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Chapter 153 Stunning and Shocking (Please Subscribe)
The manifestations and principles of manual reduction of fractures are, to some extent, similar to those of manual reduction of joint dislocations.

As a result, Fang Ziye never saw a distinction between manual reduction techniques for fractures and joint dislocations in the downstream skills of manual reduction techniques on the panel.

However, manual reduction surgery does indeed have a learning curve—

Prying reduction, rotational reduction, compression reduction...

While his proficiency in these downstream skills wasn't particularly high, Fang Ziye felt that his current level of proficiency in manual repositioning techniques was sufficient.

Having silently grasped the principle behind Huang Haitao's manual repositioning technique, I could only ponder and speculate on the corresponding manual repositioning approach on my own.

Essentially, the basic principle is to use anatomical compression to create stability within the fracture and bone ends, and then use plaster cast external fixation to achieve fixation.

However, the differences lie in how to precisely compress the fractured bone ends, how to apply traction, and how to release the traction at the right time so that the fractured bone ends can retract.

Huang Haitao and the others did not disrupt Fang Ziye's thinking, and Huang Haitao did not know what kind of skill Xue Tao had mentioned in Fang Ziye's method of repositioning.

However, just one minute later, Fang Ziye arrived at the patient's side.

Strangely, Huang Haitao did not notice that the patient had expressed refusal and rejection after learning that Fang Ziye had replaced him as the person who performed the repositioning.

Instead, she said, "Dr. Fang, in the end, you're the one who will perform the manual reduction for me?"

Yesterday, while Fang Ziye was performing manual reduction, he and his family watched with some envy from outside the operating room those who could wait in line, because these people could all be reduced in two quick movements and then go home.

But he had to go through a lot of hospitalization, surgery, injections, recovery, blood tests, and so on.

Now it's finally his turn, and he's actually quite looking forward to it.

Moreover, how many patients did Fang Ziye reposition yesterday? He personally witnessed Fang Ziye escorting people out of the department.

Hearing is believing, seeing is believing. Fang Ziye is skilled in martial arts, so he has nothing to be ashamed of.

"Yeah, don't be nervous. There are several directors watching over us. If I can't do it, Director Huang and Director Wu can definitely do it." Fang Ziye slowly reassured him, while noticing that Xue Tao had already reached the fixed position and was ready to counter-traction.

Fang Ziye stopped worrying and found a suitable position to apply traction, causing the biceps and forearm muscles of his arm to bulge out.

Orthopedics, whether it's joints, trauma, or other subspecialties, all require a certain amount of strength.

Fang Ziye is not tall and has little fat covering his muscles, but he must be quite strong, after all, he has been working in the Department of Trauma Surgery at Zhongnan Hospital for more than three years.

Moreover, Fang Ziye discovered that when his manual repositioning technique reached level 3 proficiency, he could already do so without relying on all his own strength. At level 4, it was even more so, as Fang Ziye could use the skillful manipulation of muscle deformation to divert some of his strength as traction force.

This was Fang Ziye's unique discovery. He didn't know if he had misunderstood it, nor did he dare to ask, nor did he know if others had done it this way.

The purpose and direction of traction are actually quite simple: to fully traction the displaced fracture and separate the fracture ends.

This process requires traction, but the patient will not experience pain; instead, they will feel a pleasant, relaxing sensation.

This is the difference between manual reduction of fractures and manual reduction of joint dislocations.

When performing manual reduction of a joint dislocation with continuous traction, there may be a fear of pain. However, during the manual reduction of a fracture, the pain will not occur or may even disappear because the displacement of the fracture is pulled away and the fracture ends are separated.

The patient was prepared for pain, but to his surprise, after the pain subsided, his breathing rhythm gradually stabilized.

Seeing this, Fang Ziye knew that his guidance this time had been effective.

Then, something happened that was hard for everyone to understand.

Fang Ziye, who was originally using both hands to apply traction, suddenly removed his left hand and used it to touch the patient's fracture site, while his other hand continued to apply traction as if it were an easy task.

Instantly, everyone's expression changed drastically!
This scene is truly unbelievable.

Brother, that's the patient's leg! You should at least respect the old saying, "You can't fight city hall." Even during the continuous traction phase, do you think you can manage it with just one hand?
Just how powerful are Fang Ziye's muscles? Could he kill someone with a single punch?
Everyone's first reaction was that Fang Ziye was incredibly strong and a top prospect for orthopedics.

In the eyes of orthopedic surgeons, great strength is an absolute talent.

But that's not actually the case. Fang Ziye was simply cleverly using some of the muscle's traction force.

He only used about 40% of his total strength. Of course, even 40% of his strength was not small. He could easily lift 50 or 60 pounds, but it was not as powerful as others imagined.

Naturally, Fang Ziye's focus at this moment was not on the performance of others at all.

Instead, Fang Ziye was thinking about how to use the muscles adjacent to the bone fragments in the middle of the fracture to use the strength of the muscles to bounce back or squeeze the displaced bone fragments that are not directly connected to the fracture back to their proper positions.

Anyway, Fang Ziye didn't know why he had such thoughts, but he could do it anyway.

Therefore, to others, Fang Ziye's actions were nothing more than touching the broken ends of the bone a few times and then pressing the surrounding muscles.

After pressing the muscles, Fang Ziye slowly released the traction force after the fracture fragments came into contact with the fracture ends through the strength of the elastic muscles themselves.

The rebound force of a joint dislocation is very strong, but the rebound force of a fracture is not as explosive and violent as that of a joint dislocation.

Therefore, there will be no clicking sound.

Huang Haitao, who witnessed this scene, almost had his eyes pop out of their sockets.

His eyes were filled with anxiety, as if he had a million questions; his mouth opened and closed, but he seemed to lack the strength to utter a sound.

Because shock wasn't idiocy, his remaining intelligence told him that even if he were slashed, it wouldn't affect Fang Ziye's most crucial operational step.

So what if we're shocked?
After Fang Ziye felt the fracture ends and found that the fracture was relatively well-matched, he gradually and completely relaxed the strength in his right lower limb.

The proximal and distal ends of the fracture retract, and the middle fracture fragments are pressed together by the muscle retraction force. At this moment, there is a slight pain.

"Ouch." The patient's relaxed brows furrowed slightly as he felt the pain, and he let out a muffled groan.

It wasn't too painful, because the pain was just like being stung by a bee, and it was the pain at the moment of the sting, not the burning pain of the venom afterward, so it was tolerable.

Opening her eyes, Xue Tao saw that Fang Ziye had already relaxed his strength, so she naturally followed Fang Ziye's rhythm and loosened her strength as well, and asked, "Dr. Fang, is my body already back in place?"

Fang Ziye wasn't entirely sure either, because according to his usual understanding, this patient wasn't suitable for manual reduction. However, if the assessment were based on the effectiveness of manual reduction of the fracture—

Before Fang Ziye could reply, he was pushed aside by someone's buttocks.

Unable to contain his shock any longer, Huang Haitao, after seeing Fang Ziye finish his procedure, pushed Fang Ziye aside by half a body length and immediately went to the patient's right lower limb, then touched the fracture site of the patient's lower limb.

The movements were gentle yet forceful, without causing the patient excessive pain; however, the pressure applied was considerable, a testament to the skill of a martial artist.

This was his unique diagnostic method, which Fang Ziye found difficult to understand.

But just half a minute later, he stood up instead of bowing, then looked at Fang Ziye with a thoughtful expression.

"Director Huang, how is it?" Wu Guonan asked quickly.

I was a little anxious, but not too worried.

Huang Haitao's anxious behavior might subconsciously lead him to believe that Fang Ziye has produced a bad result.

However, Wu Guonan wasn't entirely clueless or lacking in independent thought. As a highly professional trauma surgeon, he was capable of accurately assessing the quality of fracture reduction. The disappearance of fracture deformity, relief of the patient's pain, and emotional well-being are the most basic indicators of a successful reduction.

Ultimately, the diagnosis still needs to be determined using X-ray films.

Huang Haitao thought for a moment: "It should be pretty good, but I can't really comment. Let's wait for the X-ray results."

As Huang Haitao spoke, his face was full of hesitation and disbelief.

Upon hearing this, Fang Ziye and Xue Tao quickly went to get their casts put on.

The purpose of manual reduction is only to reduce and initially fix the fracture. To truly achieve the absolute principle of reduction and fixation in fracture treatment, external fixation is needed to assist in fixation. Otherwise, without the assistance of plaster cast, if the fracture is displaced again, it will be another fracture story.

The process of applying a plaster cast is not slow.

After hearing Huang Haitao's words, Wu Guonan still politely asked, "Director Huang, so for now, we don't need you to make any corrections. Let's see the results first?"

Huang Haitao looked at Wu Guonan very seriously, but he couldn't detect any mockery or sarcasm in Wu Guonan's eyes or expression, so he nodded.

The follow-up X-ray examinations for the patient were already prescribed in the doctor's order before the cast was repositioned, and the examination forms were given to the patient and their family. Therefore, the patient only needed to be pushed off the cast by their family after the cast was applied.

The curing time of the plaster can be determined simply by waiting outside the operating room.

Xue Tao and Fang Ziye went out together and gave the relevant instructions: "After the re-examination, there is no need to wait for the results. Just come up directly. We can see the results in the ward. The family can print them out two hours later."

"You can go downstairs to the X-ray examination room in five minutes."

"Is this the place where we had the X-ray yesterday? Doctor, is the repositioning okay?" The patient's family members were his wife and son. The wife was asking the question, while the son helped his father onto the trolley, asking how he was feeling...

After Fang Ziye and Xue Tao re-entered the room, Huang Haitao, who had been talking with Wu Guonan, looked at Fang Ziye with some skepticism and asked, "Dr. Fang, when you perform manual reduction, can you mobilize several muscles around the fracture?"

"???" Fang Ziye was dumbfounded and looked over with a questioning gaze.

After a few seconds, seeing that Huang Haitao still didn't seem to be explaining, she asked, "Director Huang, could you please explain more clearly? I'm a little confused about what you mean."

What do you mean by mobilizing the muscles around the fracture? Does it mean I'll use some clever techniques during manual reduction?

I haven't done a thorough calculation in this regard myself.

Upon hearing their conversation, Wu Guonan and Xue Tao exchanged bewildered glances. Wu Guonan stared intently at Xue Tao, who then discreetly moved closer to him and began to explain in a low voice the details of the joint dislocation reduction procedure performed by Fang Ziye the previous day.

At the same time, Huang Haitao hesitated for a moment before explaining: "That is, according to our traditional Chinese medicine, in the early stages of repositioning, the operator's own strength is used."

"Then, we can utilize some of the skillful force between the joints, and further, we can utilize the skillful force of the muscles as an auxiliary force during repositioning."

"Some people can use one to four or five lines, using elasticity or thrust as the lateral displacement force of the fracture fragments during reduction."

"For example, I can currently only use three muscles as auxiliary muscles on the same patient at most."

Fang Ziye was somewhat confused when he heard this.

He shook his head blankly: "Director Huang, perhaps your understanding is too profound, I don't know. I don't really understand the theories in traditional Chinese medicine either. I'm actually just using modern medical thinking to solve the problem, like traction, loosening, repositioning, and prying."

"I don't understand what mobilizing muscle power means, but I would treat muscles as a variant of a lever, to pull the bone fragments into their proper place after thorough traction."

Fang Ziye had never heard such a statement at Zhongnan Hospital. Even Professor Deng Yong, when occasionally performing osteotomy and correction, would say that in the case of closed reduction, certain muscles could be used as auxiliary points for manual reduction, but this was only based on experience and lacked theoretical support.

Things without theoretical support can only be used for popular science and experience sharing; they cannot be completely believed, nor can they be completely disbelieved.

Huang Haitao's expression remained one of surprise and uncertainty, but in addition to that, there was also a hint of melancholy, as if Fang Ziye's appearance made his presence in the ward extremely awkward.

After the first patient left, the second patient quickly came in.

This time, Huang Haitao toned down his arrogance a bit. He felt that Fang Ziye was definitely not simple, so he suggested that Fang Ziye give it a try.
Fang Ziye immediately shook his head vigorously, explaining in a low voice, "Director Huang, I can't do this. I can't design it right now. In my understanding, this patient should undergo surgery."

"If manual reduction were possible, I would have suggested it to Director Wu and Director Xue long ago, instead of waiting until now."

To know is to know, and to know is not to know.

Fang Ziye can advise patients who cannot be manually reduced to undergo surgery, and he can also advise some patients who can be manually reduced not to undergo surgery. This is an equal exchange and suggestion. Director Wu may not choose to do so, but Fang Ziye will still make the same suggestion, fulfilling his responsibility.

Fang Ziye's words instantly made Huang Haitao feel awkward.

But upon closer inspection of Fang Ziye's expression, it didn't seem like mockery. So he went through his own theory again, breaking it down once more, and asked Fang Ziye if it was possible.

Upon hearing this, Fang Ziye nodded: "I see, Director Huang, I can give it a try."

Fang Ziye gradually understood something.

The indications and contraindications of the manual repositioning technique that TM believes in have become a mental constraint, and even if one's manual repositioning technique reaches a very high level, this mental constraint still cannot be broken.

Huang Haitao is different. Theoretically, he does not particularly agree with the guidelines, indications, and contraindications followed by modern medicine. Therefore, he can easily list some manual reduction methods and routines that are difficult to reduce according to common sense.

Fang Ziye's operational skills are not a problem. After designing the corresponding routines and methods, Fang Ziye can repeat them.

With ease, Fang Ziye, with Xue Tao's assistance, also managed to reposition the second patient in a few quick clicks...

Upon seeing this, Huang Haitao felt as if he had seen a ghost.

Wu Guonan was pulled out of the room, leaving Fang Ziye and Xue Tao staring at each other in the control room.

After a few seconds, Xue Tao, seeing that the two directors hadn't returned, turned to Fang Ziye and said, "Ziye, your repositioning technique is very advanced. It didn't just amaze Director Huang Haitao, it truly shocked him."

Amazed and shocked are completely different feelings.

Fang Ziye thought about it seriously for a moment, and as he looked at the huge amount of knowledge points that had been deposited into his account, his emotions fluctuated even more intensely.

"Knowledge Points +74!"

"Knowledge Points +81!"

Two patients, two repositionings, directly caused Fang Ziye's knowledge points to surge by 155 points. Could this be considered as suddenly knocking on the nest of knowledge points, causing them to overflow?
Fang Ziye guessed that this might be the case.

Moreover, Fang Ziye speculated that this might be related to current fracture treatment guidelines.

After all, the manual reduction cases that Fang Ziye is currently working on are, to some extent, products that contradict the guidelines.

To put it simply, following the guidelines will at most produce standard surgeons, but going against the guidelines will produce very extreme results: either leading to a dead end or to rebirth and rebirth.

Why is there such a wealth of knowledge about manual reduction of fractures?

Because it's new, our understanding of it might be too superficial, based on existing theories. It's an immature system, a breakthrough point worth exploring in depth. Without further research, our understanding might be disrupted.

What is knowledge? New knowledge is knowledge.

Fang Ziye's heart began to pound—

(End of this chapter)