Medical road

What is the first metatarsophalangeal joint? It is actually very simple. It is the joint where the thumb and the instep connect.The function of the thumb on the hand is the most important, and the same on the foot, this joint is also considered as a power joint.

This group of people with joint injuries are big fat people, some ball players, fat people are too heavy to bear the joints.Most athletes suffer from fatigue injuries.But there are some ordinary people who are not fat, who are prone to this disease.It is women who wear high-heeled shoes, especially what kind of high-heeled shoes they like to wear. They look beautiful and tall, but these shoes are really a weapon to damage the metatarsophalangeal joints.

Because wearing high heels can increase the weight of the forefoot, the metatarsophalangeal joints are excessively extended, the deep transverse ligaments between the metatarsals of the forefoot are loose, the transverse arch collapses, the heads of the second, third, and fourth metatarsals sink, and the common toe nerve is located here. Excessive compression, resulting in neuroma of the sole of the toe.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 artery blockage, leading to toe nerve ischemia , Hypoxia, fibrosis.

This is not alarmist, and because this joint is a weight-bearing joint at the end, once it is injured, it is very troublesome to treat and treat, and this injury is a chronic process. If it is an acute injury, it can be recovered by surgery. But this chronic injury, The first damage is the vascular bed and nerves at the end of the limb, and then the bone.In layman's terms, when women wearing high heels start to experience pain, they have already damaged the 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, and numbness, severe numbness on the soles of the 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 put something under the front of your toes to make your thumb as straight as possible. You can imagine how difficult it is to break the bones that have already been bent. It is not only difficult, but also painful, very painful.On weekdays, a woman wears high heels for a day. The reason why her feet hurt is caused by changing the curvature of the force. So, if you love your woman, please take off her hatred!

The black man was hospitalized. He was two meters tall and weighed more than two hundred catties. The average hospital bed really couldn't make him lie down. Even if it was customized, it was too late. He could only be wronged by a friend from a neighboring country. After the end of the bed, the black man was just lying flat.

Because people’s inspections are very complete, all the inspections that can be done are done, and they are all recent inspection results, so there is no need to repeat the inspection.Arranging surgery directly, this is the result that Ms. Wang wants. For them, time is money. Heal early and play early.

The metatarsophalangeal joint is a very small joint in the human body. However, after this joint is injured, the general orthopedic surgery can improve the symptoms and relieve the pain. If you want to restore it to a normal state, it is demanding. Many basketball players , All because of this joint led to retirement.

"Make a dorsal incision and open it for repair. Now you are preparing for the operation, Lao Chen, you go and tell the patient about the condition. Sign where you should sign." Zhang Fan directly confirmed the plan.

Old Chen said cutely: "I, I don't know English!"

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

"Yes, yes, I forgot this." After talking, Old Chen went to find Ms. Wang.Although the black brothers are very reluctant to perform surgery here.But there is no way, he has passed the peak of his sports career, now it is good to have a gold master, and he has to do whatever the gold master asks him to do.

At the beginning of the operation, the anaesthetist estimated the black man’s weight and added anaesthetic, “Dr. Zhang, this fat man is so heavy that I dare not give too much anaesthetic, so the effect may not be very obvious, and it’s really impossible. , You add a little more local anesthesia." The anesthesiologist has never seen such a huge person, so he is a bit unsure.

"Okay!" Zhang Fan looked at the fat man's body, it was really too big and thick.It's dark, very dark, shut up, shut your eyes and turn off the lights, you can't find it directly."Doctor Zhang, do you think his skin is also black!" Li Liang asked, clutching the thick toes of the big black man.

"It should not be. The dermis is probably black, but below the dermis is the same as ours." Zhang Fan is also the first time he has performed surgery on a black man.

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

Li Liang began to disinfect, spread the sheets, and put on the drapes. When everything was ready, Zhang Fan and Li Liang went to the operation, and Song Bing made a tour.Looking at the weird toes of the black man, Zhang Fan sighed. The athletes looked at the scenery. In fact, ordinary people couldn't understand their hard work.

Although the big black man is not a top-notch athlete, his toes are all deformed due to year-round weight training, overloaded exercise, and his huge weight.Although each toe is very thick, but like an old man, it is very curved.

"Look, his second and third toes have obviously suffered multiple fractures, and there have been compensatory thickenings here." Zhang Fan said to Li Liang after observing the rest of the toes.

"It's really not easy for them to make money." Li Liang has separated the first toe. This separation is a bit laborious and too thick, probably as thick as a two-year-old's wrist.

"It's not easy for anyone, but it's not easy." The anesthesiologist interjected.

At the beginning of the operation, Zhang Fan took a small sharp knife and lightly cut through the skin. The scalpel was very sharp. In the early years, the scalpel was used many times. Nowadays, the scalpel is disposable. Although sharp, it is not durable. , The skin becomes dull after a few strokes.

"This operation must pay attention to minimize the damage to the blood supply. His injury has destroyed most of the vascular bed. If you want him to continue to maintain high-intensity exercise, he must protect the remaining blood supply." Zhang Fan Say while gently avoiding the dorsal toe artery, and then use the handle to separate the flexor pollicis brevis.

Surgery, not all places to be exposed need to use a knife, for example, the skin needs a knife, but also a very sharp knife. When the muscle layer is reached, it is usually separated by fingers or a knife handle.Especially for this kind of athletes, muscles are very important for them. If a sharp weapon is broken, although it can be healed later, scar tissue will form, which will affect the burst and lasting of strength.

This kind of functional joint surgery for athletes is very difficult to perform. If ordinary people do this joint injury, because there is no need to do extreme strength exercises, it is enough to reach the functional position of the joints and eliminate pain and variation. As for some insignificant blood vessels, The ligation that can be ligated does not require special attention to the joint capsule, and the scar will heal in the later stage.

However, if the athlete does this, the pain will be reduced, but the sports career is also over. This is also the case that many teams have fixed orthopedic joint doctors. This top joint doctor can achieve joints with minimal trauma. restore.

Although Zhang Fan only opened the first-level microsurgery, the amount of surgery displayed was only more than half, but because he is too liver, Zhang Fan has practiced in the system how many times, the three-dimensional graphics of the joint structure , Formed directly in his mind.

The metatarsals, phalanges, and Zhang Fan slowly separated some inflamed tissues with tweezers, and then washed them with saline.This operation is not so dangerous, but for the surgeon's understanding of the joints, the requirements for the subtle manipulation of the hands are too high.

Surgery pays attention to not dragging mud and water. Why does the mud and water here mean less movement. For example, some inflammatory tissues in the joint capsule can be scraped once with a curette. Do not scrape twice with energy. The more the movement, the greater the damage. This operation is a comprehensive consideration of the overall quality of the doctor.

The inflammatory tissue was cleaned up, and Zhang Fan began to repair it.This kind of subtle repair is even more impossible for ordinary doctors to do or use, but it is very important for this special group of people.In the United States, there are no more than 20 good doctors doing this kind of surgery, and the doctors can’t do it if they are a little older, so the cost of the surgery is also quite expensive.

"Doctor Zhang, why does this repair need to be oblique." Li Liang couldn't understand, because according to the physiological position, it should be oblique.Zhang Fan didn't speak. This time is the most critical moment, and success or failure after surgery is at this moment.

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

More than three hours have passed. This is a subtle operation, which is very time-consuming.After waiting for his breathing to become smooth, Zhang Fan said to Li Liang: "The oblique type here is based on his weight and occupation. The oblique type is more stable after it."

"Oh!" Although Zhang Fan explained, Li Liang was still a little dazed. After all, there were few operations performed, and there was no way to understand it for a while.

"Electric drill, Kirschner wire." Zhang Fan said to the operating nurse.Song Bing was dying of boredom. This operation was performed almost entirely under a microscope, and he couldn't see anything.The electric drill lightly opened the small hole, and the Kirschner wire firmly fixed the joint.

"In a plaster cast, you must make sure that the plaster is fixed around you. One day less will not work." Zhang Fan said to Li Liang and Song Bing.

"Okay!" At the end of the operation, Ms. Wang and the athlete's black buddy were almost asleep outside the operating room!When Zhang Fan and the others pushed the big black man out of the operating room with great effort, the black guys happily surrounded them, croaking and talking non-stop. Zhang Fan had studied English for so long, but he didn’t understand them. What more!

"Doctor Zhang, you have worked hard." Ms. Wang looked at Zhang Fan expectantly, Zhang Fan understood her meaning.After removing the mask, he first smiled, and then said: "The injury is serious, but it has been repaired. The rest depends on his own recovery in the later period, and he can know it from around. It is estimated that he can continue to play basketball in the future. "Before the operation, Zhang Fan could not guarantee anything, but it was different after the operation.

He has confidence in himself, because he has worked hard and has sweated in the system!