang knew that Zhang Yi was very skilled in surgery.

He has also watched a lot of surgery videos.

But most of them are heart and hepatobiliary surgery.

I haven't seen many orthopedic surgeries.

Especially last time when he was out of town and couldn't come back, Zhang Yi actually performed a UBE minimally invasive surgery!

That surgery was an orthopedic and spinal surgery that was only used in clinical practice a few years ago!

It was very difficult and even involved nerves!

Han Dongliang was still puzzled after he came back!

Which guy dared to do this kind of surgery while he was away? ?

Later I heard that it was Zhang Yi!

Since there is this opportunity this time, Han Dongliang also wants to cooperate with Zhang Yi.

So that he can see the technology that is praised so much with his own eyes!

Zhang Yi glanced at Han Dongliang and nodded:

"Okay, let's see what the result will be later. If surgery is really necessary, I can go to the operating room with you."

Seeing that Zhang Yi agreed, Han Dongliang curled his lips slightly, well~ this is almost right~

"Haha, by the way, Director Lu and Director Li are not here today, you are the person in charge, this operation will not affect your emergency work, right?"

"It's okay, don't worry, there are many doctors with more experience than me in the department.

They can still take charge of the overall situation when I'm not here."

Finally, two hours later, the test results came out.

CT showed that there were necrotic foci surrounded by sclerotic bands in the femoral head, segmental bone collapse, and subchondral fractures.

MRI showed that the outer low-signal band was hyperplastic sclerotic bone, and the low-signal band was granulation fibrous tissue repair.

(The 4-word test plus these two tests can completely confirm that it is femoral head necrosis.)

Han Dongliang frowned:

"It has collapsed? And there is a subchondral fracture? I'm afraid it's already stage 4."

Zhang Yidao was not very surprised because he saw it early in the morning.

Just thinking that the old lady is 68 years old, and the risk of artificial hip replacement surgery is much greater than that of young people.

On the side, the old man saw that Han Dongliang's expression was not right, and asked hurriedly:

"Doctor, what's the problem with my wife? Is it serious?"

Han Dongliang said seriously:

"Serious, femoral head necrosis, she really should have come to the hospital earlier after that fall.

It has been delayed until now and has been directly dragged into femoral head necrosis. If she came earlier, she could have received conservative treatment

Save the hip joint.

But now it is no longer possible, and artificial hip replacement surgery is required.

This artificial hip joint is made of stainless steel or ceramic, and it depends on your choice.

In addition, what about your children? This operation is also a major operation. I suggest that you try to let other family members or children come as well. "

"Ah? What is artificial hip joint surgery?"

The old man didn't quite understand.

On the side, Zhang Yi gestured directly:

"It's here, look." Zhang Yi pointed to the top of his right thigh root: "It's here, the thigh root connects the entire upper body joint, this position is broken.

If it is broken here, it means that the right thigh has lost the function of bending and walking.

So the only way is to remove the broken part through surgery, and then replace it with an artificial hip joint.

The artificial hip joint is also round-headed, and it can also allow the thigh to flex and extend forward, backward, left and right.

Do you understand what I mean?

The operation time is about one hour, and the fastest is half an hour.

In addition, the patient is old, and there are risks in the operation.

So the hospital recommends that you notify your child to come to the hospital as soon as possible. "

The old man immediately looked worried when he heard it: "Ah? This... Is it so serious to fall down?"

"In fact, it was not serious at first, but it was delayed for a few months and became serious."

The old man sighed and muttered:

"This old woman is really worrying! I knew that she would come to the hospital to see her leg if she had to pull it hard, but now she has to replace a fake joint..."

Then I saw the old man muttering while walking to the side to make a phone call.

As soon as Zhang Yi turned his head, he saw Han Dongliang staring at him with a surprised look.

"What's wrong, Director Han? Is there something wrong with me?"

Han Dongliang said with a smile:

"Hehe... You just said... how many hours did it end? !"

"One hour if it's slow, half an hour if it's fast, what's wrong? Is it not okay? "

Han Dongliang gasped!

Hiss!!

Wow!

Artificial hip replacement surgery!!

This... This will take at least three hours!

Anyway, Han Dongliang's previous fastest record was a surgery completed in three hours and seven minutes.

This guy only needed one hour?!

Even half an hour?!

Damn? Could it be that he has practiced artificial hip replacement surgery many times somewhere???

Han Dongliang just laughed dryly twice:

"Haha, OK, why not, haha..."

You are awesome and you can do it!

Just when Han Dongliang was about to transfer the old lady to the orthopedic surgery inpatient department.

The old man suddenly came over with an apologetic look on his face and said:

"Excuse me, doctors, please wait a moment, my son just said... they will rush over in the afternoon, so let's not do the surgery first, he will arrange it. "