Chapter 811: Sucking Beef Bone Marrow
"Doctor Xu always inserts quickly and accurately~~" the instrument nurse bit her lip and whispered.
Lin Xie looked over suddenly... He originally thought that the young instrument nurse was very shy, but he didn't expect that she was so skilled.
"Check it out." Xu Qiu also recognized his needle insertion skills and said seriously.
Soon, the sterile C-arm X-ray fluoroscopy machine was brought over, and the assistant checked the position of the Kirschner wire from the front and side positions respectively. The result was as expected - the Kirschner wires inserted in both directions did not form a perfect parallel with the joint.
"Sure enough, it's fast and accurate..." Lin Xie sighed, the gap between him and Xu Qiu was really a bit big.
For Xu Qiu, this step can be completed in one minute.
But Lin Xie needs several minutes to complete the calibration, drilling, re-adjustment, and then continue to go deeper.
The apparent gap is only a few minutes, but to catch up with this time, it requires amazing talent and decades of research.
…
As the first Kirschner wire at the proximal end of the tibia was completed, the second Kirschner wire was also inserted from the distal end. The distance between the two needles was exactly the thickness of the osteotomy block determined before the operation.
Xu Qiu did not even use a mold or a guide, but directly inserted it, accurately intersecting with the first Kirschner wire at the inner cortical bone.
To achieve this step, in addition to having an extremely clear understanding of the route and position of each needle, it is also necessary to have a clear understanding of the patient's anatomical structure, bone characteristics, etc.
It is like inserting two needles into different positions of a cooked egg, and the last two needles need to intersect on the inner surface of the eggshell, with the needles touching each other.
The operation is to replace the soft cooked egg with hard bone.
The needle can still control the force when piercing the egg, but the bone is not so easy to penetrate, especially when it comes to the cortical bone. It is possible to pierce it with a little force. It is extremely challenging to insert blindly and at the same time accurately control the direction and insertion depth of the Kirschner wire.
Coincidentally, Xu Qiu has a little skill and foundation.
"Retractor."
While talking, Xu Qiu had already adjusted the Kirschner wire. He then placed a retractor along the posterior surface of the proximal tibia and under the patellar tendon. This step was to protect the soft tissue.
"Osteotomy."
"Curette."
Surgical instruments were constantly replaced. Xu Qiu first used the osteotomy to remove the hardened bone blocking the surface of the tumor, and soon saw the osteosarcoma below.
"I see." Lin Xie was a little excited.
Under the shadowless lamp, the entire surgical area was clearly revealed.
On the originally clean tibia, white lumps now grew, and the cross-section was granular, with a large number of yellow-black structures, which looked like rotten cavities.
In fact, this whole piece was the appearance of small round cell osteosarcoma under the naked eye.
"Let's go to eat bones tonight. Wang Fan said that there is a barbecue restaurant near your clinic, and the specialty is roasted beef bone marrow." Lin Xie said with a smile.
To be honest, if it was beef in front of me, even osteosarcoma should have a good taste... I haven't eaten it before, I can't imagine it at all.
Everyone looked at Lin Xie at the same time, their eyes full of ambiguous disdain.
Xu Qiu was not interested at all: "There will be another operation later, and I have to go to the Neurosurgery Center in the evening to coordinate with Tiantan Hospital."
Lin Xie was stunned and said silently: "We are not from the same world..."
He never thought that even though he had stood at the top of the field of bone reconstruction and had already become a senior figure in the medical community, there was still a huge gap between him and Xu Qiu.
Not in status, but in the realm of thought.
Lin Xie beat his chest and stamped his feet and said: "I am too decadent. Starting tomorrow, I will also learn from you, Xu Qiu, and put more thought into work."
Xu Qiu nodded and asked: "What about today?"
"Today I will go to chew beef bones."
...
Squeak--
After removing the tumor, the sharp sagittal saw fell on the bone surface again. Xu Qiu's hand was steady, controlling the saw to make the initial cut along the axis of the proximal Steinmann needle.
This is also the first step to remove the infiltrated tibia.
After the proximal cut was completed, Xu Qiu made a second cut along the axis of the Steinmann needle further away, and the cut extended to about three-quarters of the tibia before stopping.
If it was extended further, the medial cortex of the tibia would easily split, and three-quarters was the limit that Xu Qiu could control.
Then, Xu Qiu took out the wedge-shaped bone in the osteotomy cut and drilled several holes through the medial cortex.
Lin Xie put away his desire for cow bone marrow and was stunned.
Xu Qiu's operation was precise and fast throughout the whole process, and after the resection was completed, the hinge of the periosteum was still intact, and the osteotomy fragments did not shift at all.
Cutting such hard bones, but being able to control not to produce any fragments is a technique that ordinary people cannot achieve, and it is not an exaggeration to describe it as incredible.
"Done?" Lin Xie suddenly reacted after Xu Qiu put down the instrument.
All the infiltrated tibias were removed along with the tumor...
It was so fast?
Did it add up to half an hour?
Lin Xie first thought he was dreaming, but when he thought about Xu Qiu, it suddenly made sense.
"The next step is to evaluate whether the position and length of the prosthesis are appropriate based on the position and angle of the fibula and talus, then trim the osteotomy stump, select the appropriate intramedullary nail and bone segment, and complete the reconstruction of the prosthesis..." Lin Xie is very familiar with the process of bone reconstruction.
In terms of tumor removal, he is not good at it.
But the subsequent tibia reconstruction is Lin Xie's specialty, and it is also his biggest reliance for making a living and dominating the orthopedics department.
Xu Qiu glanced at Lin Xie.
He could feel that after entering the reconstruction surgery, Lin Xie's chin was raised a little, and his face was more confident.
"Continue."
Xu Qiu didn't say much, relieved the fatigue of his eyes a little, and started the next step.
"Vancomycin powder, spiral drainage tube." He said.
Lin Xie, who was about to take the measuring tool, was stunned, and a question mark slowly appeared on his head: "Huh?"
Vancomycin powder is applied around the prosthesis, and as for the spiral drainage tube, it is placed in the wound cavity after reconstruction. There is no measurement or trimming, how can it be directly to this step?
"This, this, this..." Lin Xie stuttered.
Xu Qiu said lightly: "You can try to measure it."
Hearing this, Lin Xie suddenly had an idea in his mind, and his expression was a little unbelievable... No way, it can't be!
He quickly measured and evaluated the position and angle of the bone and talus, and recorded the length and prosthesis data. After comparing, his mouth slowly opened wide, and he was completely shocked.
"Perfect fit?!"
"How could it be such a coincidence?"
"No, that's not right...Xu Qiu, you have already completed the trimming at the same time when you cut the bone?!"