Light snack? Yang Ping looked at the bag of chips and then at Director Bai’s physique, trying not to laugh, nodded.

Director Bai put away the chips, composed himself, and said, "Professor Yang, we have a tricky case here that I’d like your help with."

Yang Ping nodded: "What case?"

"A car accident victim, very complex." Director Bai walked to the lightbox, switched it on, "The patient is a man in his forties, comminuted pelvic fracture combined with hip socket fracture, along with sacroiliac joint dislocation. I’ve been looking at it for several days and can’t come up with a good plan, was so worried I slept terribly last night."

Yang Ping walked over and stood in front of the lightbox. Fatty and Little Fatty hurriedly placed the films one by one.

"Pelvis and hip socket? Multiple injuries?" Yang Ping asked.

"Yes," Director Bai pointed at the films, "also combined with hemorrhagic shock. When he came in, his blood pressure couldn’t be measured. The emergency department spent three days stabilizing him, transfused nearly ten thousand milliliters of blood. Now, his life is saved, but whether this leg can be saved, no one dares to say."

Yang Ping looked at the images, his expression gradually becoming serious.

Indeed complex. The front and back rings of the pelvis are broken, the left side of the hip socket is comminuted, sacroiliac joint completely dislocated. The entire pelvis is like a shattered ceramic pot, split into a dozen pieces. The more troublesome part is the location of the fracture, near important blood vessels and nerves, internal iliac artery, obturator nerve, lumbosacral trunk, all are in that area. Any small mistake could lead to disastrous consequences.

Director Bai said beside him, "The patient is the deputy general manager of a central architecture company, an acquaintance of a friend of mine, hit by a large truck on the construction site. The patient and family have high demands, named me to be the chief surgeon. But I’m not confident, so I can only ask for your help."

Yang Ping said nothing, continued looking at the films, his gaze slowly moving along the fracture lines.

Fatty and Little Fatty stood by, holding their breath.

The office was extremely quiet, after a while, Yang Ping spoke.

"How do you plan to proceed?"

Director Bai hesitated for a moment, then said, "I... I want to use a combined anterior-posterior approach, first fix the posterior ring, then handle the anterior ring and hip socket. But that hip socket is too fragmented, I don’t know how to reconstruct it."

Yang Ping nodded and pointed to several positions on the film.

"Look here, this compression of the socket dome, and the fragmentation of the posterior wall, conventional methods indeed won’t work. You need to first reconstruct the articular surface of the dome, then use a plate to fix the posterior wall. But the order is very important, if reversed it would be troublesome."

Director Bai stared at where he pointed, his eyes slowly brightening.

"Which should be done first?"

"Do the dome first," Yang Ping said, "The dome is the weight-bearing area, it must be anatomically repositioned. You elevate the dome, restore the flatness of the articular surface, then handle the posterior wall. The posterior wall can use a reconstruction plate, but the shaping of the plate needs to be very careful, the curve here is large, ordinary plates won’t fit."

As he spoke, he gestured over the films, his fingers tracing the fracture lines.

Director Bai listened intently, occasionally responding with "uh-huh". Fatty and Little Fatty also leaned in, ears pricked, afraid of missing a word.

After explaining, Yang Ping asked, "Do you understand?"

Director Bai thought for a moment, somewhat embarrassedly said, "I roughly understand, but..."

Yang Ping laughed: "Not understanding is normal. This kind of case, you might not encounter one in a year. So, bring out the patient’s CT three-dimensional reconstruction, and I’ll help you with the preoperative planning."

Director Bai’s eyes lit up: "You can come and be the chief surgeon?"

Yang Ping shook his head: "I won’t be the chief surgeon, I’ll watch you do it."

Director Bai hesitated, expression becoming a bit tense.

"I... I’m afraid I won’t do well."

Yang Ping looked at him, his gaze very calm.

"You won’t know unless you do. I’m watching and covering you if things go wrong."

Director Bai was silent for a few seconds, then he nodded firmly.

"Okay, I’ll do it."

Fatty and Little Fatty exchanged a glance, their eyes filled with excitement.

Preoperative planning took a full two and a half hours.

Yang Ping broke down and explained every step of the surgery. From the choice of approach, whether to use the ilioinguinal approach or Kocher-Langenbeck approach, each has its pros and cons; to the exposure of the fracture, how to retract muscles, how to protect nerve vessels; from the handling method of repositioning, using point repositioning clamps or pelvic repositioning clamps, from which direction to apply force; to the fixation order, first fix the posterior ring or first reconstruct the hip socket; from the shaping of the plate, how to bend out the appropriate curve, how to prebend; to the insertion of screws, how long the screws are, how large the angle, selection of entry point.

Nothing was overlooked, each part was carefully covered.

This kind of trauma orthopedic surgery really tests the details. Every tiny deviation may affect the final recovery effect. And what Yang Ping explained were exactly these details.

Director Bai listened while taking notes, writing several pages densely on his notebook. His handwriting was large because his hands were chubby, holding the pen awkwardly, yet every word was written seriously.

Fatty and Little Fatty were also not idle. Fatty was responsible for the CT, rotating and enlarging the three-dimensional reconstruction images on the computer; Little Fatty held a protractor, measuring various angles; whenever Yang Ping mentioned a data point, they noted it down, afraid of making mistakes.

The most difficult part was reconstructing the hip socket. The compressive fracture of the socket dome required a top rod to elevate the collapsed articular surface, then use autologous bone to fill the defect. This operation’s force and angle were very particular, too high would jam the femoral head, affecting joint activity; insufficient elevation would affect load-bearing, possibly leading to traumatic arthritis later.

Yang Ping drew a schematic diagram on Director Bai’s notebook.

"Look, this angle, about thirty degrees." He drew a line on the paper with the pen, "The top rod goes in here, tapped lightly with a hammer, watching the C-arm as you go. Stop when the position is right. Don’t be greedy, better to slightly under than over."

Director Bai stared at the schematic, nodding vigorously.

When the planning was finished, it was already eleven thirty in the morning.

Director Bai looked at the thick stack of materials, exhaled deeply. He leaned back, and the chair creaked under the weight.

"Professor Yang, don’t leave today, I’ll treat you to lunch."

Yang Ping waved his hand: "No need for formalities, just finalize the surgical plan. When are you able to do it?"

Director Bai thought for a moment: "There’s a slot next Wednesday, it can be scheduled in. I’ll have to get anesthesia and ICU ready—this surgery is highly traumatic, might need ICU monitoring for a few days afterward."

Yang Ping nodded: "Okay, I’ll be here next Wednesday."

Director Bai was taken aback: "You coming specifically?"

Yang Ping said: "Since I said I’d watch you do it, I definitely have to come."

Director Bai opened his mouth, wanting to say something but didn’t. He just looked at Yang Ping, eyes full of genuine gratitude—not the customary kind, but from the heart.

Fatty whispered: "Director, are you about to cry?"

Director Bai glared at him: "Get lost."

Little Fatty chuckled beside him.

While they were talking, the office door was pushed open. A nurse poked her head in: "Director Bai, the patient in bed six is looking for you, wants to ask about the surgery."

Director Bai stood up and said to Yang Ping: "Professor Yang, please have a seat, I’ll be right back."

He walked to the door, turned back, and said to Fatty and Little Fatty: "You two, take good care of Professor Yang."

Fatty saluted: "As you command!"

Director Bai left, his large body disappeared at the door, footsteps fading down the corridor.

Fatty and Little Fatty gathered around like two curious children.

"Professor Yang, have you often done such complex trauma cases before?" Fatty asked.

Yang Ping nodded: "Done quite a few."

Little Fatty asked: "What’s the hardest one?"

Yang Ping thought for a moment, said: "One year, there was someone who fell from the thirtieth floor. Not a single bone was intact, we stayed in the operating room for ten plus hours."

As they were chatting, Director Bai returned.

"Settled." He sat down on the couch, the chair creaked again, "The patient just wanted to confirm the surgical plan, explaining it clearly solved everything."