The so-called trial mold is to install the standard ball head of the trial mold on the medullary cavity file, reposition the hip joint, and check the tightness of the joint. If it is loose, use the long head, and if it is tight, use the short head.
This step is necessary for general doctors. It can ensure the matching of the instruments and avoid the prosthesis being disassembled and then installed inappropriately, which would cause great losses.
Li Zheng shook his head and said, "No need for a trial mold, let's try it after we insert the prosthesis!"
There is nothing to change once the medullary cavity file is tightened. Try it now, and then try the ball head again after the prosthesis is inserted. This step can be omitted.
With the miraculous performance just now, there is nothing for everyone to worry about.
The instrument technician quickly asked the circulating nurse to open the prosthesis packaging.
After installation, Li Zheng pulled out the medullary cavity file.
After sucking out all the blood in the medullary cavity, Li Zheng inserted the prosthesis.
The instrument technician took a look at the prosthesis, gave a thumbs-up, and said, "Doctor Li, you performed this surgery most smoothly I've ever seen. If it weren't for your age, I would have thought you were a famous professor in the province!"
Duan Jianhui sighed inwardly after hearing this. Although he felt a little unwilling, he still sighed, "Xiao Hu is right. Two years ago, I trained under Professor Zhang Wanchun of the Provincial People's Hospital and performed surgery there. He was also very good at it, but I feel that Li Zheng seems to be even better than him!"
Director Duan’s words made everyone look incredulous.
Doesn’t that mean Li Zheng is better than the big professors in the province?
This is too unreal!
Li Zheng smiled faintly and said, "Director Duan, that must be your illusion. You haven't seen anyone work quickly in the past two years. Now that I'm working faster, you think I'm faster than the professor. That's impossible!"
Although he said he should keep a low profile, Li Zheng still failed to do so.
The more outstanding your abilities are, the more you will face these problems, and it will be quite troublesome to answer them.
No one was worried anymore. After all, apart from Director Duan, no one had ever seen the professor perform surgery.
"Trial mold?" asked the technician.
Li Zheng nodded. Although he was confident in using a standard ball head for this step, he still had to be low-key.
The mechanic handed the ball head to Li Zheng.
Li Zheng installed it on the femoral prosthesis.
"Reset the joint."
Li Zheng took out the gauze from the acetabulum, and while using a push rod to support the ball head, he directed Guo Weiqiang to slowly rotate outward and straighten his lower limbs.
Soon, the reset was successful.
Li Zheng picked up the affected limb and started moving it.
"Flex the hip joint 90 degrees, no dislocation, adduct it 30 degrees, no dislocation, internal rotation 15 degrees, external rotation 30 degrees, no dislocation!"
"pretty!"
Xiang Yuanzhong couldn't help but exclaim in admiration. Today's operation could finally be completed perfectly.
"Try the tightness again." Li Zheng said as he straightened the affected limb.
"Oh, yes, yes, yes!" Xiang Yuanzhong quickly used a hook to open the wound and expose the joint.
Li Zheng pulled it down hard and found the joint to be of moderate tightness.
"Wei Qiang, go stretch your legs!" Xiang Yuanzhong ordered.
Guo Weiqiang took the leg from Li Zheng's hand and began to tighten and relax it one by one.
“This gap is fine!”
Xiang Yuanzhong watched the ball joint loosen and reposition within the acetabular liner. The gap was about 2 millimeters, which he knew was a perfect gap. Any smaller and it would be too tight, and any wider and it would be too loose.
"Director Xiang, compare the lengths again," Duan Jianhui reminded.
Xiang Yuanzhong quickly put the patient's legs together, touched the tibial tuberosity, and then touched the heel.
"Haha, no problem, both lower limbs are equal length!"
Xiang Yuanzhong was in a good mood and laughed happily.
At this point in the surgery, the main operations have been completed.
"Director Xiang, the suturing will be left to you guys from now on! We need to put in a drainage tube." Li Zheng said as he prepared to step down.
Xiang Yuanzhong grabbed Li Zheng and begged, "No, we still have the joint capsule and external rotator muscles to repair!"
Dean Zhang chuckled and said, "What's going on? Director Xiang is relying on Li Zheng?"
Xiang Yuanzhong smiled a little embarrassedly and said, "If I'm going to learn the technique, I have to learn the whole set. Don't underestimate the final suture, it's also very important. If the joint capsule and external rotator muscles are not sutured properly, it will affect the stability of the joint and make it more likely to dislocate!"
"Director Xiang is right! When I perform surgery, I have to start from skin incision to skin closure. No matter how well I do in the beginning, if the wound is not sutured properly and it leads to infection, the operation will fail!" Duan Jianhui joined in. He didn't want Li Zheng to step down, because the subsequent sutures also required technical skills, and he also wanted to see how Li Zheng sutured.
Li Zheng shook his head and said, "Then rinse it!"
This is promised to be sutured.
While flushing the wound, Li Zheng said, "Get an injection of ropivacaine, an injection of epinephrine, and an injection of dexamethasone, mixed with 30 ml of normal saline."
"What are you going to do?" Xiang Yuanzhong asked curiously.
Li Zhengdao: "Prepare some 'cocktail' for post-operative analgesia."
"What, cocktail?" Xiang Yuanzhong widened his eyes, thinking he had heard it wrong.
The others were the same, why did they want cocktails?
Li Zheng smiled and said, "This is a method of postoperative analgesia. It combines the three drugs I just mentioned, like a cocktail, and injects them into the joint capsule and surrounding tissues. It can effectively relieve pain and reduce the use of postoperative analgesics."
"Oh, really? There is such a treatment!" Xiang Yuanzhong felt that today's surgery was worth it as he could learn so many treatment methods that he had never heard of before.
Duan Jianhui had never heard of this method before. He had spent a year in the Provincial People's Hospital and had never heard of it. The doctors in that hospital had studied at the Imperial Capital Shuitan Hospital and they were in frequent contact, but they didn't know about this method either, and had never even seen it in magazines or journals.
But Duan Jianhui had no doubt that Li Zheng's performance in this operation had already caught up with the level of the Provincial People's Hospital. It was impossible for such a high-level doctor to act recklessly.
Others are also very interested in this treatment method, especially Director Xiao Zhihua, who is planning to use an analgesic pump after the operation. Now that a new method has emerged, he has to learn more about it.
"Li Zheng, after using your cocktail, do I still need to use a pain pump?" Director Xiao asked.
Li Zheng knew what he was worried about, shook his head and smiled, "This is just local analgesia around the joints, and the range of action is still limited. It can only achieve the best postoperative analgesia effect when used with an analgesia pump."
Director Xiao breathed a sigh of relief. If the analgesia pump was not needed, it would have a huge impact on the entire discipline of anesthesia.
The nurse prepared the medicine quickly.
Li Zheng injected the medicine into the joint capsule, muscles, and subcutaneous tissue.
Then he continued to suture the joint capsule, the external rotator muscles, and the fascia lata. He was familiar with the process and was very fast.
Duan Jianhui looked at it and nodded repeatedly.
"Doctor Li, with your level of suturing, it would be impossible to do it without more than ten years of surgical experience! But you are so young! Really..." Duan Jianhui said a little frustrated.
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