Chapter 38 Mallet Finger- Part 2

Kim Cheolsu checked the patient’s third finger once again.

He wondered if the pin might have been inserted slightly off position.

Fingers are very sensitive parts of the body, so the procedure must be done with zero tolerance for error—even a one-millimeter deviation can be critical.

“Hmm… Did the pin go in properly?”

The terrifyingly sharp pin was deeply inserted through the dorsal side of the fingertip.

Now, even if the finger was straightened, the fractured bone fragment would not be pushed backward.

He sighed deeply and spoke.

“Fortunately, the pin went in deeply and properly inside the finger. I’ll now straighten the finger.”

Kim Cheolsu pulled on the distal interphalangeal joint (DIP) and extended the previously bent finger.

The bone fragment, which had been detached inside, almost returned to its proper place.

“Hmm… It’s roughly aligned, but I see a slight subluxation of the joint—although the bones are in contact, there’s a mild dislocation. This needs to be corrected.”

Kim Cheolsu pressed firmly on the dorsal side of the DIP joint to push the bone fragment into place, correcting the minor subluxation.

Now, the finger bones were fully restored to their original position.

All that remained was to fixate it in this position.

If the bone fragment detached from the main bone is not internally stabilized, there’s a high chance it will slip out again.

Right now, he had only managed to reposition the detached fragment to its original location.

If this position is maintained with fixation for about 4 to 6 weeks, the bone will heal through synostosis.

“The bone fragment has been properly realigned to its original position. Now, to prevent it from slipping again, I’ll perform pin fixation from the palmar side as well.”

Carefully avoiding the bone fragment, Kim Cheolsu inserted a thinner 0.7mm K-wire diagonally above the fingerprint at the fingertip.

This process is similar to applying a cast—temporarily fixing the bone fragment in place until the DIP joint is immobilized.

A pin is inserted through the straightened finger to fix the bone in place.

To put it simply, it’s like inserting a temporary framework inside a fragile apartment on the verge of collapse.

Of course, once the pins are locked, the structure becomes stable.

*K-wire = K-wire (pin)

This method contrasts with the artificial joint replacement procedure mentioned previously.

When the damage is severe and the existing joint is unusable, an artificial joint replacement is performed.

This uses prosthetic joints with a limited lifespan that must be replaced eventually, requiring revision surgery.

On the other hand, the pin fixation Kim Cheolsu was using stabilizes the original joint in place and waits for the bone to heal naturally.

Both methods have pros and cons, but since the patient’s finger joint damage was not severe, fortunately, pin fixation was possible.

After securing the joint with two K-wires, he cut off the protruding ends outside the skin, leaving a small portion of the K-wire exposed.

The K-wires inside the finger will be removed later once the bone has fully healed.

“The DIP joint is now fully fixed with pins. The crossed pins above and below the finger prevent movement of the DIP joint.

Now we just have to wait for the bone to fully heal.

Let’s proceed with the same procedure for the fourth finger.”

*****

Thirty minutes later, the procedure on the fourth finger was also complete, and the surgical team cheered.

“Wow!! The procedure was a success! It was a difficult surgery, but we managed to realign the completely detached bone fragment and fix it with pins perfectly. Chief Kim is a genius!”

“Yeah, truly amazing!!”

“This is only the second orthopedic surgery, and yet it was so perfect. To fix two fingers perfectly in just 30 minutes is incredible.”

There was reason for their surprise.

Orthopedic surgeries, which involve working directly with bones, require extreme precision.

It’s a field that demands extensive clinical experience, comparable to major surgeries like abdominal operations.

Every person’s bones are different, and even similar fractures differ slightly in location.

Therefore, successfully completing such a surgery is not easy.

Yet Kim Cheolsu, with only his second orthopedic surgery, achieved a flawless procedure.

Anesthesiologist Oh Hajin said, eyes shining.

“It wasn’t general anesthesia, but I’m glad I participated. Day by day, your orthopedic skills are perfecting. You were already a genius in thoracic surgery.”

Everyone was excited, but Shin Seyoung approached Kim Cheolsu with a comparatively calm expression, looking concerned.

He looked exhausted.

“Good work, Major. We’ll clean up the operating room and send the patient back to the ward. You should rest now.”

“Thank you for your concern. I’ll manage. The bones need 4 to 6 weeks to heal. Then we can remove the pins. Until then, we must be careful.”

“Understood, Major. I’ll make sure the patient doesn’t overexert. I learned a lot watching your brilliant surgery today. Well done!”

“Well then, I’ll leave the finishing touches to you.”

Looking at Shin Seyoung’s bright smile, Kim Cheolsu left the surgery room without showing any sign of fatigue.

Although it wasn’t a general anesthesia surgery, it required a lot of concentration.

Because resetting and healing finger bones is truly difficult.

Sometimes, spy movies show scenes where an enemy’s finger is broken with a twist.

That’s because fingers have many small and delicate bones, making them extremely sensitive.

If the bone fragments are not realigned and fixed precisely, the prognosis is not good.

-Scales…!

As Kim Cheolsu was walking down the hallway, he suddenly lost his balance and nearly fell.

He felt as if his vision blurred.

The X-ray device used during surgery seemed to be overtaxing his body.

But he couldn’t avoid using it—doing such precise surgery close up requires equipment more detailed than a C-arm X-ray.

Using the machine is much more precise than relying on eyesight alone during surgery.

Kim Cheolsu told himself this was just temporary and resumed walking.

“Nothing will happen… Nothing at all.”

Suddenly, he collapsed on the spot.

He was so exhausted that he lost consciousness momentarily.

*****

“Ugh… Where am I?”

When he came to, Kim Cheolsu found himself in a familiar room.

But it was one of those feelings where something seems familiar yet awkward.

He thought he had been here before but couldn’t quite place the exact location.

A small private room.

A wilted flower sat by the window.

-Click…!

At that moment, the door opened, and a beautiful young nurse entered.

She sat on the edge of the bed with a worried expression.

“Are you okay, Doctor? We were very worried when you collapsed, but you’ve woken up now.”

“How did I end up here…?”

“I found you collapsed in the hallway and brought you to my room.”

“I’m sorry for sleeping in a patient room alone…”

“No, it couldn’t be helped in an emergency. But how do you feel? Why did you suddenly collapse? Are you feeling unwell anywhere?”

Kim Cheolsu recalled his recent struggles.

He had thought if he kept pushing himself, something like this might happen eventually.

It was unexpected that it was his eyes causing the problem, not his nerves.

But since he had no symptoms for now, he smiled and said,

“I was probably just tired from the surgery. That’s all.”

“More surgery? Doctor, do you realize how much you’re pushing yourself? It’s too much.”

“… But if I don’t do it, where will the patients get treated? There are so many cases that need care.”

In reality, South Korea was still lacking as a medical advanced country.

Military hospitals were terrible to begin with, and rural areas had very few decent hospitals.

Kim Cheolsu’s rushed surgery on the patient today had a reason.

The patient lived in a rural area, and delayed treatment had worsened the injury.

As mentioned earlier, if the finger stiffens like a mallet, it’s a real disaster.

At that point, it was uncertain if treatment like today’s surgery would even be possible.

A disabling injury could have developed in the man’s finger, so the surgery was urgent.

He needed to go to Seoul over the weekend… and it was unclear when he might return to the rural area.

The nurse’s eyes sparkled as she said,

“Why does our doctor have so much work? The military hospital seems unfair, making you do everything.”

“No one forced me to do surgery. Before the emergency, I even treated civilians brought to the hospital. Am I being too nosy? Haha…”

He was feeling a bit down emotionally.

Physical injury also wears on the spirit.

So he shared thoughts he usually kept to himself.

But the nurse shook her head.

“Honestly, I think it makes you even cooler. Are there doctors like you nowadays? Please don’t overdo it. I worry you might get hurt.”

“Honestly, I want to rest sometimes too. I get tired and worn out. But from now on, I will risk everything to save every patient in front of me. That’s what being a doctor means. I don’t care about law violations or medical lawsuits. Nothing is more important than treating patients.”

“… I agree with that too.”

It was a rare moment of mutual understanding.

If Kim Cheolsu hadn’t suddenly collapsed, they might never have had such a conversation.

But fate intervened, and the two sat quietly in the room, sharing their innermost thoughts.

-Rain…

Thanks to the rain earlier, the weather had cooled a bit.

A cool breeze drifted in through the slightly open window, carrying the scent of summer earth.

It was a rural feeling one could only experience here.

The fresh air and the rustic atmosphere felt refreshing.

Kim Cheolsu smiled and said,

“The breeze feels nice. Sometimes summer rain is a good thing.”

“Yes, it really is.”

Kim Cheolsu opened his heart a little more to her, and she truly thought he was wonderful.

To meet a doctor like him in this day and age, she considered herself lucky.

‘If I hadn’t met the doctor the day of my terrible traffic accident, I would have died. Other doctors wouldn’t have performed emergency surgery. Ah, our doctor, isn’t he amazing?’

Thump… thump…

Her heart raced wildly.

She placed a small hand over her chest, trying to calm it.

But no matter how much she tried, it was difficult.

Her flushed face only grew redder.

Kim Cheolsu said nothing more.

They both felt the awkward tension in the room.

Yet despite that, she blushed from feelings she had never experienced before.

“… It’s a bit awkward. I’ll get you something to drink.”

“No, I’m fine just like this…”

“You should rest more. I’ll go get it. Would you like apple juice? Or coffee?”

“But still…”

They playfully argued and moved about, accidentally tangling their legs inside the room.

“Uh…? Uh…?!”

Kim Cheolsu collapsed onto the bed, startled to find Shin Seyoung underneath him.

They were perfectly entangled from top to bottom.

Flustered, he apologized hurriedly and tried to move away.

“I-I’m sorry! I’ll get out of the way immediately. I can’t believe I made such a mistake!”

-Soft touch…

At that moment, Shin Seyoung’s hand brushed past Kim Cheolsu’s ear and wrapped both arms around his neck.

-Sizzle!

Was it the heat from her hand?

Kim Cheolsu’s face flushed deeply as he remained pressed close and asked,

“What do you think you’re doing?”

The S.E.A. member shyly avoided his gaze, speaking in a tiny voice like a mosquito.

“… Wait a moment. Just stay like this for a little while. We…”