top student at medical school

Chapter 202 can be summed up in one word: Steady! (Please subscribe)
These thousand-plus knowledge points don't actually come from very legitimate sources.

According to Fang Ziye's previous probability assessment, if he had simply undergone surgery for two fractures, he would at most gain a little over a hundred knowledge points, which would be enough to dominate the entire field.

However, before the surgery, Fang Ziye created a hematoma in the emergency department by manually reducing the size of the hematoma. As his condition worsened, Fang Ziye completed the hemostasis procedure. The knowledge he gained from this was of a completely different nature.

A fracture is not life-threatening.

Active hematoma is a life-threatening condition, and the knowledge required for vascular suturing and hemostasis is quite advanced.

Therefore, the two hemostasis surgeries, one vascular suture, and two manual reduction surgeries for fractures earned Fang Ziye over 900 knowledge points. Combined with his previous savings, his balance reached 1233.7!

This outcome aligns with Fang Ziye's earlier speculation and scheme.

That's right. Since the conditions of different diseases are different, deliberately concealing medical history or aggravating the patient's condition through other tricks during medical practice, and then treating the patient, can definitely maximize the benefits of knowledge points.

Fang Ziye wasn't stupid; he had already considered this possibility long ago.

However, this path is not the right one, and Fang Ziye never thought of developing in this direction.

If it weren't for those few dishonest people in the emergency department who tried to prolong their time being taken away by the police through the hospital, and if Director Zhang Mingcan and others hadn't given them hints, Fang Ziye wouldn't have done it.

Naturally, Fang Ziye was not aloof either.

If you feel that knowledge has been obtained through dubious means, then don't bother keeping it. What's the point of keeping it hidden? Only by putting it into practice can you truly understand its value.

If 1,200 knowledge points could be of any use in Huang Kai's surgery, Fang Ziye wouldn't hesitate to sell them all!
After Fang Ziye spoke, Director Hong Du and Zhang Mingcan, who were standing in the onlookers' area, moved aside to let Deng Yong and Professor Duan Hong have a chance to speak.

"What are you getting involved in?" Deng Yong's eyes immediately sharpened.

I think Fang Ziye is just making trouble for no reason.

Fang Ziye was only offering a suggestion, and Deng Yong didn't lose his temper; his tone was also quite mild.

Moreover, upon seeing that it was Fang Ziye who was speaking, even Professor Duan Hong swallowed hard, his Adam's apple bobbing up and down twice on his chubby neck.

He felt a surge of concern and said, "Ziye, the current situation is quite complicated. If it's not handled properly, it could worsen your condition."

Upon hearing this, Fang Ziye slightly avoided Professor Deng Yong's admonishing gaze, glanced at Wu Xuanqi with a calm look, and said in a low voice, "Master, Teacher Duan, I think my manual repositioning technique is almost the same as Senior Brother Wu's."

"One rotation reset shouldn't take too long, so I'd like to give it a try. It shouldn't cause any irreversible damage; at most, it'll just be repeating what Senior Brother Wu just did."

"Of course, it's also possible that I overestimated myself and misjudged Senior Brother Wu's ability to reposition his body. But I think that if there's an opportunity, and we can ensure that we don't make any major mistakes, we can still give it a try."

Fang Ziye did not flatter or fawn over Wu Xuanqi to rise to power, but he immediately brought Wu Xuanqi out as a prelude.

Because time is of the essence, the sooner we persuade them, the sooner we can take action, and the sooner we can proceed with the follow-up.

Time is precious, and at this moment, only by bringing Wu Xuanqi out can we be more convincing.

Of course, Fang Ziye didn't really want Wu Xuanqi to be angry because of this.

Wu Xuanqi immediately said, "Master, Junior Brother Fang's repositioning technique should be better than mine."

"At least that's the theory."

"In terms of operation, it is worthwhile to try to preserve the patient's urinary and reproductive system functions, so as to avoid causing secondary or more serious damage. It will not waste a few minutes."

Wu Xuanqi emphasized the words "reproductive system" very seriously.

It means, Master, don't forget, this Teacher Huang who is lying down, he has no descendants now.

If he survives, he may be devastated for a period of time due to the grief of losing his wife and daughter, but if he has any hope of surviving, then...

Having reproductive function is actually very important.

If he is no longer able to have children, and has no wife or daughter, how should he live? He might just live for his parents.

Before Wu Xuanqi could persuade Duan Hong, Professor Deng Yong turned his head to Fang Ziye and ordered, "Wash your hands and get on stage!"

"Okay!" Fang Ziye immediately turned and left.

He had his ears perked up, waiting for instructions.

At this moment, there is no room for arguing.

If either Duan Hong or Deng Yong still disagrees with his suggestion, he will not waste any more time speaking.

Time is too precious to be wasted in the slightest.

Fang Ziye then left the operating room, washed his hands for the fourth time, and then put on his surgical gown for the fourth time after entering the operating room again.

At this moment, Fang Ziye's hands were slightly red, which was caused by the irritation from the disinfectant.

Soaking the hands in a large amount of disinfectant in a short period of time will cause the skin and fat layer to peel off and become thinner. If there is further irritation, the skin will become red and even slightly painful.

However, at this moment, not only did Fang Ziye himself not have time to pay attention to it, but no one else did either.

While they were getting dressed and putting on gloves, the people on stage weren't idle; instead, they switched to other less critical tasks.

After Fang Ziye cleared his knowledge points, his manual repositioning technique instantly reached a terrifying proficiency level of 4, 3521.4/5000!

Keep in mind that between levels 3 and 4, you only need less than 600 knowledge points!

Three thousand five hundred points are enough for Fang Ziye to add about six level 4 skills.

Proficiency is never wasted; the higher the proficiency, the more skilled one becomes—Fang Ziye firmly believed in this.

He thought to himself, "Brother Kai, I have done my best and haven't wasted any extra knowledge points. Fortunately, I did add some points to the technique of resetting so that Pang Hong could get in sooner."

If even this cannot save your artery, then it must be fate.

I'm still young, and this is all the ability I can have.

Once on the operating table, after Wu Xuanqi made way for Fang Ziye, Fang Ziye finally had a chance to clearly see Huang Kai's pelvic position, lower abdomen, and the horrific wound on his right lower limb!
It would be no exaggeration to describe it as a complete mess, with blood, flesh, and large chunks of meat separated from the bone.

Of course, the blood and gore are not so bad. The most critical issue now is that after the comminuted fracture of the pelvis, some bone fragments have become embedded and lodged in other tissues.

While the pelvis needs reconstruction, other tissues, such as blood vessels and nerves, also need to be preserved.

The complexity and difficulty of this surgery even surpassed the most difficult surgery Fang Ziye had witnessed at Zhongnan Hospital in recent years.

Without him.

Destructive injuries, osteotomy and correction, neurovascular injuries, pelvic and lower limb reconstruction—any one of these constitutes a top-tier diagnostic category in current trauma surgery.

When one's abilities are a jumbled mess, even the combined efforts of top experts like Professor Deng Yong and Professor Duan Hong are futile.

Because some diseases, once they become mixed, cannot be resolved simply by multiple doctors working together.

The bone to be repositioned and corrected is an iliac bone.

This piece of iliac bone was inserted directly deep into the pelvis, with sharp edges and a stuck base. Part of it was squeezed together by the sacrum and left rib, while another part was embedded in the muscle, cutting into it.

The sharp edges of the vessel brushed past several blood vessels, and some of the sharp edges even cut through them. Currently, the arteries and the proximal and distal ends of the blood vessels are clamped to prevent internal bleeding.

There are quite a few similar bone fragments.

The key now is to remove it from the bone entrapment and pull it out of the muscle at the same time.

Fang Ziye's master, Deng Yong, briefly described the task: "At present, you can ignore the muscles inside, but the most important thing is that you need to use your hands, in the right way and with the right force, to gradually pry open the ischium and sacrum that are stuck together."

"And the curvature can't be too large. You can check the position of the sacrum and ischium."

"The range of motion must be strictly controlled within 6mm. The force cannot be too great, but it also cannot be too small, because if the force is insufficient, the rebound force will break the iliac bone fragment!"

"If it gets ejected, that might be the end of it."

"So, even at the end, we can only gradually release the force. Are you confident?"

It's not a good start.

And once you start, it's hard to stop.

Fang Ziye put on another pair of gloves to ensure absolute sterility, but having two pairs of gloves would make Fang Ziye's sense of touch even more dulled.

Fang Ziye took a deep breath: "I can give it a try. If I can't hold on, I will let you know."

At this moment, Fang Ziye realized why Wu Xuanqi had been so anxious and decisive in stopping earlier.

This repositioning, or rather displacement, is not just about the technique of repositioning force or which muscles to stretch as the force transmission structure, but about the control of force and the degree of range of motion, which must be excellent.

Moreover, the force must be distributed evenly.

Another layer of meaning in Deng Yong's words was that you also cannot break the remaining segments of the ischium and sacrum.

If it breaks, it's the same principle as a fragment of the iliac bone being squeezed, broken, and bounced out, causing damage to multiple blood vessels.

There was pressure, but Fang Ziye felt it was still worth a try!
Wu Xuanqi and Fu Qianjin, who went on stage to help, both gave their seats to Fang Ziye.

Fang Ziye stood next to his "senior brother" Duan Hong. After taking a deep breath, he carefully reached out and slowly touched and explored the contents of the surgical field.

This is an intraoperative physical examination, which is a more specialized application of physical examination techniques.

Sometimes, during surgery, no auxiliary examinations such as MRI or CT scans can provide information that can only be obtained through a physical examination. "It's an irregular fracture, and the fracture fragments are not thick enough; they are very thin and sharp, and the pressure and rebound force they can withstand are not very large."

"So we need to be even more careful!" Deng Yong said.

Fang Ziye did not reply, but simply performed a simple physical examination, probing without making any movement. He felt the shape and structure, but did not delve deeper.

This demonstrates the usefulness of Level 4 physical examination techniques.

It might be more effective if we didn't have to wear gloves, but that's not possible.

Forty seconds later, Fang Ziye looked up, placed his hands between his ischium and the opposite sacrum, and said, "Master, Professor Duan, I'm going to start using force. When you're removing the iliac bone fragment, try to apply force towards the genitals and the opposite knee joint. This may make it easier to remove the fragment from the muscle."

"At the same time, Master, the area in your direction might need some bleeding control." Fang Ziye couldn't determine whether the fragment had severed an artery in the anterior abdominal wall or an artery within the muscle, so he gave this reminder.

"Then start!"

"Wu Xuanqi, be prepared to take over at any time," Deng Yong said to Wu Xuanqi.

He still didn't trust his students, but if it weren't for the reason Wu Xuanqi gave, he would have immediately kicked Fang Ziye off the stage. "At your age, you don't need to worry about these things."

Unlike Wu Xuanqi, you are not an older PhD.

“It’s alright, there are vascular surgery teachers here,” Wu Xuanqi said.

It was only then that Fang Ziye noticed that Nie Mingxian, who had previously said he couldn't go on stage, had now violated the rules and gone on stage.

Although he didn't say a word, Fang Ziye still noticed him from his assistant's position.

Fang Ziye felt a chill run down his spine upon seeing this, but dared not say a word.

It's not even possible to say that Wu Xuanqi didn't mention his name, so why shouldn't he be a fool?

As for why Nie Mingxian didn't perform Zhang Yu's surgery before, but now performs Huang Kai's surgery, Fang Ziye doesn't want to delve into the reasons.

Soon, Fang Ziye began to exert his strength.

Take it slow, from simple to complex.

The rate of strength improvement should not be too fast, because a lack of strength can cause bones to break, resulting in irreversible damage. Therefore, a sustained lack of strength should never be changed rapidly!
"Steady. Steady. Steady," Fang Ziye thought to himself.

At the stage of mastering precise control of power, what is needed is stability.

Seek progress while maintaining stability; prioritize stability, even if it means not making any progress at all.

Everyone in the orthopedics department held their breath, but the general surgery continued, though they tried to give more space to the orthopedic surgeons.

That is, Wu Xuanqi.

Next to Wu Xuanqi, Professor Duan Hong pushed his buttocks back and tucked in his abdomen to avoid hitting Fang Ziye's elbow.

There was a five-centimeter gap between his abdomen and Fang Ziye's elbow, but his upper body, his hands, and the bone-holding instrument in his hands remained in their proper positions.

Maintaining such subtle movements is also very strenuous.

However, at this time, there was no one to help him; he could only rely on Professor Duan Hong and his own efforts to maintain the situation.

And at that very moment, in the blink of an eye!

Duan Hong and Deng Yong both saw that Fang Ziye had separated the stumps of the ischium and sacrum. The clamped iliac bone suddenly lost its support, and one end slid down slightly before continuing to be clamped.

Upon seeing this, Professor Duan Hong was about to take action when the bone-holding instrument moved down two centimeters and then stopped.

Since Fang Ziye hasn't said that the bone can be removed, even if he determines that it can be removed, the procedure cannot be performed!
Knowing when to stop exercising is also a psychological quality, a quality of a surgeon.

The main operator decides everything.

Even though Fang Ziye is just a student, he is now the main operator of manual repositioning, so everything depends on his arrangements!

Fang Ziye's hands and body were very steady; he didn't tremble at all.

Fang Ziye was not allowed to tremble, because such a tremor could cause bone fracture!

Keep pushing.

It cannot be too large, and Fang Ziye has slowed down the rate at which he increases the force again.

Another ten seconds passed.

at last!

When the ischium and sacrum were visibly separated by about 3 and 4 millimeters, and the other stumps were already close to the blood vessels!

"Take it!" Fang Ziye said softly and steadily, his face expressionless.

His breathing was steady, and he was not agitated.

Duan Hong and Deng Yong, each holding a bone-holding device, worked together very well to pull the iliac bone fragment outward. At first, it went smoothly, but after it came out two centimeters, it got slightly stuck!

The two stopped again, their actions identical, showing no signs of fighting.

“It can still be retrieved.” Fang Ziye surveyed the entire scene, his tone remaining calm and unwavering, like an ancient well.

"Towards the patella of the opposite knee joint," Fang Ziye added.

Deng Yong and Duan Hong did not hesitate to increase their strength slightly.

This time!

at last.

The bone fragment was pulled out of the muscle, its edges slightly tearing through the muscle layer.

But, with the bone fragments revealed!
The muscle stump was perfectly fine, with no unusual openings, but then suddenly, a jet of blood spurted out.

The jet of blood struck Fang Ziye's face directly.

Upon seeing this, everyone's expression changed drastically.

This column of blood, with its impact on Fang Ziye at this moment, will cause the surgery to take an unexpected turn. If Fang Ziye is frightened at this moment, that would be understandable, after all, everyone has a defensive reaction.

If there is an impact near the eyes, the body will instinctively retreat without regard for anything else.

If Fang Ziye were to release the force at this moment, the rebound of the ischium and sacrum would definitely lead to a secondary irregular bone fracture during the operation. Once the fracture fragments fly out, they would be like blood vessel cutters!

The blood vessels in the pelvis are so numerous and complex that they are comparable to those in the mesenteric arteries.

However, Fang Ziye did not do that.

After closing his eyes in time, he remained motionless.

A bloody knife mark was visible on the mask, half of it on the eyelid.

But Fang Ziye did not release his force in time. Instead, he slowly loosened the power in his hand, little by little, as if he were being killed by this relatively continuous bloody blade!
Deng Yong was a full second late in inserting the gauze-covered hemostat into the muscle tear, stopping the gushing blood and completing the local packing hemostasis.

Many people are looking towards Fang Ziye's direction.

Fang Ziye, however, continued to breathe calmly until, after a full five seconds, he slowly released all his strength.

Open your hands steadily to the sides in a slight arc, like a crab.

She calmly called out, "Teacher, please help me take off my clothes and wipe the blood from my eyes! I need to go out and wash my face before going on stage."

The procedure performed in the orthopedics department did not cause any abnormalities elsewhere.

Right now, everyone's focused on saving lives and their own specialized skills; nobody cares about the blood pillar over there, unless you accidentally spray someone else.

"Okay, I'll be right there!"

"Go downstairs to wash your face." Deng Yong was filled with satisfaction and admiration for Fang Ziye's composure, feeling that his student would surely achieve great things in the future.

Similarly, to avoid Fang Ziye making mistakes in his haste, he was instructed to wash his face at the sink outside later.

"Get on stage after you've finished washing!" Deng Yong immediately followed up with another order without hesitation.

No one refuted it, and no one dared to refute it.

Because similar operations will definitely not be limited to this one time, but this time is the most crucial. After this step is done well, Wu Xuanqi can handle the subsequent operations without Fang Ziye's help.

But Fang Ziye has played such a significant role, so it's not unreasonable for him to perform another surgery.

"Okay!" Fang Ziye left.

"Stop the bleeding," Duan Hong instructed Wu Xuanqi expressionlessly.

The gap left by Fang Ziye's departure was quickly filled with sterile surgical gowns; the surgery had to continue, and it would be a long one...

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(End of this chapter)