Chapter 439: The dilemma of replanting a severed hand, Xu Qiu’s solution!

But... the doctor can hardly see his own operation.

Special microscopes, special instruments, and long-term training will eventually qualify him to move needles on the blood vessels and nerves of the fingers, but when it comes to suturing, what he actually considers is the feel of the hand.

Or, it is the mechanical memory trained in daily life.

No one knows whether each suture is good or not. If the number of needles is too few, the blood will flow out along the broken ends, and only then will he know that there is a flaw in the suture.

Too many needles is a more fatal problem.

Too few will at most cause bleeding, which can be seen at a glance.

But excessive suturing can easily cause blood clots here, causing necrosis of the fingers, and then causing more serious complications.

"Inflatable tourniquet."

After the operation began, the assistant, under the command of Xu Qiu, cleaned the surgical field and then clamped the artery with an inflatable hemostatic clamp.

Then, Xu Qiu began the anastomosis.

There was nothing fancy, just a simple 2-point interrupted suture.

However, because he found multiple arteries during the debridement stage, the atmosphere of the operation was particularly relaxed.

In conventional surgery, it is best to anastomose two digital arteries, which can maximize the survival rate, and sufficient blood supply can also restore the appearance and feeling of the fingers better, and the nerves can be repaired more effectively.

As for three or four fingers, there is basically no need to think about it.

It has come to the stage of finger amputation, and transplantation is extremely urgent. How can there be time for doctors to slowly find them?

But Xu Qiu easily found three or four fingers, which can almost double the survival rate of fingers!

After the blood vessels are repaired, it is the dorsal skin, tendons, etc.

The order of tendon repair is first the extensor tendon, then the flexor tendon.

Qiu Qinghu's broken finger situation is more complicated, and the broken parts of each finger are not consistent.

For example, the thumb Li phrase is close to the proximal interphalangeal joint. In addition to repairing the central tendon, this finger also needs to repair the lateral tendon bundle.

The ring finger is severed from the proximal interphalangeal joint to the distal end of the middle segment, so the lateral tendon bundle and the extensor tendon need to be repaired.

In addition, the little finger is severed at the distal interphalangeal joint and needs a joint fusion.

"Wait, does this stump also need to be sutured?" Everyone was suddenly stunned.

After Xu Qiu completed the repair of the deep flexor tendon, he tried to suture another muscle. It seemed that the synovial fluid nourished the tendon.

Wang Shengde and others were puzzled.

Shouldn't the suture of the finger tendon be declared complete after the repair of the extensor tendon and flexor tendon?

At this time, supplementing a nutrient tendon will not affect the function of the finger, but will double the difficulty of the operation!

However, at this moment, Noah, who had been silent, suddenly widened his eyes and said in disbelief: "Where did you see it?"

Wang Shengde was stunned. Is there something else to this?

Noah whispered, "This is one of the topics I have been studying...

In the Hand Surgery Hospital of Orthopedics, many patients recover faster than others.

Many people think that this should be the gap between different individuals.

But I don't think so.

Therefore, I conducted a long-term follow-up and investigation for ten years, and finally I really found something...

These patients who recovered faster, their synovial tendons were not damaged, or the damage was very small!

Therefore, I speculate that this seemingly useless synovial tendon can continuously provide synovial fluid, thereby promoting the repair of the superficial flexor tendon of the digitorum, and help the nutrition and regeneration of the tendon sheath!

I even speculate that the synovial tendon may also play a role in providing a certain degree of blood supply..."

Wang Shengde looked at Noah in surprise.

He is worthy of being the inheritor of the father of hand surgery. A casual word is enough to inspire all the hand surgeons present!

But then, they showed greater shock on their faces and looked at Xu Qiu.

It's okay for Noah to know...what's going on with Xu Qiu!

He didn't hesitate at all and ran to suture the synovial tendon!

If Noah's hypothesis was just a guess and had not been put into clinical use, then Xu Qiu had really done it. How could he be so sure!

"Doctor Xu, am I right?" Noah suppressed his voice, and his voice could no longer be calm.

"Basically correct."

"Basically?"

"There is another advantage, which is to prevent tendon adhesion."

Noah's pupils shrank.

Wang Shengde and others also looked at each other, and then joy emerged on their faces.

There is an extremely contradictory prognosis problem in the replantation of a broken hand.

The time for rehabilitation!

If the rehabilitation is done too early, the various tissues inside the replanted finger have not grown well, and they will tear and bleed, causing severe pain.

However, if the rehabilitation is done a little later, adhesions will occur at the internal sutures and various anastomoses.

In clinical practice, it is definitely better to do rehabilitation training as early as possible, even if it is painful to move the fingers and tear the wound open, it is better than adhesion.

After all, once adhesion occurs, the finger must be cut again to remove the adhesion, and then wait for recovery.

Previously, there was no good way to prevent adhesion except for forcing patients to do finger exercises and forcibly tearing the wound open.

But now Xu Qiu actually said... repairing synovial fluid to nourish tendons can do this? !

"Xu Qiu, really?" Wang Shengde was surprised.

Although he has long been out of the front line, if this theory is confirmed, countless patients with severed fingers will benefit, and they will no longer need to endure the severe pain of torn fingers and tissues and undergo rehabilitation training prematurely.

Moreover,

Relying on medical means to reduce the probability of adhesion is definitely smarter and more effective than hurting the enemy and hurting yourself.

"Yes." Xu Qiu nodded calmly.

Noah was shocked: "If what you said is true, it can prevent adhesion, which can be regarded as solving a huge problem in the field of finger replantation... Why can you be so calm?"

Xu Qiu: "Why can't you be calm?"

"I..."

Noah wanted to say a few more words, but he thought of the young doctor in front of him who had already developed the sea-side small blood vessels, and also opened up the world's first complete cranial fusion and separation.

For such a monster, it seems that solving the problem of adhesion is not something worth making a fuss about...

"I still underestimated you." Noah looked at Xu Qiu deeply, his fingers trembling slightly.

...

The operation was progressing slowly.

As the finger nerves were also repaired, the broken palm was about to be reattached.

Due to the urgency of time, the medical and medical equipment department could only provide a roughly usable artificial metacarpal bone, but this was much better than losing half a palm.

Everyone focused their attention.

Metacarpophalangeal regeneration surgery, the fingers have been replanted, it's the palm's turn.

With the experience of the previous four hours of surgery, Xu Qiu was very comfortable with metacarpal replantation.

The three-dimensional anatomy of the broken palm emerged in his mind, and the blood vessels, nerves, tendon ends, etc. were marked.

Then, he began to repair the bone scaffold...

The distal end of the metacarpal bone, the artificial metacarpal bone and the proximal end were aligned...

The Kirschner wire was inserted from the proximal end into the distal metacarpal bone, I~V metacarpal bones in turn...