Surgery Godfather-Chapter 589 - 536 Case is Topic

Anyways, getting scolded by Xu Zhiliang wasn’t new to Zhang Lin; he was used to it.

The two of them belonged to the same medical team. Zhang Lin liked to play the big shot, handling graduate students, standardized training students, interns, and even doctors from outside who came for further studies, very tightly.

But, Xu Zhiliang handled him just as tightly. When Xu Zhiliang took him on rounds, he would basically be sweating profusely, shaking with fear.

Little Five had also never seen such a case and didn’t know what to say.

Song Zimo and Xu Zhiliang had vast knowledge, read various journals every day, although they were unfamiliar with this case, they at least had some preliminary understanding of it.

"I’ve seen a document on this, the first case appeared in 1800. Since then, it has sporadically appeared a few times. The cases recorded in the literature show that although the knee bends backward, there is no front-to-back reversal in the anatomical structure. Every one of those cases was caused by various factors leading to ligament laxity, the knee evolving to bend forward excessively, and eventually all patellofemoral and tibiofemoral joints either dislocate or partially dislocate, with the knee stiffening in a deformed backward position. This knee is not the same, its backward bending is not due to ligament laxity, but is completely anatomically reversed. Look, the patella is actually at the back."

"Could this be an example of atavism? The knees of mammals, like dogs, face backward." Zhang Lin asked again. He was not ready to give up and wanted to show off because he had recently read an article by Professor Qin Sihe and was trying to learn from him, viewing some orthopedic issues from the perspective of human evolution.

Teacher Zhang is awesome!

This high-level statement immediately garnered admiring looks from the graduate and standardized training students nearby.

Seeing everyone’s reaction, Zhang Lin immediately straightened up, exuding a scholarly presence.

It seems that if you want to show off, you need to read more books. Without culture, the failure rate of showing off is very high. Even if you succeed, the level is not high.

Xu Zhiliang picked up the conversation, "Is your pet dog’s knee facing backward? The knees of mammals, just like humans, are also facing forward, with the patella in the front. With the patella of this case’s knee behind, where does the atavism come from? Strictly speaking, we should call this case ’Knee joint posterior-anterior anatomical reversal deformity.’

Zhang Lin failed to show off again, but there was no other way. This was a case discussion, and everyone was entitled to their own opinions. He learned online that a dog’s knee joint faces backward, and it now seemed that such knowledge from the internet isn’t reliable. He had to read more academic journals in the future.

Song Zimo magnified the image and took another look: "Old Xu’s description is very good and very consistent with the situation of this disease. When we write a paper, we can name this disease ’Knee Joint Anterior-Posterior Anatomical Reversal Deformity Syndrome.’ The hip joint also exhibits serious underdevelopment and is in a deformed dislocation state, and the ankle and foot are also inwardly deformed. Professor! You can’t possibly be thinking of making her stand up through surgery right?"

Song Zimo looked at Yang Ping, thinking that he is a half-human half-god guy, has a head full of crazy ideas, and somehow always manages to actualize them.

Now, Song Zimo really hopes that Yang Ping can mentor some postdocs in the future and that he himself can become one of them.

You say surgery, no matter how impossible it seems, he always manages to perform it as steadily as an old bull.

You talk about scientific research. The external spinal fixator for treating scoliosis, such a complex thing, was completed successfully by him in one step.

And now he’s preparing to conduct research on a project involving the cultivation of muscle stem cells. If this project is successful, it’s worthy of a Nobel Prize.

At this moment, Song Zimo had not the slightest doubt that this guy could make it happen.

Learning from such a person, Song Zimo felt excited at the mere thought.

"Once this patient arrives, we handle it as a new topic from start to finish. If we handle this case well, no lower limb orthopedic surgery will be an issue in the future. This case practically incorporates all knowledge of lower limb anatomy and physiological mechanics. If we fail to handle even one step well, the postoperative effect will be very poor. If the postoperative effect is too poor, it will backfire. Initially, the patient could crawl around, but after surgery, if they can neither walk nor crawl, they will end up in a wheelchair." Yang Ping hopes that the team will pay attention to this case. Since he’s already a professor, he might as well act like one.

Little Five laughed and said, "If the surgery doesn’t go well, not only will there be no chance of a new life, but we might also destroy their current livelihood in the circus."

Indeed, that’s how it is!

"I will contact Ruixing’s laboratory, carry out 3D computer modeling, and then carry out simulations of osteotomy and soft tissue balance adjustment to find the best force line. After that, we can design the artificial joints for the hip and knee. Little Five, you are responsible for the patient’s reception work. Zhang Lin, you are responsible for case collection, and Old Xu, you will be in charge of checking related materials and collating and organizing them into booklets for everyone to learn." Song Zimo immediately assigned tasks to everyone on the spot.

After discussing this case, Yang Ping led everyone on rounds.

There was a patient who specifically requested Yang Ping to perform the surgery, saying that he knew Yang Ping and held in his hand a small note written by Yang Ping himself.

Yang Ping found it strange, when did he write a note for anyone?

When he was doing the rounds, he met this patient.

Yang Ping had a good memory and recognized the young man in his twenties at first glance.

He used to be a patient that was treated during a free clinic in Nanqiao County. He had uneven lower limbs. When he was a child, he fell from a tree and didn’t receive proper medical treatment. He was treated instead by a folk bone-setting doctor in the countryside who spat cool water on his leg and pulled it hard a couple of times. Consequently, his left leg ended up 5 centimeters shorter than his right leg, and his left ankle and foot also had deformities. He had a limp when walking.

The moment the young man saw Yang Ping, he immediately crawled out from the bed and shook Yang Ping’s hand: "Doctor Yang, I’ve finally found you. Do you still remember me?"

"How could I forget, you are from Nanqiao County, right?" Yang Ping immediately remembered him.

This guy even said at the time that with today’s medical techniques, men can be transformed into women, so there should be some way to fix his leg too.

"You have a good memory. I thought you were the type to forget since you’re successful. Look, Dr. Yang, I’ve kept that note you gave me,"

The young man carefully pulled out a notebook from his pocket with a note carefully tucked inside it.

Upon examining the note, Yang Ping was surprised to see it was laminated. It was well preserved and contained the address, phone number, and name written systemically by Yang Ping.

"It’s hard to find hospital doctors, so I dared not lose this note. I only dared to come find you after I had enough money," said the young man as he carefully put the note back in his pocket after Yang Ping returned it to him.

"Dr. Yang, in all candor, I want to walk normally and marry a good wife," the young man admitted, stating the ultimate goal of his surgery.

Securing a good wife could be a bit challenging because of his leg.

Yang Ping chatted casually with him, the young man’s family was poor and had no relatives or friends to speak of. He dropped out of junior high school and started working at a construction site, carrying bricks.

He was determined, saved money for a few years doing manual labor, and later enrolled himself in a cooking school. Eventually, he became a chef and his income increased drastically.

The young man was also ambitious when it came to finding a wife, he had standards—he wouldn’t just settle for anyone.

"What’s your standard for a good wife?" joked Little Five patronizingly.

The young man responded seriously, "At least a junior high school education, good conduct, a clean history, healthy, taller than 1.6 meters, a good figure, and good-looking. As a skilled man, I can’t be casual in choosing a wife. Women are allowed to be picky when choosing their husbands, and I should be picky when choosing my wife too - gender equality."

This guy had a well-thought-out theory, and his worldview was pretty straightforward.

His standards weren’t too high, but they weren’t too low either.

If his leg isn’t cured, achieving his goal could be a bit challenging.

The young man’s name was Fang Faquan. He had already completed his hospital entry check. Song Zimo passed him the full-length leg X-ray. Looking closely Yang Ping observed a chronic leg fracture which should have overlapped and healed improperly. At the time of injury, he must have been around twelve or thirteen, not leaving much space for the bone to mold, hence the inward rotation and shortening of the tibia and fibula. Even the hip joint, ankle joint, and foot had problems and he also had spine curvature.

Corrective operations of this sort are usually difficult as they aim to restore as much functionality as possible.

There are three stages of surgical operations: removal, repair, and reconstruction.

Reconstruction is the highest level and also quite complicated.

An apparently small surgery can become significantly more challenging once functional reconstruction is involved.

If someone doesn’t understand the core knowledge of the surgery, the operation may seem very visually pleasing but still not achieve the desired functionality.

Just like some small factories can produce perfect replica Porsche exteriors and interiors, but they can’t replicate the core technology, such as the engine and power and all that.

Therefore, reconstructive surgery is the ultimate test for a doctor’s skill.

"Is the purpose of your surgery just to get a good wife?" asked Yang Ping.

Fang Faquan did not hide it, "Yes, Dr. Yang, if it wasn’t for this leg, I wouldn’t bother. Although I limp, I’ve gotten used to it, and it doesn’t affect my current job."

"You have a clear goal. There are two methods for it. The first one is relatively cheap and simple, and the second one is relatively expensive and complicated. The latter also carries more risks. For the first method, the normal long leg will be shortened by five centimeters, and then the left leg will be corrected. The second method is to correct and lengthen the left leg by five centimeters at the same time. You choose." Yang Ping simply told him the options for surgery.

Without hesitation, Fang Faquan replied, "The kind that lengthens it. If the long leg is shortened, I would only be 1.55 meters tall, whereas if the short leg is lengthened, I could be 1.7 meters tall. I asked Dr. Zhang about the cost, and I have enough money."

"The latter option carries more risk!" added Yang Ping.

Fang Faquan replied, "I’m not scared. At most, I’ll still be a cripple, or even a more severe one. What’s there to do without risks? In our kitchen, someone cut off his fingers while chopping vegetables. Just a while ago, an auntie washing dishes stumbled and broke a bone. So, Dr. Yang, please help extend it. Ideally, both sides are stretched. I have read the introduction of your department. There was a patient whose leg was extended by thirty centimeters. Please help me stretch until I’m 1.8 meters tall."

Fang Faquan became more and more excited as he spoke.

Yang Ping felt that this young man was indeed ambitious, "Your condition is different from others, and it’s good enough to be able to walk normally after correction. Don’t think about making it to 1.8 meters."

The young man’s words amused everyone, and they all laughed.

He not only had his own opinions, he also had his own views on life.