Digital simulation, imaging tracking, precise positioning... The perfect combination of digitalization and bone trauma treatment, microscopic repair, multidisciplinary cooperation, and the shortest time to help patients return to normal life, these have been realized in the First Affiliated Hospital of Shandong First Medical University (Shandong Qianfoshan Hospital, hereinafter referred to as "Shandong University One Affiliated Hospital"). Wang Pingshan, the director of the department, led the team to innovate and forge ahead, and has been at the forefront of the country in the fields of comprehensive treatment of severe trauma, multidisciplinary comprehensive treatment of elderly trauma, digital minimally invasive treatment of various types of fresh and old fractures, and comprehensive treatment of post-traumatic complications.
<b>Digital simulation Imaging tracking</b>
<b>Bone trauma treatment has entered the era of digital minimally invasive</b>
According to Wang Pingshan, the treatment of bone trauma used to use open surgery and traditional minimally invasive techniques in the clinic, although the effect of open surgery is good, but the trauma is larger, and the patient recovery also takes a long time. Traditional minimally invasive surgery has less trauma, but in fact, it is still an open surgery with a small incision, which often requires manual closure and reduction multiple times, repeated adjustment of position, and often does not achieve the ideal reduction effect.
In order to make the treatment of each bone trauma patient achieve accurate reduction and ideal functional recovery, while minimizing trauma, the Department of Bone Trauma Surgery of Shanyi University First Affiliated Hospital adheres to the concept of "rapid repair", adopts digital minimally invasive technology, conducts accurate preoperative analysis of patients through digital analysis, mechanical simulation, combined with intraoperative CT and navigation, customizes personalized surgical treatment plans for the first time, and makes trauma treatment more refined, minimally invasive and standardized.
Wang Pingshan led the team to carry out digital minimally invasive treatment for various types of fresh and old fractures, including cervical, thoracolumbar, pelvic acetabular and limb fractures, acute joint injuries, deformity healing, non-unionization, internal fixation failure and other difficult diseases of spine and limb fractures, helping countless patients to return to normal life as soon as possible and being generally recognized by patients. Now, more and more patients are coming, and bone trauma treatment has entered the era of digital minimally invasive.
Not long ago, a 65-year-old male patient was hit by a large truck, resulting in pelvic instability fracture, in order to allow patients to restore function as soon as possible, the Department of Bone Trauma Surgery of Shanda University Affiliated Hospital adopted pelvic minimally invasive surgery. The doctor used multi-directional channel screw technology with the help of fluoroscopy to place 5 screws perfectly, and the postoperative x-ray showed that the patient's fracture was well reduced, and effective fixation was achieved in a limited space.
According to reports, the minimally invasive channel screw technology is based on the irregular anatomical morphology of the pelvis, combined with its biomechanical characteristics and fracture type, and simulates the design of the bone safe fixed channel in the limited three-dimensional space of the pelvis. The percutaneous minimally invasive channel screw technique has small surgical incisions, less bleeding, shorter surgical time, significantly reduced than traditional surgical trauma, faster postoperative recovery of patients, and significantly lower hospitalization costs. Pelvic fractures are one of the most difficult fractures in traumatic orthopedics, and the traditional practice is to incise the reduction of the steel plate internal fixation treatment, and the surgery is relatively invasive and bleeding. Pelvic channel screw technology is the international advanced pelvic fracture minimally invasive treatment methods, at present, the Department of Bone Trauma Surgery of Shanda University First Affiliated Hospital has fully mastered and skillfully used the minimally invasive treatment concepts and methods of various types of pelvic fractures, and has been at the forefront of domestic minimally invasive pelvic treatment.
<b>Precise minimally invasive multidisciplinary cooperation </b>
<b>The 90-year-old man with a fracture walked on the ground the next day</b>
Wang Pingshan said that with the acceleration of the pace of life and the development of the aging population, the proportion of elderly bone trauma patients treated by the department has increased significantly. Because the elderly are often accompanied by other underlying diseases, the ability to pay off is weakened, and complications are prone to complications, before treatment, the department will conduct multidisciplinary consultation, and after full discussion and comprehensive evaluation, develop a rigorous personalized preoperative, intraoperative and postoperative plan, and complete treatment within 24-48 hours.
Recently, the department just received a 91-year-old man with a hip fracture due to a fall, after understanding, the elderly have high blood pressure and other underlying diseases, the risk of surgery is extremely high, in order to ensure that the operation is foolproof, before the operation, Wang Pingshan led the team to conduct a comprehensive examination for the elderly, including the department of anesthesiology, and at the same time carried out a multidisciplinary consultation including anesthesia, and formulated an exclusive surgical plan for the elderly, the team through digital mechanical simulation design, to find the most accurate fixed position, relying on skilled surgical skills, quickly operated on the elderly. On the second day after the operation, the elderly began functional training under the guidance of medical staff and successfully walked on the ground.
In the past, in such a situation, using traditional treatment methods, the elderly may need 2 months of bed rest, the family needs long-term careful care, and now they can walk on the ground the day after surgery, and they can soon resume their pre-injured life, which greatly improves the quality of life for patients and families.
Wang Pingshan reminded that after the elderly fall and fracture, it is recommended to operate as soon as possible in line with the surgical conditions, otherwise most of them need to be bedridden, and once the elderly are bedridden, they may have complications such as urinary system diseases, respiratory diseases, and pressure sores. Especially the elderly, due to poor physical fitness, more underlying diseases, any kind of complications may be life-threatening.
In recent years, most of the elderly with femoral neck fractures treated by the department have adopted hip protection treatment, without replacing joints, through digital minimally invasive technology, accurate internal fixation, repair of damaged joints, can achieve early landing, shorten the length of hospitalization, help patients restore their original life as soon as possible, and avoid complications that may be brought about by joint replacement. In addition, Wang Pingshan introduced that for the swelling of the injured area, it was necessary to reduce the swelling before, and seven or eight days was wasted, which not only increased the pain of the patient, but also easily missed the best surgical time and affected the recovery of function. Now because it is a minimally invasive operation, the requirements for soft tissue conditions are not high, and it can be operated on by the patient for the first time without swelling to achieve rapid recovery.
<b>Comprehensive treatment Microsurgical repair </b>
<b>Help patients with thigh detachment to achieve functional rehabilitation</b>
More than half a year ago, a patient with a thigh disconnection due to an accident was rushed to the First Affiliated Hospital of Shanda University, and when he arrived at the hospital, the patient was in shock and his condition was extremely critical. The emergency surgery department immediately launched a trauma emergency plan, carried out anti-shock therapy such as hemostasis, rapid rehydration, and blood transfusion, improved imaging examinations, and quickly convened multidisciplinary consultations. Wang Pingshan, who is also the director of emergency surgery, led the team to rely on years of experience in handling complex critical trauma patients, and used the shortest time to formulate a perfect treatment plan and perform surgery, saving patients' lives as much as possible and preserving limbs. The patient's thigh is detached on one side, and it is winter, and the heat ischemia time of the severed limb is short, and the leg replantation needs to be completed within 10 hours.
Time is life, and wounds are commands. Thorough debridement, short limb reduction, temporary immobilization of external fixation stents, microscopic repair of arteries and veins, nerves, muscle repair, wound avulsion and skin replanting... Wang Pingshan led the team to complete each step of the operation in a race against time, replanted into life, and finally helped the patient save his thigh. This is only the first step, because after the patient's thigh is replanted, the injured leg is shortened, and the second step requires bone extension. Under the premise of retaining soft tissue and blood supply, a special traction device is used to gradually apply a pulling force to slowly pull the bone segment, constantly stimulating the body tissue, so that the osteotomy space forms new bone, and achieves the purpose of bone regeneration. After six months of bone extension treatment, the patient's legs were already the same length. At present, the third step of treatment - functional repair, the need for internal fixation of the fracture site, assessment of the function of nerves and muscles and other tissues, if there is a problem, it needs to be re-transplanted, and the damaged nerves, blood vessels, skin, and free flaps are repaired under all-round microsurgery to help patients gradually return to normal life.
For the treatment of such severe trauma patients, the Department of Osteo trauma surgery of Shanda University First Affiliated Hospital has a complete set of rescue treatment and rehabilitation programs to help patients recover their functions as soon as possible, and the recovery to the state when they were not injured is the direction that the whole team has been working towards. In the microsurgical repair of osteomyelitis, bone defects and tissue defects, the use of combined flaps, composite flaps, myodermal flaps, musculoskeletal flaps and other repairs are also the focus of Wang Pingshan and his team and achieve remarkable results.
The team regularly holds academic discussions every Thursday, where everyone speaks freely and makes progress together. Wang Pingshan also turned clinical experience into a normative guide, and formulated unified diagnosis and treatment norms and standards within the department for digital minimally invasive treatment, so that every doctor has the same technology and is "expert". At the same time, it supports the development of each doctor in his or her own field of expertise, promotes the development of disciplines to specialization and refinement, and better serves patients.
Find reporters, reports, ask for help, major application markets download the "Qilu One Point" app or search for weChat Mini Program "One Point Intelligence Station", more than 600 mainstream media reporters in the province are waiting for you to report online!