The circulating nurse was stunned for a moment, and Director Duan urged again.
The nurse quickly crawled under the sterile sheet and loosened the front and back fixation boards on the patient's body.
"It's okay." The nurse's voice came from under the sterile sheet.
Duan Jianhui laughed and said, "Everyone, the time to witness a miracle has come!"
Everyone's attention was drawn to him.
Duan Jianhui was seen holding the test mold connecting rod with both hands and pulling it hard.
Except for the few people who saw it yesterday, everyone else was completely dumbfounded.
"This... the patient has even left the bed!" Zhu Qidong stood beside the operating bed and saw it most clearly, but even so, if he hadn't been wearing gloves, he would have wanted to rub his eyes to see if he was seeing things.
Zhang Yong stood on the footrest, looking down from above, and could see clearly.
If the mask wasn't covering his mouth, you could see that his mouth was wide open enough to fit a goose egg.
"How is this possible? This press fit... is too tight!" Zhang Yong muttered to himself, completely overturning his understanding of the effect of this operation.
Zhou Ming was also standing behind Li Zheng. He rubbed his eyes after what happened just now, his dark face full of disbelief.
"Director Duan... Director Duan, can you pull it out again and see?" Zhou Ming stuttered.
Director Duan shook his head and said, "Just once is enough. Too many times will easily damage the acetabulum."
You only have one chance, if you don’t see it, you can only wait for next time.
Zhou Ming took a deep breath and said, "With the press-fit strength of this acetabular trial mold, there's no need to worry about postoperative loosening. You can get out of bed and move around after the surgery!"
Duan Jianhui chuckled and said, "Of course. The purpose of asking Li Zheng to perform this operation is to get the patient out of bed as soon as possible!"
Director Duan asked the nurse to re-fix the patient's body positioning baffle.
The operation continues.
Zhang Yong and Zhou Ming both put away their contempt and began to observe carefully.
Li Zheng used a hammer to follow the connecting rod and used force to knock out the trial mold cup.
Then the prosthesis is installed.
Jiang Youwei finally doesn't have to worry about the prosthesis not matching like he did yesterday and have to pay for it out of his own pocket.
I asked the nurse to open the prosthesis packaging early.
Li Zheng handed the connecting rod to Jiang Youwei and asked him to install the prosthesis.
Continue to hammer the prosthesis into the acetabulum.
After the sound became firm, Duan Jianhui tried to pull it out again and found no problem.
Then Li Zheng inserted two more acetabular screws.
The polyethylene liner is installed and the temporary Kirschner wire is removed.
The acetabulum has been processed.
"Perfect!" Duan Jianhui said happily.
"Cameraman, change the angle, we need to deal with the femur." Duan Jianhui said.
The cameraman adjusted the camera and focused on the femur.
Li Zheng helped Chen Dayong and Director Duan adjust the position of the retractor to fully expose the proximal femur.
Then clean off the soft tissue on the femoral neck section.
Jiang Youwei handed the opener and hammer to Li Zheng.
"The soles of your feet must face the ceiling." Li Zheng said to Zhu Qidong again.
Duan Jianhui also emphasized: "The next operation is related to the positioning of the forward tilt angle, so your task is very important!"
Zhu Qidong nodded and said seriously: "Don't worry, I won't hold Li Zheng back."
Li Zheng chiseled the cancellous bone and bone marrow in the medullary cavity at the center of the femoral neck osteotomy section to open up the medullary cavity.
Hand the opener to Jiang Youwei and seamlessly connect the medullary expander.
Li Zheng inserted a slender medullary expander into the femoral medullary cavity, and a yellow, white and red substance mixed with fat and blood continued to flow out of the bone marrow.
Director Duan immediately used a suction device to clean it out.
Turn the medullary reamer to stir out all the bone marrow.
Then continue to change to a larger size medullary expander.
After only two changes, Li Zheng felt the medullary expander scraping the femoral cortex.
Li Zheng pulled it out, and Jiang Youwei handed him a medullary cavity file and a hammer.
Start from the smallest size.
Li Zheng easily inserted the medullary cavity file into the medullary cavity.
Then change to a larger size intramedullary file.
Changed twice in a row.
"It's okay, this size." Li Zheng turned the handle, and the intramedullary file was firmly fixed in the intramedullary cavity.
"Okay." Jiang Youwei had already prepared the femoral prosthesis and immediately asked the nurse to open the package and install the connecting rod.
"Don't you want to try out the mold?" Zhou Ming asked in a low voice.
Li Zheng shook his head and said, "No, this is the only model of femoral prosthesis that can be installed."
Zhou Ming nodded. In the past, Director Duan would always try out the mold before doing anything. The fact that Li Zheng didn't try it only showed that he was very confident.
Li Zheng used a file to rasp out the medullary cavity and pulled it out.
Director Duan quickly inserted the suction tube and sucked out the blood and bone marrow in the medullary cavity.
Li Zheng slowly inserted the femoral prosthesis stem into the medullary cavity and took another look at the calf that Zhu Qidong was holding. It was well maintained.
After adjusting the forward tilt angle to 15 degrees, Li Zheng took the hammer and began to hammer on the connecting rod.
While Li Zheng was tapping, Director Duan was observing the cortex of the lesser trochanter of the femur.
Because the prosthesis is 0.2 mm larger than the intramedullary file, there is a risk of rupturing the femur, so observation is required while the procedure is being performed.
But Li Zheng did not stop. He had reached a very high level in terms of perception of the tightness of the prosthesis and control of the force of the hammer. He knew very well whether the femur would break.
"Is it OK?" Director Duan asked tentatively, because he had seen that the marking line of the intramedullary file was almost flush with the osteotomy surface.
"Not enough." Li Zheng said, continuing to hit hard.
Everyone around became nervous.
With such violent blows at the last moment, the femur can easily be broken.
But Li Zheng did not reduce his strength and continued to hit very hard.
"alright."
The knocking suddenly stopped and everyone finally felt relieved.
Director Duan checked the femur immediately.
"There is no problem! The prosthesis marking line just reaches the osteotomy plane." Director Duan said loudly.
"Director Duan, please check the tightness." Li Zheng released the connecting rod.
"What else do we need to check? There must be no problem!" Director Duan said as his hand already grasped the connecting rod.
As it rotated, the femur also rotated.
"I told you there's no problem. The compression fit is very tight, and you can get out of bed and do partial weight-bearing exercises after the surgery." Director Duan said with a smile.
"Trial mold." Li Zheng said.
Jiang Youwei handed the standard ball head model to Li Zheng.
"Replace it with a ball head with an extended inner diameter." Li Zheng said.
"Will it be too tight if it is lengthened?" Director Duan whispered.
"No." Li Zheng did not explain much.
Jiang Youwei changed one immediately.
After the ball head was installed on the femoral stem, Li Zheng instructed Zhu Qidong to reposition the joint and incorporate the femoral head prosthesis into the acetabulum prosthesis.
"External rotation, straightening the lower limbs...yes, it went in."
Zhu Qidong has a good understanding.
Li Zheng took over the lower limbs, flexing the hip joint more than 90° and internally rotating more than 30°.
"It's not dislocated, it's stable."
As Li Zheng spoke, he placed his entire right leg on his left leg and compared the lengths through the sterile sheet.
"Director Duan, please compare." Li Zheng said, letting go of his hand.
Director Duan carefully compared the positions of the tibial tuberosities of the two knees and then the heel positions.
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