Where is the first metatarsophalangeal joint? It is actually very simple. It is the joint where the thumb and the instep connect. The thumb on the hand has the most and most important functions, and the same is true on the feet. This joint is also a power-producing joint.
People with joint injuries are mostly fat people and ball players. Fat people are too heavy and their joints cannot bear it. Most athletes suffer from fatigue injuries. But there are some ordinary people who are not obese and are prone to this disease. Women who wear high heels, especially the sky-high shoes they like to wear, look beautiful and tall, but these shoes are really a weapon to damage the metatarsophalangeal joints.
Because wearing high heels can increase the weight of the forefoot, excessive dorsiflexion of the metatarsophalangeal joints, relaxation of the deep transverse ligament between the forefoot metatarsals, collapse of the transverse arch, and the sinking of the 2nd, 3rd, and 4th metatarsal heads, which happens to be opposite to the common toe nerve located here. Excessive compression may result in neuroma of the common nerve at the base of the toes. In addition, because the heel is too high, the arch of the foot collapses, and the metatarsal head sinks, which can compress the common digital artery adjacent to the common toe plantar nerve at the metatarsal head, causing artery obstruction and leading to digital nerve ischemia. , hypoxia, fibrosis.
This is not alarmist, and because this joint is a terminal load-bearing and force-producing joint, once it is injured, it is very troublesome to deal with and treat it. Moreover, this injury is a chronic process. If it is an acute injury, surgery can be performed to recover. But this kind of chronic injury, The first thing to be damaged is the vascular bed and nerves at the end of the limb, and then the bone. In layman's terms, by the time a woman wearing high heels begins to experience pain, her joints and related soft tissues and bones have already been damaged.
If the treatment is discovered late, she will be accompanied by permanent toe pain, burning pain, numbness, and severe numbness in the soles of her feet. You can imagine how uncomfortable this must be. Even early treatment is very troublesome. There are two methods, surgical and non-surgical.
The non-surgical method is to wear flat shoes and put something on the front and bottom of your toes to straighten your thumb as much as possible. Imagine how difficult it would be to forcefully straighten the already bent bones. Not only was it difficult, it hurt, very painful. On weekdays, why a woman’s feet hurt after wearing high heels all day? It’s caused by the change in the curvature of the force. So, if you love your woman, please take off her high heels!
The black man is hospitalized. He is two meters tall and weighs more than two hundred kilograms. There is really no way for him to lie down on an ordinary hospital bed. Even if he customizes it, it is too late. He can only wrong his friend from a neighboring country. Two long benches are placed on the After reaching the end of the bed, it was just enough for the big black man to lie down flat.
Because their inspections are very complete, all possible inspections have been done, and the inspection results are all recent, so there is no need to repeat the inspection. Directly arranging the operation is the result that Ms. Wang wants. For them, time is money, recover as soon as possible and get on the field as soon as possible.
The metatarsophalangeal joint is a very small joint in the human body. However, after this joint is injured, what general orthopedic surgery can do is improve the symptoms and reduce the pain. If you want it to return to normal, it is very demanding. Many basketball players , it was all because of this joint that led to retirement.
"Make a dorsal incision, open it and repair it. Now prepare for the operation. Lao Chen, you go and discuss the condition with the patient, and sign all the places that need to be signed." Zhang Fan immediately determined the plan.
Lao Chen said cutely: "I, I don't know English!"
"Haha, isn't Ms. Wang here? Just tell her!"
"Yes, yes, forget about this." After saying this, Lao Chen went to find Ms. Wang. Although the black brothers are very reluctant to have surgery here. But there is no way. He has passed the peak period of his sports career. It would be good to have a financial backer now. He will do whatever the financial backer asks him to do.
At the beginning of the operation, the anesthesiologist estimated the weight of the big black man and added anesthetic. "Dr. Zhang, this fat man is so heavy. I dare not give too much anesthetic, so the effect may not be very obvious. If it doesn't work, , you add a little more local anesthesia." The anesthesiologist had never seen such a huge person and was a little unsure.
"Okay!" Zhang Fan looked at the fat man's limbs. They were really too big and thick. It's dark, very dark. If you shut up, close your eyes and turn off the lights, you won't be able to find it. "Dr. Zhang, do you think his skin is also black?" Li Liang asked, grabbing the big black man's thick toes.
"Probably not. The dermis is probably black, but below it is just like us." It was also Zhang Fan's first time to perform surgery on a black man.
"Start! The anesthesia is ready." the anesthesiologist said.
Li Liang began to disinfect, lay out sheets, and put in drapes. After everything was ready, Zhang Fan and Li Liang went into surgery, and Song Bing made a tour. Looking at the weird toes of the black people, Zhang Fan sighed. The athletes looked at the scenery, but in fact, ordinary people really couldn't understand their hard work.
Although the big black man is not a first-rate athlete, his toes have become deformed due to years of weight-bearing training, overloading exercises, and his huge weight. Although each toe is very thick, like an old man, it is very curved.
"Look, his second and third toes have obviously been fractured many times, and there has been compensatory thickening." Zhang Fan looked at the other toes and said to Li Liang.
"It's really not easy for them to make money." Li Liang had already separated the first toe. This separation was a bit laborious and too thick. It was probably as thick as a two-year-old child's wrist.
"It's not easy for anyone, nothing is easy." The anesthesiologist interjected.
At the beginning of the operation, Zhang Fan took a small sharp knife and gently opened the skin. The scalpel was very sharp. In the early years, scalpels were used multiple times. Today's scalpels are disposable. Although they are sharp, they are not durable. , the skin becomes dull after scratching it a few times.
"In this operation, we must pay attention to minimizing damage to blood supply. His injury has destroyed most of the vascular bed. If we want him to continue to maintain high-intensity exercise, we must ensure the remaining blood supply." Zhang Fan said on the side While speaking, gently avoid the dorsal digital artery, and then use the handle of the knife to separate the flexor pollicis brevis.
In surgery, not all areas that need to be exposed need to be knifed. For example, the skin needs to be knifed, and a very sharp knife is used. When it comes to the muscle layer, it is usually separated with fingers or the handle of the knife. Especially for this kind of athlete, muscles are very important to them. If a sharp weapon is severed, although it can heal later, scar tissue will form, which will have an impact on the explosion and durability of strength.
Functional joint surgeries of this kind are very difficult to perform for athletes. If an ordinary person suffers from such joint injuries, there is no need to perform extreme strength exercises, so all it takes is to reach the functional position of the joint and eliminate pain and variation. As for some insignificant blood vessels, It can be ligated, and no special attention is needed to the joint capsule. The scar will heal later.
But if an athlete does this, the pain will be relieved, but the sports career will be over. This is why many teams have fixed orthopedic joint doctors. Such top joint doctors can treat joints with minimal trauma. recover.
Although Zhang Fan has only opened the first level of microsurgery and has only performed more than half of the surgeries, he is so capable that Zhang Fan has practiced the three-dimensional graphics of this joint structure countless times in the system. , it took shape directly in his mind.
Zhang Fan slowly separated some inflammatory tissues from the metatarsal bones and phalanges bit by bit with tweezers, and then rinsed them with physiological saline. This surgery is not very dangerous, but the surgeon's understanding of joints and the fine manipulation of his hands are too demanding.
When doing surgery, we should pay attention to not being sloppy. What does sloppy mean here? It means that there should be fewer movements. For example, some inflammatory tissues in the joint capsule can be scraped once with a curette. Do not scrape twice as hard as you can. The more movements you make, the greater the damage. This operation is a comprehensive consideration of the comprehensive quality of doctors.
After cleaning up the inflammatory tissue, Zhang Fan began to repair it. This kind of subtle repair cannot be done by ordinary doctors and cannot be used, but it is very important for this special group of people. In the United States, there are no more than twenty doctors who are good at performing this kind of surgery. Moreover, when the doctor gets older, he or she cannot perform the surgery, so the cost of the surgery is quite expensive.
"Dr. Zhang, why does this repair need to be oblique?" Li Liang couldn't understand, because according to the physiological position, it should not be oblique. Zhang Fan didn't say anything. This was the most critical moment, and the success or failure of the operation depended on this moment.
Zhang Fan held his breath, tried his best to achieve absolute stability with his hand, and repaired it gently, once, twice, three, or four times. Finally, Zhang Fan let out a long breath, "Shh!" The deformed and scarred muscles were finally repaired.
More than three hours have passed. This is microsurgery, which is very time-consuming. After Zhang Fanlue waited for his breathing to become smoother, he said to Li Liang: "The oblique shape here is based on his weight and occupation. The oblique shape will make it more stable."
"Oh!" Although Zhang Fan explained, Li Liang was still a little confused. After all, he had done so little surgery that he couldn't understand it for a while.
"Electric drill, K-wire." Zhang Fan said to the operating nurse. Song Bing was almost bored to death. Almost the entire operation was done under a microscope, and he couldn't see anything. The electric drill lightly opened a small hole, and Kirschner wires firmly fixed the joint.
"When putting on a plaster, make sure the plaster is fixed all around. It won't be enough if you miss it for a day." Zhang Fan said to Li Liang and Song Bing.
"Okay!" After the operation, Ms. Wang and the athlete's black buddy almost fell asleep outside the operating room! When Zhang Fan and the others pushed the big black man out of the operating room with great effort, the gang of black guys gathered around me happily, chatting non-stop. Zhang Fan had studied English for so long, but he didn't understand them. Say anything more!
"Dr. Zhang, thank you for your hard work." Ms. Wang looked at Zhang Fan expectantly, and Zhang Fan understood what she meant. After taking off the mask, he first smiled, and then said: "The damage is serious, but it has been repaired. The rest will depend on his own recovery in the later period, which will be known from the surroundings. It is estimated that he can continue to play basketball in the future." "Before the operation, Zhang Fan couldn't guarantee anything, but it was different after the operation.
He has confidence in himself because he has worked hard and poured countless sweat into the system!
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