Chapter 358: Dimensionality Reduction Strike!

Fang Ziye wasn't lying; his Open Reduction and Internal Fixation of Fractures had long since reached Level 4. Last year when he was in Enshi, Fang Ziye felt he might get to handle fracture surgery feeding, so he added the corresponding skill points early on.

At the time he only added points to Level 3; adding points to Level 4 later seemed to be because he had to operate on a pelvic fracture patient, so he temporarily decided to add points up to it.

That time, the chiefs were detained in the ward by Wu Xuanqi, who is now at Tongji Hospital, and they entrusted Shen Tao — who wasn't particularly proficient in simple fracture surgery — to go to the OR as lead surgeon...

Yuan Weihong digested his emotions for a long while before slowly saying: "It seems Shen Tao still held back quite a bit from me."

Shen Tao of the Provincial People's Hospital was Yuan Weihong's good friend; after returning to Han City, they had gathered many times. Although he usually spoke of Fang Ziye's excellence to Yuan Weihong, perhaps to avoid striking a blow to Yuan Weihong's Dao heart, he still held back.

The OR's sensing door opened, and because someone was at the doorway, it stayed open for a long time without closing.

This was a split-station surgery; the anesthesiologist and circulating nurse were makeshift arrangements. The anesthesiologist shouted outward: "Are you Orthopedics teachers? If so, come in!"

"Start the station early, get off work early."

The anesthesiologist wasn't old either; speaking with urgency laced with politeness, afraid of offending anyone — should be a relatively young attending.

Yuan Weihong, Fang Ziye, and Jie Han, the three of them, walked in together. After entering the operating room, they saw the patient already lying on the operating table, still seeming as if his body and soul were separated, drifting uncertainly.

Seeing Yuan Weihong had no mind to make arrangements, Fang Ziye took the initiative: "Jie Han, you lift the leg; I'll disinfect and drape. Let's start the station early; the anesthesia teacher is urging us..."

Fang Ziye didn't know just how tumultuous Master Yuan Weihong's mood was at this moment, but he knew the teacher definitely needed to calm his chaotic state of mind.

Hearing Fang Ziye's words, Yuan Weihong snapped back to his senses. Seeing Jie Han and Fang Ziye already each performing their duties, Yuan Weihong then remembered he also had to go out first to scrub and disinfect his hands, then put on a sterile surgical gown directly, and help disinfect and drape.

This surgery had no assigned instrument nurse; Yuan Weihong also had to play the role of instrument nurse assisting with draping the sterile surgical drape before starting the station.

Disinfecting and draping belongs to the most basic content of Orthopedics; all three were familiar beyond compare. Very quickly, they finished the relevant preparations before starting the station.

Fang Ziye actively stood at the assistant position, clearly giving Yuan Weihong full face.

Speaking frankly, my proficiency in Open Reduction and Internal Fixation of Fractures is sufficient, but face still needs to be given — Yuan Weihong should still be lead surgeon. After all, he's my Master.

However, Yuan Weihong steadied himself for a moment, then actively said: "Ziye, how about this — you be lead surgeon. I want to see what you're like as lead surgeon."

Yuan Weihong handed the kidney dish containing the scalpel blade and toothed forceps to in front of Fang Ziye.

Hearing this, Fang Ziye's heart stirred, but he still said: "Master, I'll be lead surgeon. If I do fracture surgery, the sequence might not be the same as a typical teacher's sequence."

"Isn't that just how it is? At most you just do manual traction reduction and setting under anesthesia first, then incise and pry for reduction?" Yuan Weihong said.

Suddenly he seemed to think of something, and looked at Fang Ziye sternly again, his eyeballs rolling: "Your manual reduction..."

Last time, at Zhongnan Hospital, he handled a mangled extremity limb-salvage surgery; the current patient is still hospitalized, and the prognosis isn't too good.

But the poor surgical prognosis didn't prevent Yuan Weihong, while participating in surgery, from hearing someone say Fang Ziye's manual reduction technique was very substantial — seemed he studied under part of the philosophy of that very famous old Chinese doctor in Enshi.

"Mhm—" Fang Ziye nodded.

Immediately after, Fang Ziye went to the film viewer first, confirming up, down, left, right the patient's fracture location on X-ray, the specific fracture classification, and the current displacement status.

He walked to the patient's right lower limb, both hands reaching out simultaneously — left hand holding the tibial plateau area, right hand pinching the patient's ankle joint.

One saw Fang Ziye's right hand seemingly didn't exert much force; with a soft "Crack—" sound.

The deformity produced by the patient's right lower leg tibial and fibular midshaft double fracture had already disappeared.

This was the first time Yuan Weihong and Jie Han, the two of them, particularly intuitively felt Fang Ziye's clinical effect doing fracture manual reduction after returning from overseas.

Instantly, four eyes of the two slightly bulged outward, shocked beyond measure.

As trauma surgeons, the naked-eye visual standard for judging whether a fracture is reduced is that the lower limb deformity completely disappears — just like right now.

It's just that patients who can be wheeled into Zhongnan Hospital's OR are basically all within surgical indications — non-manual-reduction-indication fractures — basically ones that are hard to manually reduce.

Yet Fang Ziye just went "Crack" once, and the lower limb deformity disappeared.

"Fluoro, fluoro one?" Yuan Weihong asked?

Hearing this, Fang Ziye nodded: "Works too, Master. This manual reduction effect will show even more clearly under the C-arm fluoroscopy."

Unlike Enshi Central Hospital which needs circulating nurses to assist with fluoroscopy, Zhongnan Hospital's Orthopedics and Spine Surgery jointly employ three dedicated intraoperative fluoroscopy technicians, specifically responsible only for the C-arm fluoroscopy.

Their job is C-arm turnover, fluoroscopy, instrument operation, instrument maintenance, and other relatively detailed work.

After the circulating nurse used the OR's built-in panel phone to call them over, the fluoroscopy technicians didn't even need Fang Ziye and the others to point out specifically how to fluoroscope the intraoperative AP and lateral views — just a rough gesture at the fracture location sufficed.

The young man called "Xiong Ge" pushed the mini C-arm into the OR, and after about two minutes, completed the AP and lateral fluoroscopy.

He didn't even look at the result, just said: "Wei Ge, I still have to rush to Spine Surgery for fluoroscopy. This trip counts as an intraoperative temporary turnover, so when the surgery ends later, fluoroscopy will still be needed — keep calling."

"Okay, Xiong Ge, wait a moment. I'll continue looking at the fluoroscopy results." Yuan Weihong had no leisure to look at Xiong Ge's expression, seriously watching the fracture reduction dot-matrix image on the C-arm display?

The fracture lines were nearly hidden; the fracture ends opposed perfectly. If not for the fracture classification itself being an unstable fracture — very prone to displacement — and lacking a stress angle.

Yuan Weihong almost wanted to tell the circulating nurse to bring a plaster cast, do a plaster external fixation, and call it done.

Fang Ziye only glanced once and roughly confirmed his own level. Although it had been a long time since he did manual reduction in the OR — only intraoperative temporary assisted manual reduction for complex fractures — this time doing it, his hand skills hadn't grown rusty.

Waiting for Yuan Weihong for twenty-odd seconds, sensing Yuan Weihong had already seen the quality, Fang Ziye placed both hands flat folded on his chest and said softly: "Master, done."

"You still have to do intramedullary nail internal fixation?" Yuan Weihong tilted his head and said.

Fang Ziye then tilted his head to look at Jie Han, who was eager to try.

The treatment principle for fractures lies in reduction, fixation, and postoperative rehabilitation.

The most core factor affecting overall surgical quality lies in fracture reduction, then firm fixation.

Generally speaking, the overall surgery is hard to absolutely disassemble.

But Fang Ziye's manual reduction quality this time was nothing short of excellent — forcibly splitting a surgery that clearly belonged as an organic whole into two very simple, delicate little surgeries.

Manual Reduction of Fracture — a Category 1 surgical operation — even ordinary resident physicians have permission to operate.

Fracture Internal Fixation Device Placement — this isn't even a standard procedure; it's a local component of Open Reduction and Internal Fixation of Fractures. As long as an assistant who can get on the station, under a superior's guidance, can operate.

It falls into the category of retracting, tightening screws, and such.

Equivalent to giving this unstable fracture disease type a direct dimensionality reduction strike, so that his fellow trainee Jie Han, if he possesses a certain degree of fracture instrument operation proficiency, can be led by Yuan Weihong to complete the subsequent surgery.

Actually, Fang Ziye could totally go click-click-click-click-click straight through at a jog, finish the intramedullary nail fixation in five-six-seven-eight minutes, even put in the locking screws.

That's unnecessary. Fang Ziye isn't very lacking in these one or two fracture surgeries' knowledge points anymore. He should yield to the cute fellow trainee Jie Han who hopes to get more operation opportunities — so he yields.

A senior brother must have magnanimity.

Jie Han gazed at Yuan Weihong with burning eyes. If Yuan Weihong agreed, Jie Han could unlock the admission ticket to the first relatively formal surgery of his life.

Intramedullary Nail Internal Fixation Device Placement Surgery!

For ordinary Resident Physicians, many who went to Prefecture-level City Hospitals would only perform Internal Fixation Device Removal Surgeries; the purpose of removal surgery was merely to remove the hardware, for cosmetic reasons or other factors, to wrap up a therapeutic surgery.

Where could one find the fragrance of Internal Fixation Device Placement Surgery?

Yuan Weihong's lips twitched beneath his Mask: "The sequence you speak of is different; so that's how different it is? You fundamentally don't want to operate, do you?"

Fang Ziye shook his head and hurried to explain: "Master, what I mean is, you can step down and rest; the subsequent operation, I can bring Fellow Trainee Jie Han to do."

"Master, you've been exhausted in the Operating room next door all day……"

Jie Han also nodded vigorously.

Senior Brother is Invincible, Senior Brother is capable, Senior Brother brought a Miracle to himself.

If this surgery still followed the traditional approach of Incision, then Reduction while Fixating, then Yuan Weihong certainly would not let Jie Han operate the subsequent Internal Fixation Device Placement Surgery.

"Sigh, alright then, I'll step down." Yuan Weihong was helpless.

No way to handle it!

Also no way to teach; the student's skill surpasses the teacher's, how can one teach?

He originally thought he could still watch for where Fang Ziye was not proficient, but Fang Ziye's surgical level, under the dual bonus of Open Reduction Internal Fixation and Manual Reduction Technique, had already shifted from therapeutic purpose to teaching purpose.

Yuan Weihong began taking off his Clothes and stepping down at the Operating Room Doorway.

Xiong Ge then pushed the C-arm away; he was just a worker master, he wouldn't nitpick clinical treatment quality; if Zhongnan Hospital needed him for quality evaluation, it would have collapsed long ago.

And the Anesthesiologist hiding from radiation at the doorway was Confused at this moment.

"What does this mean? The surgery is almost finished?" Zhongnan Hospital had too few Fracture Surgeries, he with little experience, froze in place.

The Circulating Nurse also stared blankly, eyebrows raised slightly.

Who is Yuan Weihong? North Sea One Leaf; nodding, compared to the Junior Attending Anesthesiologist with obviously lower Seniority, tone flickering: "Right, weren't you urging faster? Is this surgery fast enough?"

The Anesthesiologist's eyes immediately flickered with Terror, thinking he had inadvertently Offended some 'Big Shot', hurriedly smiling like a Chrysanthemum Face, eyes like Cosmetic Surgery: "I didn't mean to urge, Teacher, I'm called Xiao Zhou……"

Yuan Weihong left happily.

(Chapter End)