In the early years, there was a joke in the medical industry: gold ophthalmology, silver orthopedics, and obstetrics and gynecology. Although it is not very accurate, in general it is similar.
But with the development of science and technology and the rapid improvement of national pharmaceutical and device manufacturers, this talk in the medical field has become a thing of the past. Let’s talk about ophthalmology first. The state provides very large subsidies in this area. Operation Bright costs a lot of money every year.
Orthopedics is even worse. Most of the equipment is made in China, and the medical insurance for orthopedics is strictly guarded and stuck. Therefore, the life of orthopedics is not easy, and they must be careful with their budgets. Otherwise, if the ratio of one drug exceeds the standard, the fine will be extremely severe.
Not to mention the obstetrics and gynecology department, I would be lucky if I didn't get beaten, and I was very tired. Of course, this is all for ordinary doctors, just like ordinary people talking about gossip.
With the changes in recent years, in fact, it is not these departments where ordinary doctors really make money. On the contrary, some emerging departments are the best.
For example, reproductive centers, men's and women's specialties, dentistry, and cosmetology, all with leisure and high bonuses. A facelift costs thousands, a breast augmentation costs tens of thousands, there’s really no way to tell.
In the hospital, currently only one department of interventional medicine has the highest income, but even if it is the highest, no one is rushing to do it. This is the case in the city hospital. In my heart, for example, Ye Jing, who was the teacher of Zhang Fan's transfer department at the time, would not do this intervention even if she was given 100,000 yuan a month.
Because this thing radiates too much, it is protected and the radiation is very strong. Almost all interventional surgeries are done under X-rays. Therefore, doctors who perform interventional surgeries are almost risking their lives.
Orthopedics is actually similar. Although it is not as exaggerated as intervention, it is still similar. After many internal fixation surgeries are completed, you need to see whether the bones have been reset and whether the bones are in alignment. This must be viewed under X-rays.
Generally, in this situation, the patient needs to be supported on the fixed part. Who should support him? Of course, whoever is sick is treated by someone, and he also takes a lot of rays throughout the day.
protective suit? It's all nonsense. Should I wear protective clothing after wearing a surgical gown? Who knows who does it.
Xu Xian was extremely unhappy, and I don’t blame him. When he was a graduate student in Bird Market, there was a teacher who taught him because he took too many rays, and his white blood cells dropped sharply. In the end, I died without retiring. So he was very conflicted.
"Come on, you're all here, just be happy. It's okay. It's good to eat it once or twice!" Zhang Fan said with a smile. Zhang Fan has never failed a teacher, so he is not afraid. People are like this. If you don't see it with your own eyes, you won't believe your ears at all, regardless of professional or not.
"Believe me!" Xu Xian said helplessly. Although Xu Xian said this, he also admired Zhang Fan. There really aren’t many active C-arm lower reductions.
Galeazzi's fracture is actually a fracture of the bone on the big finger side of the upper wrist. It's that simple. The most convenient and quickest way is to cut the steel plate, remove the sutures in ten days, remove the plaster in half a month, and remove the steel plate in one or two years. It's that simple and crude.
Of course the damage was huge. General manual reduction is also possible, but it is too difficult if it is not under direct vision. Because the forearm of the human body is located under the elbow joint. There are two bones in it, the ulna and the radius. The radius is on the thumb side and the ulna is on the other side. The radius is slightly thicker and the ulna is slightly thinner.
Not to mention anything else, you take two chopsticks, break off one and wrap it in a towel. It’s hard to pinch it with your hands outside the towel, let alone the muscles that are thicker than the towel.
"My Director Zhang, what are you going to do? This position is really hard to fix." What Xu Xian said is absolutely right. This bone is like a chopstick. If you pinch it together, the muscles may pull it and it may deflect again, so he is also worried.
"Look at me. I'll teach you a trick." Zhang Fan winked at Xu Xian. If Xu Xian can follow him to do this reset, he has already recognized Xu Xian.
"Sister Xia, anesthetize the brachial plexus. We will perform a manual reset today." Zhang Fan said to Xia Yonghong, the oldest anesthesiologist in the anesthesia room.
"Okay, just take it easy. If it doesn't work, just do surgery." There were many methods of reduction in Sister Xia's time, so she knew it very well.
"Okay. Xu Xian, put on the protective clothing for you." Zhang Fan said.
"Is it useful? Ours is broken at three points and is broken like this. The straps are gone. Do you want me to hold it between my legs?" Xu Xianyi said that this protective suit was also defective.
The protective clothing in the hospital is just fooling people to death. This came with the purchase of the C-arm, and it has long been in tatters. And it’s the most old-fashioned kind.
There is one piece to protect the thyroid gland, then a large piece on the chest, and another piece to protect the male testicles (a), but the one in the hospital is too broken. It cannot be used directly.
"Just come and get it." Zhang Fan had no choice. The hospital was pursuing big equipment and high technology, but it really didn't care about small things like this. I don’t know what Ouyang He, the director of the equipment department, thinks. Zhang Fan complained a few words in his heart.
Reduction and forearm reduction have very high requirements for doctors. Therefore, the hospital now directly operates the forearm without repositioning it. Because this is too difficult.
The dexterity of human hands relies on the rotational function of the forearm. If the reset is not appropriate, there will be problems with arm rotation, which will subsequently affect hand function. Let alone writing or working, I can't even unbutton a girl.
It's like two pieces of wood put together. One of the two ends is round and the other is a track. Then the two bones rotate around, pulling the muscles and causing the hand to make corresponding movements.
If the stick is of different lengths or is at an angle, it blocks the rotation. Give you a Coke and you won't be able to unscrew the lid. Complications like open reduction are relatively rare, so doctors are almost reluctant to perform manual reduction.
Although Sister Xia is older, her eyes are still quite good. "Young man, your body is really strong!" Sister Xia said with a smile while looking at the fat man's flesh while being anesthetized.
"Haha!" At this time, the fat man was laughing harder than crying. Lying on the operating bed, he was extremely flustered.
"Okay, let's get started." After Sister Xia was anesthetized, she packed the tray and said to Zhang Fan and the others.
"Turn on the power, Xiao Li, please go out too. Women are too sensitive to radiation." Zhang Fan said to the nurse who was doing the surgery. Xiao Li is the nurse who was interested in Zhang Fan at first. This girl holds a grudge and doesn't talk to Zhang Fan very much until now.
Hearing what Zhang Fan said, the girl subconsciously touched her breasts, ran out quickly, and then closed the electric door of the operating room.
"It's no use looking at me. If you have as much subcutaneous fat and glands on your breasts as she does, I'll let you out." Xu Xian looked at Zhang Fan innocently, and Zhang Fan said angrily.
"But let me go..."
"Okay, come on, why do you look a bit like the person with the same name as you?"
"Your sister!" Xu Xian hated it when others compared him with the person who married the snake.
"Does it hurt?"
"pain!"
Zhang Fan took his hand and gently twisted the fat man's arm. "Too fat. Wait a moment, the anesthetic hasn't taken effect yet."
After a few minutes, "Does it hurt?"
"pain!"
"Stop talking nonsense, I haven't touched you yet. Does it hurt?" Zhang Fan asked after touching it deliberately. At special moments, patients are like this. Lying on the operating bed, they are the same as everyone else.
Zhang Fan looked at the fat man's expression and secretly twisted it hard. There was no reaction on the fat man's face.
"At first, he was a little scared." After that, he said to the fat man: "How can such a big man with such a strong body be so timid? Don't worry, it will be okay."
"Thank you doctor."
"Come on, let's start." Zhang Fan greeted Xu Xian.
For manual reduction, the first step is to pull apart the bones that are stuck together. Zhang Fan turned the patient's wrist, and Xu Xian grabbed the patient's elbow.
"Slow down, push slowly, use slow strength." Zhang Fan spoke to Xu Xian, and the two of them were like tug-of-war, with their buttocks lowered, their waist bent, and their hands straightened.
"No, try harder!" The fat man was so fat that he couldn't even reach his forearm with both hands.
"Oh my God, it's so hard." Xu Xian gritted his teeth and said, "Why are your muscles so strong? What on earth do you do?"
"He's a jerk! He's been a jerk since he was a teenager." When the fat man saw that he was not being operated on, he was relieved. In fact, he was worried for nothing. The patient didn't agree to the operation. The doctor was bold enough to directly Forced surgery.
"Okay, okay, hold on, hold on, this is the position." Zhang Fan gently pressed the broken part of his forearm with his thumb and said to Xu Xian.
This is really not an easy job. You need to use force in the front, from small to strong. When the pull tends to separate, you must always maintain a constant force.
Muscles are not rubber plugs and cannot be pulled violently. The gap between the bones must be slowly opened with a force just greater than the pulling force of the muscles. Zhang Fan is a little better, after all, he is a systematic person, and he has been exercising for a long time and has good strength.
Xu Xian couldn't do it. When he was in school, he scrimped and lived like a stick in order to find a partner. When he was working, he was buying a house and getting ready for marriage. He couldn't bear to eat or drink, so he didn't gain weight. .
At this time, Xu Xian was sweating, gritting his teeth and persisting. It only takes about ten minutes to make a man sweat profusely. You can imagine how time-consuming this work is.
"Xiao Li, open the C-arm." Zhang Fan shouted loudly. Compared with other surgeries, orthopedic surgery has an additional observation room, a small room isolated by a lead board. The door is only ten centimeters thick. It's better not to be too loud, Xiao Li can't hear it.
This sound almost scared Xu Xian off his hands.
"Buzz! Buzz! Buzz!" The C-arm started, like thousands of mosquitoes taking off. Then an image appeared on the monitor next to the C-arm.
An image just like an X-ray, but in real time. "Pull it tight, don't let go." After Zhang Fan said this, he began to reset.
Just relying on his two big fingers, Zhang Fan used his strength to reset the angular bones bit by bit. The thumbs must be pressed hard, and the body must move slowly from side to side to allow the fracture to form a moment.
This action is too strenuous. The hands need to be pulled steadily, the body needs to move, and the two thumbs need to coordinate the reset. Zhang Fan gritted his teeth and persisted.
Too fat, thick fat, and muscles gained from years of practice almost made Zhang Fan and Xu Xian collapse.
After more than 40 minutes, Zhang Fan's hands started to shake a little, "Okay, don't move, Xu Xian releases it slowly. Slower." Through the monitor, Xu Xian also breathed a sigh of relief, and the fracture was finally reset.
It's still a very dangerous time, because this fracture is like a broken chopstick. If you move it a little bit, it may deflect again.
"bandage!"
Xu Xian let go of his hands and quickly brought the bandage. "Bandage. Spiral!"
Finally, the plaster was put on, and the fat man left with great gratitude. The cost was: 80 RMB for surgical reduction, RMB 230 for anesthesia, and RMB 120 for materials. The skills of doctors are the least valuable.
"No, I'm so tired. I'm going to take a nap." Xu Xian lowered his head and said. Although Zhang Fan was a little dizzy, he had not reached that point yet, "You don't know how, go sleep somewhere."
Zhang Fan didn't take it seriously. As a result, the next morning, Zhang Fan was too tired to get out of bed. He was tired, very tired. After working under the ray for more than 40 minutes, I thought it was hellokitty without showing off its power.
