Chapter 376: Chapter 0356: Dominating the List

Takahashi, Xu Zhiliang, Zhang Lin, Little Five, and Fatty, the lot of them had consumed several boxes of beer.

The vicinity was strewn with empty bottles, and everyone had pretty much let off their steam.

As the gathering was about to take its course, Little Five suddenly recalled, “Zhang Lin, aren’t you trying to have a baby?”

Zhang Lin narrowed his eyes, “Already got one, no need for any more considerations. Look at us today; whoever has not had a drink is prepping for a baby.”

This remark prompted everyone to cast their gazes upon Yang Ping and Song Zimo, then onto Xiao Su and Tang Fei.

At the utterance of Zhang Lin’s words, everyone fell into a strange silence while Xiao Su and Tang Fei, the two girls, flushed red with embarrassment.

“Zhang Lin, has your brain been soaked in alcohol? We’ve always stuck to not drinking.” Song Zimo quickly clarified.

Zhang Lin chuckled, “I didn’t specifically say anything. Even if I had, I can’t remember, so don’t take offence.”

“Why are you all staring at me?” Yang Ping started feeling uneasy.

After Song Zimo’s explanation, everyone shifted their gaze back onto Yang Ping. Takahashi leaned in, “Dr. Yang, come! How do you say it in Chinese?”

Takahashi held up an empty cup in a hazy manner, thought for a while, “May you have a child soon!”

“Takahashi…” Miyuki looked at Takahashi, whose eyes were stained with a tipsy red glow, and promptly reminded him.

Takahashi’s mind worked quickly. With a single hint from Miyuki, looking at the crimson faces of Yang Ping and Xiao Su, he sobered up sudden realising the faux pas he had committed.

But, why was Miyuki blushing too? What concerned her? Takahashi couldn’t understand.

Zhang Lin immediately urged Takahashi, “Little Takahashi, send red packets, quick, two hundred a piece, quick—”

With ten thousand in spare change, send more red packets now instead of saving it to collect interest. Keeping the money in a wallet wouldn’t earn any interest anyway.

As they carried on with their banter, it took a sizeable amount of disk to eventually settle down and call it a night.

But they didn’t have to perform surgery the next day, so there were no concerns. During the competition, they would perform surgeries for one day and take a break the next.

This was a suggestion offered by Professor Zhang. This way, they could take a day to reflect and summarise, as well as check on the preparations for the next set of surgeries, to prevent any oversights.

On the days off, the department would hold discussions. Professor Zhang and Director Han would attend and offer some advice, but only as suggestions for the younger ones to refer to.

The surgeries on the first day, most of the hospitals only performed one as an opening act, exploring the waters so to say, which was mostly an open reduction internal fixation for a forearm with a dual fracture.

During the discussions on the second day, the scores from all the judges from the first day of surgeries were already compiled and displayed on the high-definition screen, via the Golden Knife Award’s website.

Song Zimo had received full points from all the judges. On the leaderboard for the South China region, teams from Sanbo’s Song Zimo, Fuyi’s Su Nanchen, Lin Hao, Chen Ge, Cao Qian, Su Fengyu, Fuer’s Yan Jiejun, as well as Tian Xu from the Provincial People’s Hospital, were all tied for first place with perfect scores.

The other hospitals, including the Provincial Chinese Medicine Hospital and the Affiliated Hospitals of the University of Traditional Chinese Medicine, had their points deducted to varying extents, as it was challenging to attention to every detail during surgery.

The team from the Comprehensive Orthopaedics department conducted a summary of their first surgery, then scrutinised the preparations for the second batch of surgeries, closely inspecting the several aspects in management around the surgical area, operation procedures, medical case writings and so on. Any detail missed was promptly rectified with no issues found, finally putting their minds at ease.

In the initial stages of the competition, Fuyi employed a similar strategy, allowing their surgical team to perform surgery one day and take the following day off.

They were also conducting a debrief on the surgeries performed on the first day. Taking the dual fracture surgery on the forearm as a reference, they dissected the surgery to clarify what should be paid attention to. Everything from the big picture to the details were made crystal clear.

Among the eight teams with full scores on the leaderboard, only Sanbo’s team had their surgeries performed by an assistant.

According to the Golden Knife Award’s rules, surgeries during the regional competition can all be performed by an assistant. Sanbo’s arrangement didn’t violate these regulations, but no other team dared to do the same.

There was indeed a significant gap between the capacities of a chief surgeon and an assistant. Allowing an assistant to perform a surgery or two, to display their skills, would not pose an issue.

But entrusting all surgeries to the assistant could risk unforeseen circumstances. It would be challenging to restore the points once there was a drop, especially when competing against strong opponents.

Furthermore, no team had the courage to let an assistant perform the first surgery. Establishing confidence in the first battle was crucial. Any mishap would directly impact the mood during the subsequent surgeries.

Currently, except for Sanbo Hospital in the South China region, no other hospitals in the other five regions had their first surgery performed by an assistant.

In the East China region, the first surgery was also performed by Wen Rentao from Mo Sixth, and he had no intention of allowing an assistant to take over.

Lin Hao was always keeping a close watch on Yang Ping’s performance. But now, all of Sanbo’s surgeries were being performed by Song Zimo, and Yang Ping hadn’t made an appearance.

What did that mean?

Did they give up on the Golden Knife Award? Did they treat it as an experience?

But it didn’t seem like it, they managed to garner full points for their first surgery, judging by the score, they were clearly aiming to be among the top few.

For the second batch of surgeries, each team from Fuyi had multiple surgeries prepared, all kinds of fractures – femur shaft fracture, tibiam fracture, humerus shaft fracture – had all been scheduled.

The pre-surgical preparations, operative plans, and post-surgery precautions for each case had been reviewed multiple times by several head surgeons to ensure there were no oversights.

As the second batch of surgeries began, some people gradually started to fall behind, some of the eight teams which had full points before had already fallen apart.

Tian Xu from the Provincial People’s Hospital, while performing a closed reduction PFNA fixation for an intertrochanteric fracture of the femur, had the position of his helical blade slightly off-centre on the lateral X-ray, which resulted in points being docked, and lost his full score.

Yan Jiejun from Fuer, while performing surgery for a femoral shaft fracture, did not apply enough traction pre-surgery, and took too long for the reduction during surgery, almost going over ten minutes. He barely managed the reduction successfully just at the ten-minute mark, barely managing to save his full score.

Pulling off such basic surgeries without any points being docked required the surgery and theory to be impeccable.

This required the Chief Surgeon to have received standardised training since they started clinical practice after graduation, developing good habits and a meticulous attitude.

Due to intensive training before the competition, achieving full marks for one or two surgeries is possible. But consistently achieving full marks for each surgery is extremely difficult, a single lapse can result in a deduction of points.

Thus, these surgeries maintaining a consistent perfect score can only be attributed to a profound accumulation of everyday surgical skills.

Take the surgery for femoral shaft fracture, for instance. The closed reduction during surgery must be performed quickly. The scoring criteria dictate that reduction during surgery may not exceed ten minutes; any excess leads to point deductions.

Managing to reposition a fracture within ten minutes and ensuring appropriate alignment, length, and rotation is entirely reliant on the accumulation of everyday surgical experience.

Of course, if the repositioning time exceeds this duration, there could be many reasons for it, such as not operating at optimum capacity, insufficient muscle relaxation due to anesthesia, or the fracture being embedded in the muscle.

As Professor Zhang puts it, whether it’s nervousness, carelessness, or simply subpar performance, all are rooted in inexperience.

In reality, there is no nervousness, carelessness, or poor performance. These are just excuses for inexperience.

One plus one equals two–how is it possible to make a mistake due to nervousness, carelessness, or subpar performance?

By the third day of the competition, Song Zimo had completed surgeries for femoral shaft, tibial shaft, and humeral shaft fractures, achieving full marks for each operation with remarkable consistency.

Reviewing the judges’ grades, it’s clear there are reasons why these chief surgeons achieved full marks.

One of the patients with a tibial shaft fracture treated by Sanbo team was a foreigner who, due to his religious belief, frequently knelt.

In such cases, those with a transverse tibial shaft fracture, undoubtedly, closed reduction and Intramedullary nailing is the gold standard treatment.

In long bone fractures of the lower extremities that do not involve the joint surface, according to Golden Knife Award’s grading rules, direct point deductions will occur if minimally invasive techniques are not used. If you want to score high, you must use minimally invasive techniques and cannot perform open surgery.

Percutaneous minimally invasive techniques for long bone fractures of the lower extremities offer a choice of Intramedullary nailing or plates; the choice depends on the specifics of the case.

In this instance, Song Zimo forwent the first-choice Intramedullary nail fixation and opted for a minimally invasive approach using a long locking plate. Many in the comments section disagreed with this decision.

“For transverse tibial shaft fractures, the first choice is not a locking plate but Intramedullary nailing. The stability of Intramedullary nail’s central fixation is clearly superior to the eccentric fixation of a plate.”

“Indeed, the chief surgeon and first assistant of Sanbo Hospital are still inexperienced. They may lose points due to incorrect choice, and the point deduction may not be insignificant.”

“There goes another perfect score.”

Many of the comments came from high-ranking orthopedics doctors with rich experience, but also from aspiring young doctors eager to learn.

“No need to rush. I attended an academic conference at Sanbo Hospital. The chief surgeon, Yang Ping, is no ordinary person. How could such a simple operation result in a mistake in the choice of internal fixation? There must be some hidden reason.”

“What hidden reason could there be for something so straightforward? From Campbell to orthopedic surgery, and then to AO internal fixation manual, Intramedullary nailing is the first choice for this kind of surgery everywhere. Now is not the time to be pioneering.”

“Let’s keep watching. The chief surgeon of this team is truly an expert. It is too early to draw a conclusion.”

Except for a few who reserved their judgments, the majority were unanimous in their belief that the team chose the wrong fixation method in pursuit of novelty.

This is not uncommon, some surgeons, in their quest to stand out and bring a new perspective, come up with some bizarre surgical techniques.

Take, for example, open reduction and plate fixation for humeral shaft fractures. The anterolateral incision is the gold standard, yet some insist on using an anterior-medial incision, boasting about its many advantages.

The anterior-medial side has so many nerves and blood vessels, extending upwards into the axilla, filled with nerves and blood vessels. How could it possibly be superior to the anterolateral side?

If they didn’t strive to be original, how would they write their research papers?

But now this is a surgical competition, not a paper-writing contest. One inappropriate innovation could wind up costing them the competition.

Finally, the first judge began scoring. Everyone was fixated on the score revealed.

Each step received full marks, right up to the final step which too was marked perfect, making it an overall perfect score.

“What’s going on?”

“Where did we go wrong?”

“Why weren’t there any points deducted?”

“—”

“Read the scoring instructions carefully!”

The scoring instructions clearly state: Due to the patient’s religious beliefs that required frequently kneeling, using Intramedullary nailing for tibial fractures could result in a higher probability of developing anterior knee pain. Such complication could severely impact the patient’s ability to kneel, whereas percutaneous techniques using a long locking plate do not have this complication. Therefore, for professional athletes, those who frequently kneel for their activities, or those unable to tolerate possible complications of anterior knee pain, Intramedullary nailing should be avoided if possible.

“Experts! They’ve thought of this, something we would never have considered.”

“I told you, this is a truly expert team.”

“Over at the provincial hospital, a professional athlete’s case was penalized for this.”

There were eight perfect scores on the board; now only seven remain, with Song Zimo still among them.

They managed to avoid any point deductions for this case, an issue most orthopedic surgeons wouldn’t consider.

A certain soccer player once had a transverse fractures in the middle of the tibial shaft. The surgery was performed at a hospital in East China. After much thought, the chief surgeon abandoned the Intramedullary nailing method in favor of a long locking bone plate. Pre and post-operative X-rays were posted on a forum online, and many questioned this approach.

Only when an expert stepped in to explain did everyone finally understand what had happened.

Enjoying a panoramic view of surgical thinking is built on a solid foundation of theory and experience.

Lin Hao continued to analyze Sanbo Hospital’s surgery, wondering how long they could maintain their impressive performance in the competition.

Source: Webnovel.com, updated on Novlove.com