Surgery Godfather
Chapter 1240 - 953: The Disappearing Femur_2

Chapter 1240: Chapter 953: The Disappearing Femur_2

"That’s good!"

Dean Sun was relieved.

---

At that time, Yang Ping was in the Doctor’s office at the Surgical Research Institute participating in a routine case discussion, where a unique case caught everyone’s attention.

This X-ray was very unusual; the entire right femur had only the proximal and distal ends remaining, with the middle shaft of the femur completely missing, leaving a lone metal plate spanning from the proximal to distal end, forming a powerless bridge over the empty middle.

"What in the world was the purpose of this surgery, ignoring the bone deficit in the middle? What good is a metal plate bridge?"

Zhang Lin now had the demeanor of a great professor, and his occasional use of coarse language was not a display of vulgarity but highlighted the fiery spirit of a cultured person.

"A simple bone graft probably wouldn’t work in this case, we would need a whole segment of allogenic femoral shaft to replace the deficit. Even if we went to Shanxi’s bone bank personally to choose, it would be hard to find such a good complete femoral shaft, not to mention, even if there is such good allogenic bone that long, how can it be traversed? The best method would probably be the Ilizarov’s bone elongation technique, which theoretically, doesn’t involve the nerve vessels extending together, can work no matter the length."

Little Five pointed to the bizarre X-ray, sharing his views during the department-wide case discussion, with so many interns, standardized training students, and graduate students watching; he had to show something impressive.

At this moment, Professor Zhang and Professor Lu of the Surgical Research Institute were calmly discussing the case, expansive in their detailed conversation.

"Have you two reviewed the medical history? Take a good look at the medical history before you speak," Song Zimo said, his tone suggesting a reminder.

The two professors lowered their heads, scrolling on the tablets in their hands. They were hasty, as this patient initially just had a simple right femoral shaft fracture, for which percutaneous techniques were used to install a locking metal plate fixation. There were no abnormalities on the first X-ray during the hospital stay, but after being discharged, the patient never followed up as advised and continued using a wheelchair. A year later, the X-ray showed that the femur had surprisingly disappeared.

After reviewing the medical history, the two professors looked up, their faces filled with confusion. What was going on? How could a perfectly good femur just disappear, leaving only the pitiful ends?

At this time, the gazes of many students converged on Zhang Lin and Little Five, waiting for their impressive performances, ideally a comprehensive and continuous discourse, covering etiology, pathophysiology, pathology, diagnosis, treatment, and prognosis all in one go.

However, the two of them now looked as if they were choked, they looked at each other and couldn’t say a word, having never encountered this illness and not knowing what was going on.

If it were anything else, they could have bluffed their way through, but this was medicine, a legitimate case discussion. Wildly guessing could not only earn a scolding from the professor but could also ruin their reputations for life.

"Was there any—other—illness in the past?" Xu Zhiliang asked.

"Previously healthy with no other diseases, this time it was a car accident that caused a fracture of the right femur. Both preoperative and postoperative X-rays were normal. After being discharged, the patient did not follow the doctor’s orders to return for a check-up. Six months later, he attempted to walk with the aid of crutches, but the pain made him abandon the effort. He never attempted to walk again, as even slight weight bearing would cause severe pain. After a year, the patient wondered why he still couldn’t walk and went to get an X-ray locally, and that’s the image here—his femur had mysteriously disappeared," Song Zimo continued updating the medical history.

Everyone looked at this mysterious X-ray, having never seen anything like it before. How could the femur just disappear? Even if it did not heal after surgery, and the fracture ends were absorbed, it would not simply vanish—the gap created by the fracture might have just gotten a little wider at most.

"This is a patient from City People’s Hospital. Now the patient and the hospital are at odds. They are claiming that the doctors stole the bones to sell for money. Coincidentally, the patient was also found to have only one kidney during a separate examination. The patient’s family is now convinced that the doctors stole the kidney as well and are causing a commotion at the hospital. Dean Chen is in a headache, hence he asked us for help. Not only the bones being missing, but now even a kidney is gone. The media followed suit and even made a documentary claiming someone stole the patient’s kidney and bones, and now City People’s Hospital is being roasted over the fire," Song Zimo said, turning to Yang Ping.

Yang Ping looked at him and said, "Print out the urinary system’s imaging."

Song Zimo printed out the images of the patient’s kidneys, ureter, and bladder, which included both surface ultrasound and CT. The surface ultrasound images didn’t show much on the report, so Song Zimo printed out the CT images.

Yang Ping looked at them and said, "This isn’t about a missing kidney. This is a solitary kidney, meaning the patient was born with only one kidney." Then he asked, "Has he ever had an ultrasound or CT of the urinary system before?"

"City People’s Hospital hasn’t found any previous imaging of the patient, so they are on the defensive in the media. A media outlet is making a prolonged fuss about this, accusing a heartless hospital of stealing kidneys and bones, talking about the miraculous disappearance of the patient’s kidney and femur. These writers, why don’t they clarify the basic facts? It’s not the first or second time this has happened. And even after it’s found that these reports are false, those who fabricated them don’t have to take responsibility at all. How could this be?"

Song Zimo was puzzled, having encountered many similar reports that wildly deviated from the truth. For instance, there was a case where the patient’s second toe was used to create a new thumb after losing the original thumb to injury, a classic surgery, yet the media claimed the patient merely injured his finger and the unscrupulous doctors mistakenly attached a toe to his hand. The patient faced the media unflinchingly, claiming he knew nothing until he woke to find his toe attached to his hand, realizing the doctors had operated incorrectly.

It baffled Song Zimo how such blatant smear tactics could be openly broadcasted in the media.

"It’s not that they don’t know, but rather they pretend not to know. You can’t awaken someone who’s pretending to sleep. To put it in today’s terms, they’ll say anything for clicks, ignoring the truth just to capture people’s attention. Most of the underlying logic for these things is economic reasons. Like you mentioned about these fake news, it’s all for traffic, all for money. Why would the patient claim ignorance regarding his surgery? To feign ignorance to collaborate with the media, knowing ultimately, he might get some money out of it. Many things, if considered from an economic foundational logic, aren’t that complicated, actually quite simple. But let’s not talk about these, let’s focus back on the medical condition," Yang Ping said, his tone very calm, steering the topic back on track.

"There’s no doubt about this kidney, this case is definitely a solitary kidney, and the effects of a solitary kidney are distinctly different from a removed kidney. You all can read more about this whenever you have the time. Now about this missing femur, let’s think about what could possibly be happening. Knowing the diagnosis of common and frequent diseases is basic, but we must also learn the diagnosis of rare diseases. Diagnosing rare diseases tests a doctor’s knowledge extensively. Some diseases we don’t necessarily have to see firsthand to diagnose; having read about them in books, journals can also serve as a basis for diagnosis. The process of diagnosing the first AIDS case in our country is a classic example of diagnosing rare and unknown diseases. You might want to read up on this story,"

Indeed, when Peking Union Medical College Hospital was diagnosing the first case of AIDS, the doctors lacked clinical experience with the disease, all their knowledge coming from international journal articles. At that time, they didn’t even have the methods and reagents for the diagnosis. The doctors used the available experimental equipment and conditions to design a diagnostic method, ultimately achieving the diagnosis of the first case of AIDS.

Now, this mysterious case of the missing femur is viewed as either a rare or unknown disease for everyone here, requiring strong clinical thinking to diagnose.

"This patient has visited many hospitals but has yet to find the cause of the disappearing bone. Some hospitals suggested amputation might be necessary, which terrified both the patient and his family. Dean Chen referred the patient to us to see if there is a chance we might determine the cause."

Song Zimo reprojected the patient’s X-rays.