Chapter 312

What is the first metatarsophalangeal joint? In fact, it is very simple. It is the joint where the thumb is connected with the instep of the foot. The thumb function on the hand is the most important, and the same is true on the foot. This joint is also a force generating joint.

The people with joint injuries are some fat people, some ball players. The fat people can't bear the joint because they weigh too much. Most athletes suffer from fatigue injuries. But some ordinary people who are not fat are prone to this disease. Women who wear high-heeled shoes, especially those who hate sky high shoes, are beautiful and tall, but these shoes are really a sharp tool to damage metatarsophalangeal joints.

Because wearing high-heeled shoes can increase the weight of the forefoot, excessive back extension of the metatarsophalangeal joint, relaxation of the deep transverse ligament between the metatarsals of the forefoot, collapse of the transverse arch, and sinking of the second, third and fourth metatarsal heads. It is just that the common plantar nerve located here is excessively compressed, resulting in common plantar neuroma. In addition, because the heel is too high, the arch of the foot collapses and the metatarsal head sinks, which can compress the common toe artery adjacent to the common plantar nerve at the metatarsal head, causing arterial obstruction, resulting in ischemia, hypoxia and fibrosis of the toe nerve.

This is not alarmist, but also because this joint is a load-bearing joint at the end. Once it is damaged, it is very troublesome to deal with and treat it. Moreover, this injury is a chronic process. If it is acute, it can be recovered by surgery. However, this chronic injury first destroys the vascular bed and nerves at the end of the limb, and then the bone. Generally speaking, when women wearing high heels begin to have pain, they have already damaged their joints and related soft tissues and bones.

If it is found that the treatment is late, she will be accompanied by permanent toe pain, burning pain, numbness and severe numbness of the soles of her feet. You can imagine how uncomfortable it is. Even early treatment is troublesome. There are two methods, surgical and non-surgical.

The non-surgical method is to wear flat shoes, and then pad something under the front of your toes to straighten your thumb as much as possible. Imagine how difficult it is to break straight the bent bones by force. It's not only difficult, but also painful, very painful. On weekdays, when a woman wears high heels all day, why her feet hurt is caused by changing the stress curvature. Therefore, if you love your woman, please take off her hatred for Tiangao!

The black man was hospitalized. With a height of two meters and a weight of more than 200 kilograms, the general hospital bed really couldn't let him lie down. Even if it was too late to customize, he could only grievance the friend of the neighboring country. Two long benches were placed at the end of the bed, which could just make the black man lie flat.

Because other people's inspections are very perfect, all the inspections they can do have been done, and they are all recent inspection results, so there is no need to repeat the inspection. Directly arrange the operation, which is the result that Ms. Wang wants. For them, time is money, recover early and play early.

Metatarsophalangeal joint is a very small joint in the human body, but after this joint is injured, general orthopedic surgery can do, that is, improve symptoms and reduce pain. If you want it to return to normal state, it is demanding. Many basketball players retire because of this joint.

"Make a dorsal incision and open it for repair. Now prepare for the operation, Lao Chen. Go and talk to the patient about the condition. Sign where you should sign. " Zhang Fan directly determined the plan.

Old Chen said lovably, "I, I can't speak English!"

"Hehe, isn't Ms. Wang there. Just tell her! "

"Yes, I forgot this crop." Then Lao Chen went to find Ms. Wang. Although the black brothers are very reluctant to have surgery here. But there is no way. He has passed the peak of his sports career. Now it's good to have a gold owner. He has to do whatever the gold owner asks him to do.

At the beginning of the operation, the anesthesiologist estimated the black man's weight and added anesthetics. "Dr. Zhang, this fat man weighs so much that I dare not give too many anesthetics, so the effect may not be very obvious. When it doesn't work, you can add a little local anesthesia." The anesthesiologist hasn't seen such a huge man. He's a little uncertain.

"OK!" Zhang Fan looked at the fat man's limbs. They were really too big and thick. Black, very black. Shut up, shut your eyes and turn off the light. You can't find it directly“ Dr. Zhang, do you think his skin is also black? " Li Liang grabbed the big black man's thick toes and asked.

"It shouldn't be. The dermis is estimated to be black, but below the dermis, it's the same as us." Zhang Fan also operated on blacks for the first time.

"Start! The anesthesia is ready. " The anesthesiologist said.

Li Liang began to disinfect, lay sheets and put hole towels. When everything was ready, Zhang Fan and Li Liang had surgery, and song Bing toured. Looking at the black's strange toes, Zhang Fan sighed. The athletes looked at the scenery. In fact, their hard work is really hard for ordinary people to understand.

Although he is not a first-class athlete, his toes are deformed because of perennial weight-bearing training, overload sports and his huge weight. Although each toe is very thick, it bends very badly like the old man's music.

"You see, his second and third toes have obviously had multiple fractures, and there has been compensatory thickening here." After observing the other toes, Zhang Fan said to Li Liang.

"Their money is really not easy to earn." Li Liang has separated the first toe. This separation is a little laborious and too thick. It is estimated to be as thick as the wrist of a two-year-old child.

"It's not easy for anyone. It's not easy." The anesthesiologist interposed.

At the beginning of the operation, Zhang Fan gently cut the skin with a small sharp knife. The scalpel is very sharp. In the early years, the scalpel was used many times. Now the scalpel is disposable. Although it is sharp, it is not durable. The skin will be blunt after several times.

"In this operation, we must pay attention to minimize the damage to the blood supply. His damage has destroyed most of the vascular bed. If he wants to continue to maintain high-intensity exercise, he must ensure the remaining blood supply." Zhang Fan said while gently avoiding the dorsal toe artery, and then separated the flexor pollicis brevis with a knife handle.

Surgery, not all places to be exposed need to use a knife. For example, the skin needs to use a knife, but also a very sharp knife. When it comes to the muscle layer, it is usually separated with fingers or knife handle. Especially for this kind of athletes, muscle is very important for them. If the sharp weapon is disconnected, although it can heal later, it will form scar tissue, which will have an impact on the outbreak and durability of strength.

This kind of functional joint surgery of athletes is very difficult to do. If ordinary people do this joint injury, because they don't need to do extreme strength exercise, they just need to reach the functional position of the joint and eliminate pain and variation. As for some insignificant blood vessels, they can tie up, and they don't need to pay special attention to the joint capsule. In the later stage, scar healing is OK.

But if athletes do this, the pain will be reduced, but their sports career is over. This is also that many teams have fixed orthopaedic joint doctors. This top joint doctor can achieve joint recovery with minimal trauma.

Although Zhang Fan has just opened the first-class microsurgery, and the displayed operation volume is only more than half, because he is so good at liver, Zhang Fan has practiced in the system for many times. The three-dimensional graphics of the structure of this joint are directly formed in his mind.

Metatarsal, phalangeal and Zhang Fan slowly separated some inflammatory tissues with tweezers, and then rinsed them with normal saline. This operation is not so dangerous, but the delicate operation on the hand is too demanding for the surgeon's understanding of the joint.

Surgery should not be sloppy. What does it mean here? It means less action. For example, some inflammatory tissues in the joint capsule can be scraped once with a scraper, and the strength should not be scraped twice. The more actions, the greater the damage. This operation is a comprehensive consideration of the doctor's comprehensive quality.

The inflammatory tissue was cleaned up and Zhang Fan began to repair. This kind of delicate repair cannot be done or used by ordinary doctors, but it is very important for this special population. In the United States, there are no more than 20 doctors who can do this kind of operation well, and the operation can't be done when the doctor is a little older, so the operation cost is also quite expensive.

"Dr. Zhang, why should this repair be inclined?" Li Liang couldn't understand, because according to the physiological position, it should be oblique. Zhang Fan didn't speak. This is the most critical moment. The success or failure of the operation is at this moment.

Zhang Fan held his breath and tried his best to make his hand reach an absolute stability. He repaired it gently, one, two, three and four times. Finally, Zhang Fan took a long breath "Shh!" Finally, the deformed and scarred muscles were repaired.

More than three hours have passed. This is a delicate operation, which is very time-consuming. After Zhang fanlue breathed smoothly, he said to Li Liang, "the oblique type here is more stable after considering his weight and occupation."

"Oh!" Although Zhang Fan explained, Li Liang was still a little confused. After all, there were few operations, and he couldn't feel it for a moment.

"Electric drill, Kirschner wire." Zhang Fan said to the operation nurse. Song Bing is so bored that he can't see anything. The operation is almost done under a microscope. The electric drill gently opened a small hole, and the Kirschner wire stably fixed the joint.

"When applying plaster, make sure the plaster is fixed around. Not one day less. " Zhang Fan said to Li Liang and song Bing.

"Good!" At the end of the operation, Ms. Wang and the athlete's black friends were almost asleep outside the operating room! When Zhang Fan pushed the big black man out of the operating room, the gang of black brothers happily surrounded him and kept talking. Zhang Fan didn't understand what they said after learning English for so long!

"Doctor Zhang, it's hard." Ms. Wang looked forward to Zhang Fan, who understood her meaning. After taking off the mask, he smiled and said, "the damage is very serious, but it has been repaired. The rest depends on his own recovery in the later stage, which can be known around. It is estimated that he can continue to play basketball in the future. " Before the operation, Zhang Fan didn't promise anything, but it was different after the operation.

He has confidence in himself, because he has worked hard and shed a lot of sweat in the system!