"Thank you to all the medical staff and wish you a happy new year. "In the thirtieth year of the Chinese New Year's Eve, Ms. Chen was finally discharged from the hospital and embarked on the road back to her hometown for the Spring Festival with peace of mind. And it was the medical staff of the Department of Thoracic Surgery at Beijing Jishuitan Hospital who allowed her to recover her health and reunite with her family.
At the beginning of February, near the end of the year, when people were in a hurry to buy tickets to leave Beijing and return to their hometowns, Ms. Chen anxiously rushed to the thoracic surgery clinic of Beijing Jishuitan Hospital.
Doctor Xie, please help me take a look**, I have already seen many hospitals. ”
Taking the film from Ms. Chen's hand, Dr. Xie Hao frowned slightly.
How long have you been hurting? ”
I was injured in December, and I have been injured for more than a month. ”
CT tomography showed sternoclavicular dislocation.
After careful medical history, it was learned that 36-year-old Ms. Chen (pseudonym) suffered a posterior dislocation of her right sternoclavicular joint due to a traffic accident more than a month ago. Ms. Chen ignored the condition as there was no severe pain and discomfort and significant limitation of movement after the injury, and since there were no problems detected in the imaging reports of various hospitals. Until two days before she came to Xinjiekou Hospital for treatment, Ms. Chen still felt soreness, pain and discomfort in her shoulder, back and anterior chest wall when her right upper limb was moving, and she was re-examined at the local hospital, and the CT results showed that the right sternoclavicular joint was posterior dislocated. This result made her realize the seriousness of the problem.
Three-dimensional reconstructive CT showed that the sternoclavicular joint had been dislocated to the retrosternal bone.
Doctor, is my disease still curable? ”
The longer the time of the dislocation of the bone and joint, the less hope of recovery, not only because the torn joint structure is now filled with fibrous hyperplasia, and it is difficult to perform manual reduction by closed reduction. More critically, after more than one month of deformity repair, it is likely that fibrous adhesion has formed between the clavicle and the clavicle of the posterior dislocation of the sternoclavicular joint, and the rash reduction of the clavicle when the degree of fibrous adhesion between the two cannot be judged is very likely to cause a tear in the middle cardiovascular system and cause massive bleeding.
Dr. Xie Hao knew that the operation might face difficulties and challenges, but looking at Ms. Chen with a sad face, he said, "Leave it to us, you can wait for the operation with peace of mind." ”
Carefully separated, with gentle movements, everything is careful. During the preoperative discussion, Zhang Qiang, director of thoracic surgery, repeatedly admonished.
After a series of intensive preoperative preparations, the patient was wheeled into the operating room on the third day of admission. After the successful intubation under general anesthesia, the thoracic surgery team successfully cut the soft tissue to the sternoclavicular joint.
As anticipated before the operation, the most complex and difficult situation was before the surgical team. The patient's right sternoclavicular joint has been completely torn and has lost its anatomy, and the right clavicle is deeply embedded behind the sternal stem, surrounded by fibrous hyperplasia that makes it difficult to move. These unfavorable factors interfered with Dr. Xie Hao, who was undergoing surgery. He held his breath and carefully cleaned up the fibrous growth around the dislocated joint step by step, and slowly, the clavicle head fixed by fibrous hyperplasia showed signs of loosening.
Next is the most critical "level". Dr. Xie Hao began to perform joint reduction, and although he was a little nervous, his hand holding the instrument was still steady and strong. At the moment when the clavicle head resurfaced from behind the sternum and returned to its position, the surgeons invariably looked up at the ECG monitor.
There is no obvious bleeding at the incision, the heart rate, blood pressure, and blood oxygen are stable, and it can be fixed! ”
After the combination of suture anchor and fibrous junction line, the patient's right clavicle was finally safely and stably returned to "home", and the reduction was successful and the operation was successful. In the final suture, considering that the patient has a certain scar constitution, Dr. Zhang Chuhan used cosmetic sutures to complete the suture, which reduced the patient's worries about postoperative scars.
Postoperative chest CT showed that the right clavicle had been reduced.
On the third day after surgery, Ms. Chen's upper limbs were able to move normally, the drainage tube was successfully removed, and she was discharged from the hospital the next day without complications such as bleeding and infection after surgery. "I can finally go home for the New Year! Holding the CT film for the pre-discharge review, Ms. Chen excitedly thanked the thoracic surgeons. The happy smile of the patient when he receives the discharge notice is the best gift for the medical staff who stick to the frontline post.
Ms. Chan underwent a postural activity test and her upper limbs were able to move normally.
Introduction to the Department of Thoracic Surgery, Beijing Jishuitan Hospital.
As an important department of the hospital, the Department of Thoracic Surgery of Beijing Jishuitan Hospital mainly diagnoses and treats thoracic, lung, esophagus, mediastinum and other chest related diseases. The thoracic surgery team is in a leading position in the diagnosis and treatment of "thoracic trauma, thoracic deformity, and sternoclavicular joint disease" in China, and has been responsible for the compilation of Chinese expert consensus on related diseases for many times. He has rich clinical experience in patients with multiple trauma, combined chest and abdominal injuries and severe chest trauma, and has carried out a lot of clinical practice on thoracic bone injury, bone lesions and bone deformities in combination with the characteristics of the hospital, and the diagnosis and treatment technology ranks among the top in China. With the development of minimally invasive surgery, minimally invasive chest wall deformity correction, minimally invasive rib tumor resection, and small incision thoracic trauma surgery have become the best programs for basic surgical diseases in thoracic surgery. In addition, the department has set up a special diagnosis and treatment of sternoclavicular joint diseases, and is the first in China to carry out arthroscopic sternoclavicular joint lesion removal, with small incision and fast recovery, which has been widely praised by patients.
At present, the Department of Thoracic Surgery has opened full-day outpatient clinics in Xinjiekou, Huilongguan and Xinlongze, and in addition to the ordinary number source, it also opens specialist outpatient clinics, thoracic trauma outpatient clinics, pulmonary nodule outpatient clinics and sternoclavicular joint outpatient clinics. All the doctors and nurses of the Department of Thoracic Surgery will adhere to the motto of "sincerity, art, and meticulousness", and sincerely serve the majority of patients with exquisite medical skills and full enthusiasm.
Contributed by丨Department of Thoracic Surgery.