When the Doctor Uses A Hack

To gauge the level of a doctor, you can tell from the very first moment they see their patient!

The moment An Yanjun saw the patient’s condition, his brain immediately started working at high speed, as he pondered over the best treatment plan.

He quickly gained a comprehensive understanding of the patient’s situation.

What needed to be done first was to reposition the palm injury.

The patient’s main issue was the dislocation between the metacarpophalangeal joints and fractures of the phalanx bones.

Tan Zhonglin was proficient in dealing with such joint issues, and An Yanjun was no less capable.

However…

At this moment, both unconsciously stepped away from the main surgeon’s position, silently preparing to grab the auxiliary equipment.

Tan Zhonglin looked at Chen Cang, “Chen, you do it!”

Chen Cang was taken aback and awkwardly said, “Director, you should do it, I… I’m not particularly good at orthopedics.”

Tan Zhonglin was surprised, such a nice young man, giving me so much face, but he sighed, “Chen, this is not the time for modesty, you do it!”

Chen Cang was astonished, “Director, I really don’t quite know how.”

This caught Tan Zhonglin and An Yanjun off guard as well.

Was there something Chen Cang didn’t know?

Tan Zhonglin took a look at Chen Cang, and seeing he wasn’t joking, tentatively asked again, “Really? You don’t have to spare our feelings, we’re not strangers!”

Chen Cang couldn’t help but laugh and cry, “Really, Director, I really don’t know how. You guys handle the bone reduction, I’ll take care of the tendon, nerve, and vascular issues. Let’s divide the tasks clearly, alright?”

Hearing Chen Cang’s words, Tan Zhonglin’s heart relaxed and he couldn’t help but let out a sigh of relief.

That’s more like it!

You’re only 27 years old, after all; even with great talent, there are limits.

How could you possibly know everything?

At this thought, Tan Zhonglin found himself amused by his initial expectations.

We are all human, how could the difference be so big!

It’s just that everyone has their specialty!

Moreover, orthopedics requires long-term work experience and a buildup of surgical cases. Chen Cang is adept at tendon and vascular sutures, probably because he has spent a lot of time on the front line, dealing with trauma patients more frequently.

Suddenly, Tan Zhonglin felt much lighter inside.

“Director An, come on, let’s do this.”

Meanwhile, Chen Cang was intently observing on the side. Clinical work requires constant learning; if you don’t learn, how can you improve?

If the phalanx fracture hadn’t displaced, the primary approach would be manual reduction, which Chen Cang was capable of.

Only now did Chen Cang realize how powerful the manual reduction techniques he learned from Director Wang Xiangjun were!

But for an open fracture like this one, requiring incision and internal fixation, for example, Tan Zhonglin’s use of Kirschner wires for fixation is a reliable method commonly used in the clinic.

Providing instruments, Chen Cang on the side also had a clear view!

Tan Zhonglin, witnessing Chen Cang’s earnest learning, felt a little proud inside!

Young people should be eager to learn more!

After all, open phalangeal fracture fixation surgeries are common procedures that hand surgeons often need to perform. Tan has been doing them for half his life, rich in experience, and adept in technique, occasionally showcasing it at annual meetings to earn applause.

Thus, Tan Zhonglin was quite confident in this area.

In fact, performing surgery, like playing sports or singing, requires a certain state of mind. As long as a doctor feels well mentally, the surgery can’t go too wrong.

Tan Zhonglin discovered that when Chen Cang was watching as an observer, this sense of confidence was overwhelming.

With this in mind, Tan Zhonglin couldn’t resist showing off a skillful move, causing An Yanjun’s eyelids to twitch. When An looked at Tan, his eyes were filled with a touch of respect. That Tan, he was truly impressive!

Chen Cang, watching from the side, also had to admit, the older the ginger, the hotter the spice. Director Tan’s work on the phalangeal surgery was really good!

[Ding! Congratulations, the title attribute of 5% “Skill Thief” has been triggered: you have acquired Tan Zhonglin’s skill: Phalangeal Fracture Surgery: Master level.]

[Phalangeal Fracture Surgery: Includes phalangeal repositioning and fixation, etc., Master level; Special effects: 1. Accurate repositioning; 2. Firm fixation;]

Chen Cang’s face brightened with joy!

My goodness.

It’s been such a long time since the “Skill Thief” task was triggered, and now it finally happened.

Thinking of this, Chen Cang couldn’t help feeling elated inside, as both special effects, one being precise and the other being firm, were very effective.

Because the treatment of phalangeal fractures needs to achieve accurate repositioning as well as firm fixation, and to start functional exercise as early as possible to restore the nimble activity of the fingers.

And the surgical outcome can basically be influenced by accurate repositioning and firm fixation!

The bone fracture surgery ended quickly, and Tan Zhonglin couldn’t help but breathe a sigh of relief, finally able to show off in front of Chen Cang.

Ever since meeting Chen Cang, each time his worldview was challenged anew, he nearly forgot that he himself was the role of the Director of Hand Surgery at the Provincial People’s Hospital.

With that thought, Tan Zhonglin glanced at Chen Cang.

An Yanjun then came in with a flattering remark, “Director Tan’s surgery on phalangeal fractures is really good! I saw it last year at the annual meeting, and didn’t expect to see improvement again!”

Tan Zhonglin, looking at Chen Cang, said earnestly, “I’m in good form today, Xiao Chen, the rest is up to you.”

Chen Cang nodded his understanding. He knew that the work coming up was the crux of the matter!

The orthopedic surgery only took a little time and did not affect the surgery on nerves and blood vessels in the hand.

Tan Zhonglin and An Yanjun both looked worriedly at Guo Zhiyong’s dorsal hand which, even after debridement, was in bad condition!

Because both the ulnar and radial arteries had been completely severed!

This wasn’t as simple as just saying.

Even when clinical reports showed that the survival rate for hands with complete severance of both ulnar and radial arteries was still around one-third.

But is one-third high?

While some might think it is quite high, putting it another way, you wouldn’t think so.

The probability of surgical failure was as high as two-thirds.

The arteries had been ligated before the surgery, and the task at hand was to perform anastomosis on the damaged blood vessels.

It’s fortunate that it was an arterial ruptural injury in the hand; if it were somewhere else, the chances of recovery might not even reach ten percent.

Because the blood supply to the hand is extremely rich, mainly coming from the radial and ulnar arteries, and in addition, there are the anterior and posterior interosseous arteries.

Of course, there are some so-called naturally gifted individuals, who are built differently, also referred to as “one with astonishing bones, a martial arts prodigy”, within whose hand blood supply, 3.7% of individuals have the participation of the median artery.

In fact, medical statistics only cover the majority of people; there are so many with unusual physiques, indeed naturally gifted. The one Chen Cang remembers most vividly was a patient with a cerebral infarction.

Generally, after a cerebral infarction, it means that the brain tissue behind suffers necrosis due to ischemia and hypoxia, but at the time of discharge, cerebral vascular magnetic resonance angiography (MRA) revealed a collateral circulation had formed at the original infarct site, compensatory blood vessels had restored blood supply to the infarcted area!

Chen Cang was dumbfounded then!

It was truly what one would call a medical miracle.

Since then, Chen Cang approached the human body with awe; seeing people attempting to jump from buildings, he would give them a wide berth, just in case their bone quality was abnormal and they ended up running off after landing—what if they were actually just tired of climbing stairs?

The blood supply to the hand, in the form of arterial networks or arterial arches, constitutes a smooth traffic channel, ensuring a strong adaptability of blood supply during various functions such as pinching, holding, grasping, and gripping.

And it is precisely because of the rich anastomosis between these blood vessels and their good compensatory ability that the hand still has a chance of over thirty percent recovery, even if the radial and ulnar arteries are ruptured.

Chen Cang found that his eyesight was really useful when he was handling these delicate surgeries.

Looking at the names written above, Chen Cang knew that he definitely wouldn’t make a mistake in identifying the blood vessels!

[Severed distal end of the radial artery] + [Severed proximal end of the radial artery] = A complete radial artery.

Yes, it’s that simple, just like assembling toys back in school.

Of course, stitching is the most critical part of the surgery.

Because the surrounding vessels are relatively fine, the procedure is quite arduous and the difficulty of operation is also high.

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