The thumb was so badly damaged that even if I had the best K-wire internal fixation technique, it would be impossible to put the finger back together. Even if you can build the skeleton yourself, how will you deal with the skin? After everything is cleaned up, only free flaps can be made, but the level of self-made flaps cannot even reach the level of silver.
His thenar eminence was compressed, and his skin and muscles were necrotic. The entire thenar eminence and the first metacarpal bone had to be cut off. However, there would be no place for rooting for thumb reconstruction in the future, and half of the function of his right hand would be lost. , for a manual worker, the blow is huge, and many factories will no longer be able to recruit him.
Jin Cheng thought for a moment and said as calmly as possible: "First take an X-ray to check the condition of the bones, and then we will formulate a surgical plan! Don't worry, we will do our best to preserve your thumb!"
"thanks, thanks!"
The middle-aged man wiped away his tears and felt much more at ease. In this age where there are old people and young people, a working hand is so important!
Jincheng quickly printed out the examination form and arranged for Lin Yan to take the patient for examination.
"Brother, what should I do? Is there any possibility of insurance?"
As a professional, Zhao Xiaogang immediately sentenced the finger to death, but he still asked Jin Cheng politely.
Jin Cheng took a deep breath and said: "It's difficult, but you can challenge it!"
"Challenge? Is there really any hope of saving this?" Zhao Xiaogang's eyes widened. Looking at this finger, he didn't think anyone could save it across the country.
Jin Cheng nodded and said: "It all depends on people. If you don't try, how can you know whether you can do it or not?"
Zhao Xiaogang took a deep breath, gave a thumbs up, and said: "My brother is my brother, with this height and this pattern!"
Praise is praise, flattery is flattery, Zhao Xiaogang doesn't believe in Jin Cheng at all.
"This patient, when his X-ray comes out, we will report to Director Tang together!" Jin Cheng said.
Zhao Xiaogang nodded. Such a serious patient would definitely need the director's nod to admit it to the emergency department. There is no missing step in the required procedures.
The two returned to the doctor's office. Mi Yingxue's transfer procedures had not yet been completed. Taking advantage of this gap, Jin Cheng found a chair to sit down and began to close his eyes and rest.
Simulated operating room.
How to do it?
Jin Cheng looked at the thumb that could only be amputated and felt at a loss what to do.
It’s not like such serious damage has never been done before. Anyone who has done so has been amputated!
The thumb phalanx and first metacarpal bone were broken into 21 pieces in total. Can they still be put back together?
Under the observation of the Celestial Eye, most of the skin and muscle tissue appear black, indicating that they are necrotic or about to become necrotic and have no value to be preserved.
Most of the extensor tendons of the thumb are in a damaged and stringy shape and are no longer worth preserving and must be cut off. The flexor tendons are still fine and can be preserved.
In order to save this finger, it is necessary to integrate various top-notch technologies outside the hand, such as phalanx Kirschner wire fixation, tendon transplantation, free skin flap transplantation, micro-suturing, etc.
Jin Cheng believes that every technique requires a master level to be as perfect as possible. Otherwise, if there is a problem in any part, the effect of the surgery will be greatly reduced.
Now I only have king-level Kirschner wire internal fixation technology, micro-suturing, which is at least diamond level or even higher, tendon transplantation, which is silver level at most, and free skin flaps, which are not even silver level.
Bite the bullet! You won’t know until you do it!
Jin Cheng no longer hesitated, he was still waiting, he could try countless times, but he could always complete the operation!
He pulled the instrument cart over, picked up the No. 11 scalpel handle, picked up his favorite No. 15 small round blade with the needle holder, clicked, and installed the blade.
Jin Cheng used drastic measures to quickly remove the necrotic skin and muscle tissue, and the bones were basically a polished commander, and a very broken commander...
Just piece it together piece by piece, there’s nothing to think about!
Pick up the electric drill, install a 1.0 mm diameter Kirschner wire, and fix the large fracture first...
…
In the office, Jin Cheng opened his eyes.
He felt a little dizzy after staying in the simulated surgery room for too long.
I came to the sink and washed my face with cold water. I felt much more awake.
"Brother, are you thinking about how to perform the surgery?" Zhao Xiaogang asked while clicking on the imaging system.
Jin Cheng nodded and said, "After thinking about it for a while, I already have a plan for surgery."
Zhao Xiaogang was stunned for a moment and said: "Brother, are you really ready to do it?"
Jin Cheng slapped Zhao Xiaogang on the shoulder and smiled without humility: "Any operation your brother and I plan to do will definitely be guaranteed! You must have faith!"
Zhao Xiaogang grinned, nodded fiercely, and said: "Unconditional trust!"
Jin Cheng nodded and said with a smile: "Don't blindly engage in personality worship!"
"Ha ha!"
Jin Cheng boasted a bit and the film was already released.
"hiss!"
Zhao Xiaogang took a breath of cold air.
Can my brother really make such broken bones?
Just now he said he had unconditional trust, but he immediately began to doubt it again.
Jin Cheng took a few photos and went to find Director Tang with Zhao Xiaogang.
In the director's office, Director Tang frowned after looking at the appearance of the patient's fingers and the X-ray photos.
"Jincheng, do you really plan to save the patient's limb?"
Although Director Tang is engaged in general surgery now, doctors of his generation have a good foundation in bone and exocrine surgery. In his opinion, there is absolutely no possibility of saving this finger, even if it is from the First Affiliated Hospital of Jiangnan University. Appendix 2: The two best hospitals in the province do not have this capability. Forced insurance will cost a lot of money, but the thumb will still become necrotic in the end.
Jin Cheng nodded and said: "I still want to give this patient a try. This thumb is very important to him. If the entire thenar eminence is amputated, there will be no local conditions for thumb reconstruction. It will be an almost unbearable blow to the patient." !”
Director Tang nodded. He knew that the so-called thumb reconstruction means cutting off the second toe, which is the longest toe, and transplanting it to the position of the thumb. It can also achieve good function, but the thenar must be basically intact. Otherwise, even if such a short toe is transplanted, it will not be able to complete the grasping function with other fingers.
"Does the patient have the idea of going to a higher-level hospital?" Director Tang still didn't want Jin Cheng to take risks. After all, if you want to save it, you will have to spend at least 50,000 yuan in hospitalization expenses. In the end, if it fails, the finger will be amputated, which the patient will definitely not be able to accept.
Jin Cheng shook his head and said: "It's too late. This patient has been injured for 5 hours. If he goes to the province again, it will definitely exceed the golden 8 hours. He cannot be insured even if he wants to. What's more, the province will not protect him at all!"
Director Tang shook his head, dumbfounded. You all know that the province will not guarantee it, so you still want to guarantee it? Are you at a higher level than the provincial boss?
Thinking of this, Director Tang was suddenly shocked again.
In the past few days, Jin Cheng has brought many surprises, constantly slapping those who doubted him, including himself. Will he be slapped in the face again this time?
If you want to save this pulpy finger, the requirements on the user's comprehensive ability are too high, and it is impossible to save it. No matter how defiant Jin Cheng is, he will never be able to do it.
Director Tang really didn’t believe it, he couldn’t be slapped in the face every time! Jin Cheng is a human being, not a god!
