The 19-year-old girl was in her prime when she was having fun with her friends when an accident happened. The ring on the middle finger of his left hand was caught by something, and the skin and flesh of the finger were torn off by rapid and violent external force. When he was rushed to Shanghai Sixth People's Hospital, what the doctor saw was a "white bone". Just like taking off a glove from a hand, the skin and soft tissue of the entire finger, including nerves, blood vessels and nail beds, were all peeled off.
The girl is only 19 years old, how should she respond to her expectation for a better life? Faced with the only "white bone" left after high-intensity injury, orthopedic experts from the Sixth Hospital conducted consultations on repair and reconstruction plans. A 7-centimeter finger requires full finger repair. Not only the external image needs must be considered, but also the internal blood supply, nerve sensation and tendon function needs must be considered. After careful preoperative discussions and adequate preparations, the chief surgeon Zhou Zhengbing finally decided to select the right toe nail flap and dorsum of foot flap as donors to repair the middle finger. At the same time, he used the superficial iliac circumflex perforator flap in the ilioinguinal area to repair the foot donor area, completely preserving the five toes of the foot and striving to minimize damage to the donor site while reconstructing the fingers.
During the 13-hour operation, the most important factor that determines the success or failure of the operation is the high-quality vascular anastomosis . "Three arteries and veins with a thickness of only 0.3 mm were sutured with 5 stitches using silk threads that were almost invisible to the naked eye under a microscope to restore blood circulation ," Zhou Zhengbing said. Today, the girl's injured finger has returned to full flesh and blood, and after a period of rehabilitation training, the range of motion of the finger has been significantly improved.
What makes girls regain their yearning for life is "the cradle of amputated limb replantation in China" - the Orthopedics Department of Shanghai Sixth People's Hospital. On January 2, 1963, the world's first severed limb replantation operation was successful in the Sixth Hospital. At that time, facing a young worker Wang Cunbai whose right wrist was completely severed, Dr. Chen Zhongwei led the team to complete the world's first severed limb replantation surgery after 8 hours of hard work. Since then, China has begun to develop rapidly in the field of microsurgery. Over the past 60 years, the Department of Orthopedics of the Sixth Hospital has always regarded replantation of amputated limbs and microsurgery technology as traditional skills for the development of the discipline, and has continued to innovate and strive for excellence.
"Currently, we are already carrying out 0.2 mm blood vessel transplantation and anastomosis surgeries, which means that super microscopic surgeries that could not be done before can now be done." Professor Zhang Changqing, deputy dean of the Sixth Hospital and leader of the Department of Orthopedics, said that with the development of the times, work-related injuries have greatly reduced, but accidental injuries ranging from car accidents to small rings are still occurring. Limb salvage is a once-in-a-lifetime opportunity for patients. Every operation may affect their lifelong happiness, which drives doctors to continuously pursue technological advancement. "Initially, it may have been just to repair and reconstruct the patient's labor function; then, starting from the concept of 'wholeness', we paid attention to the repair of the patient's appearance; now starting from the 'integration of mind and body', we hope to repair and reconstruct the patient's hope for life."
At present, the Sixth Hospital performs more than 1,000 replantation surgeries of amputated limbs every year, with a success rate of more than 95%. The limb salvage team of the Department of Orthopedics of the Sixth Hospital has diagnosed and treated more than 20,000 patients, increasing the limb salvage rate from the previous 32.43% to 64.43%. The team created a series of new limb salvage technologies such as bridge cross flap transplantation, new combination flap transplantation and residual limb flap transplantation, which promoted a huge leap in international limb salvage levels. At the same time, the Department of Orthopedics of the Sixth Hospital is known as “the largest replantation center in the world” due to its large number of patients, numerous categories, high technology, and large scale.
Today, the Department of Orthopedics of the Sixth Hospital continues to grow and develop on the basis of inheritance and development. It has formed an "aircraft carrier" level major orthopedics department, with 8 majors and 12 sub-disciplines including repair and reconstruction (including limb wards), trauma, joints, arthroscopy, spine , bone tumors , pediatrics, foot and ankle , etc., which is the best in the country. In addition, the Department of Orthopedics of the Sixth Hospital has always been at the international level in terms of diagnostic capabilities for difficult diseases, including 7 international technologies including surgical treatment of femoral head and osteonecrosis, limb salvage treatment of severe and complex limb injuries, and surgical treatment of tibial plateau fractures.
Zhang Changqing said that with the approval of the National Orthopedic Medical Center, the Department of Orthopedics of the Sixth Hospital will continue to comprehensively improve the development of orthopedics, strengthen talent training, and coordinate regional development to benefit more patients and promote more "Chinese Hand" glory.
column editor: Gu Yong
source: author: Huang Yangzi
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