Chen Bing and Li Zhiliang came up quickly after eating. After carefully explaining to Lu Cheng where the food was, they guarded the patient and urged the anesthetist to administer anesthesia.

When Lu Cheng finished his meal and came to the operating room again, the patient had already been anesthetized, and one of Li Zhiliang and Xu Chongliang began to lift his legs, while the other began to spread the sheets with the handwashing nurse.

Chen Bing was sitting in front of the anesthesia table, chatting with the anesthesiologist about what to eat in the evening.

As usual, after Li Zhiliang and Xu Chongliang disinfected the sheets, it was Chen Bing's turn to wash his hands and go on stage, but Chen Bing still sat there with no intention of moving.

Chen Bing glanced at Lu Cheng and said, "Hurry up, wash your hands, put on clothes, and go on stage to help. This surgery is simple. I won't be able to do it. You and Xu Chongliang can help Li Zhiliang and it should be done."

Lu Cheng nodded and ran to wash his hands.

Li Zhiliang is a graduate student. It has been three years since he graduated. He has been following Chen Bing and has passed the exam for attending physician.

Moreover, in the team, Lu Cheng also knew that Li Zhiliang had begun to perform some internal fixation, amputation, debridement and suturing alone, debridement and drainage of post-operative wound infection, etc. It seemed that Chen Bing had slowly let go of some simple fractures on him.

Had surgery.

It doesn't matter if you follow the steps step by step.

Lu Cheng would not be so narcissistic as to think that Chen Bing wanted to leave the surgery to him because he saw that he was doing well.

Wash your hands quickly, then with the help of the circulating nurse, get dressed and come to the stage.

Li Zhiliang and the two have already connected the electric knife, circular knife, tweezers, suction tube, etc.

When he was about to start the stage, Li Zhiliang glanced at Chen Bing. Chen Bing was still chatting with the anesthesiologist, only looking at the stage with his peripheral vision.

Li Zhiliang said calmly: "Tourist, please note the time and the operation will begin."

The circulating nurse immediately pressed the operation timer, and then Li Zhiliang once again determined the patient's fracture site, and then used a round knife to cut the skin on the front edge of the tibia.

Once under the skin, the electrosurgery was switched to start electrocoagulation to stop bleeding and continue to penetrate deeper. After reaching the muscle layer, blunt peeling was performed with tissue forceps.

The operation is very smooth and the basic skills are very good.

Finally, we quickly arrived near the periosteum of the tibia,

Li Zhiliang did not rush to open the periosteum, but continued to repair the soft tissue, expanding the area where the incision should be made, and trying to expand the surgical field of view under the limited surgical incision.

Whether an operation is done well or not, the exposure of the surgical field is very critical. This is Li Zhiliang's second fracture reduction and internal fixation operation. The first operation failed. He went back to sort out his thoughts and summary, and found that the first operation was

I am too afraid of expanding the surgical field and fail to expose the surgical field properly.

This time, he had to make all the preparations and sharpen his knife to chop wood.

In this way, after another five minutes, the fracture was finally exposed.

The fracture is very simple, diaphyseal fracture type A2, long bone fracture type A has three subtypes, A1 is a simple spiral, A2 is a simple oblique, and A3 is a simple transverse. The joints are not involved and there is no comminution.

Oblique fracture, displaced!

The basic operation is basically temporary fixation after traction reduction. After X-ray fluoroscopy shows that the fracture is satisfactorily reduced, internal fixation with plates and screws is performed.

The overall idea is very simple and clear. First, reset.

Second, fix it!

Then, the operation is over!

Lu Cheng saw that Li Zhiliang also knew the surgical idea very well. He said to the handwashing nurse: "Sister Ya, give me a rongeur."

The handwashing nurse for this operation was still Jiang Ya. Although Chen Bing was angry with her during the first operation, this did not affect the personal relationship or the subsequent work.

Work is work, and you can't just stop coming because of disputes at work.

And Jiang Ya also apologized to Chen Bing afterwards.

Jiang Ya quickly handed the rongeur to Li Zhiliang.

"Lu Cheng, pull the hook,"

"Xu Chongliang, go and pull it! It must be pulled in place." Li Zhiliang ordered.

Traction is a very important operation. Li Zhiliang is not familiar with Lu Cheng, so he prefers to use Xu Chongliang, who he is more familiar with.

Xu Chongliang handed the retractors to Lu Cheng, then held the patient's ankles with both hands and began to pull toward the far end of the body.

Suddenly the force was so strong that the fractures were separated.

Li Zhiliang hurriedly said: "You don't have to be so powerful!"

Xu Chongliang's strength is a little smaller.

At this time, Chen Bing also walked to the side of the operating table, standing half a meter away from the operating table and looking inside.

"You can't just loosen it all, you have to keep pulling!" Li Zhiliang tried hard to bite the fractured part with a rongeur, while letting Xu Zhongliang adjust his strength.

Xu Chongliang slowly began to pull again,

"Pay attention to the traction force and draw it in slightly!" Chen Bing ordered from the side!

Xu Chongliang followed suit,

Li Zhiliang found the right opportunity and immediately caught him.

The pliers finally clicked together, but the alignment was not very good and there was still a little bit of displacement.

Chen Bingdao: "Don't be anxious, let go and try again."

…

Five minutes later, Xu Chongliang ran out of energy.

Said: "Brother Zhi, I can't do it anymore."

Continuous traction for five minutes, and the patient is not light, will make everyone tired, and the hands will be sore.

Li Zhiliang frowned slightly and glanced at Xu Chongliang. He was almost caught, but he couldn't blame Xu Chongliang, so he said, "Then you and Lu Cheng change places."

Lu Cheng waited for Xu Zhongliang to throw away his hand and take the retractor again, then he directly grasped the patient's ankle with both hands.

Back and inward just a little pull!

There was a click.

There are some gaps between the originally displaced fractures that will get stuck, and because the traction of the soft tissue will cause the direction of the fracture to be incorrect, a slight pop will occur when the stuck position is returned to its original position.

"This is the time, clamp it!"

"Lu Cheng, don't let go." Chen Bing shouted quickly.

Li Zhiliang finally clamped the broken end of the fracture with rongeurs, and then shouted to the nurse who was washing her hands: "Kirschner wire, 2.0 electric, give it to me."

Jiang Ya was already ready and had been waiting for Li Zhiliang for four or five minutes.

Hand it over immediately.

Li Zhiliang quickly perpendicular to the fracture line and inserted two Kirschner needles.

Then he said: "Lu Cheng, you can loosen it, it's basically fixed."

When Chen Bing saw this, he nodded slightly. At this point, the operation was already half over.

He personally started pushing the C-arm machine and then inserted it into the patient's leg.

The fracture line is basically invisible.

It can be seen with the naked eye, but this step is still needed to leave evidence for the patient that we have reduced the fracture.

Chen Bing pushed the C-arm machine away again, and then the circulating nurse said thank you.

Chen Bing didn't reply, he just looked up and down on Lu Cheng's body. He was not stupid. Xu Chongliang had been reset for so long, and it was basically impossible to pull him in place.

As soon as Lu Chengcai got started, the fractures were basically aligned steadily, combined with his experience from the previous surgery.

This Lu Cheng has a problem.

not simple.

Chen Bingdu watched Li Zhiliang start driving nails step by step.

Just ready to leave.

Li Zhiliang drilled the holes, but Li Zhiliang directly handed over the hard work of screwing in to Xu Chongliang. This was a reward for him and also to save himself some effort.

Xu Chongliang twisted so hard that he screwed two in a row. It was not until the fourth time that he smiled and said, "Brother Zhi, we can get off work very early again today!"

"Yeah!" Li Zhiliang just nodded when he felt that there were still two screws left and he could step down.

"Click!"

There was a sound of metal breaking from within the incision.

Crisp and loud.

No need to guess, it must be slippery.

Chen Bing's face suddenly turned green as he walked at the door of the operating room.
Chapter completed!