Perfect Diary for the World-class Trauma Master Prof. Lehmann’s Visit to the Zhengzhou Orthopaedic Hospital

From May 20th - 24th, Prof. Lehmann, the Director of Trauma Surgery, Orthopedics, and Plastic surgery at the Medical Center of the University of Göttingen, visited Zhengzhou Orthopedics Hospital for academic exchange activities in the hospital, including outpatient consultations, ward rounds, surgical guidance, internal lectures, discussions on department management and complex cases, and public lecture, etc.

Highlight

Even if you were the greatest doctor in the world, you wouldn’t be able to treat patients a hundred years later. The only thing you can do is to train more and better doctors with a conscience. In this way, this job will allow the great endeavor and the great desire of your life to continue for the sake of patients. In the early morning of May 18th, we flew all the way from Guangzhou to Shanghai. Prof. Lehmann, Director of Trauma Surgery, Orthopaedics and Plastic Surgery at the Medical Center of the University of Göttingen, arrived at Pudong International Airport aboard a new aircraft from Air China. He is one of the kindest people in the world to Chinese hospitals and doctors. During the pandemic, he accepted four MD students for Grade Three Class A hospitals in China. He also bought new computers and set up an office for them. He designed research plans and assigned senior researchers to support their scientific activities. He helped them publish articles in scientific journals, jointly developed patented instrument and took them to attend The German Congress of Orthopaedics and Traumatology annually. During the pandemic, he accepted multiple Chinese surgeons as clinical fellows in Göttingen. From May 20 to 24, Prof. Lehmann visited Zhengzhou Orthopaedic Hospital for a weeklong international visiting professorship. During his visit, together by Party Secretary MEI Wei, Vice President WANG Yingqiu, chief expert WANG Aiguo, Director of Lower Limbs I LI Xinghua and teams of relevant sub-specialty in orthopedic trauma, Prof. Lehmann had in-depth exchanges via ward rounds, case discussion, surgical observation, internal seminars, global live surgery and public lecture. The topics covered the clinical hotspots of trauma surgery,research in orthopedics and trauma, hospital and department management, talent training, etc. In addition to clinical academic exchanges, Prof. Lehmann unreservedly shared his 8-year experience in managing the department. He turned a marginal department into one of the top departments in the hospital. It attracts more than 1 million euros of third-party research funding and about 6,000 surgeries are performed every year. The complication rate and the hospital lethality of polytrauma patients decrease steadily. It has ranked among the World’s Top 100 Orthopaedics Department by U.S. Newsweek for three consecutive years. During the visit this week, Prof. Lehmann was impressed by the number and difficulty of the cases in Zhengzhou Orthopedics Hospital. This also allowed him to gain deeper insights into the development of trauma surgery in China and the similarities and differences in specialty settings and management systems of orthopaedics and trauma surgery in China and Germany. Prof. WANG Manyi from Beijing Ji Shui Tan Hospital, the former Chairperson of AO Trauma Asia Pacific, was also invited to participate in the Sino-German Public Lecture on Trauma Surgery on May 24. In his opening remarks, Prof. Wang mentioned that the week-long academic week would contribute to deeper exchanges between both sides. He also highly acknowledged the efforts made by the hospital executives of Zhengzhou Orthopedics Hospital in promoting specialty development and talent training through international exchanges in recent years. 

Visiting Professor Appointment Ceremony

On May 20th, 2024, the second Sino-German Academic Exchange Week of Zhengzhou Orthopaedic Hospital and the appointment ceremony of International Visiting Professor was held at Zhengzhou Orthopaedic Hospital. Prof. Lehmann, Prof. FU Dengxiao, Deputy Director of Zhengzhou Municipal Health Commission, Prof. WU Xuejian, Chairman of Orthopaedics of Henan Provincial Medical Doctor Association, Prof. ZHU Zhi, Standing Member of Orthopaedics of Henan Provincial Medical Association and Director of Orthopaedics of Zhengzhou Central Hospital, Prof. MEI Wei, Party Secretary of Zhengzhou Orthopaedic Hospital, Prof. WANG Aiguo, chief expert of Zhengzhou Orthopaedic Hospital, HU Ming, Deputy Party Secretary of Zhengzhou Orthopaedic Hospital, attended the meeting, with over 200 attendees including all members of the hospital's executives, directors of clinical departments, head nurses, etc.

MEI Wei, Party Secretary of the hospital awarded the appointment letter to Prof. Lehmann. 

In the welcome ceremony, Prof. Lehmann expressed his gratitude for the invitation from Zhengzhou Orthopedics Hospital. Göttingen is at the center of Germany, the same location as Zhengzhou in China, which made him feel very connected.

Prof. Lehmann introduced that the University of Gottingen and its medical faculty were founded in 1737 and is especially strong in biomedical research. So far, 46 Nobel Prize winners had contributed to the development of the University. The trauma center led by Prof. Lehmann is one of the largest trauma centers in Germany, serving over 4.2 million people and treating more than 42,000 patients annually, including more than 900 polytraumatized patients. It is the largest BG center for professional association medical treatment in southern Lower Saxony and northern Hesse with more than 5000 cases per year. The department attaches equal importance to medical education and research. From 2020 to 2022, the department has published papers with an accumulated Impact Factor of more than 370 and has received third-party funds of over 2.6 million euros.

After the welcome ceremony, Prof. Lehmann started his visiting professorship activities right away. Together with Prof. WANG Aiguo, he had ward rounds and case discussions on 19 cases in the Dept. of Lower LimbsⅠ, Dept. of Lower LimbsⅡ, Dept. of Bonesetting, Dept. of Foot and Ankle Surgery. Prof. Lehmann was impressed by the population of Henan Province and the number of cases in the orthopedic trauma departments of the hospital. He also highly recognized the treatment concept and expertise of each sub-specialty and looked forward to further exchanges and discussions in the coming week.

Outpatient Consultation

On the morning of May 21, Prof. Lehmann first visited the Dept. of Upper Limbs,, Dept. of Minimally Invasive Orthopedics, and Dept. of Trauma Surgery, and had ward rounds and case discussions on 9 key cases. Then, he visited the operating room to observe an internal fixation of the proximal humerus fracture the team from the Dept. of Upper Limbs and another internal fixation of distal femur fracture by the team from the Dept. of Lower LimbsⅡ.

In the afternoon, Prof. Lehmann offered  outpatient consultations to 12 patients  together with the host team of Zhengzhou Orthopaedic Hospital. For each patient, Prof. Lehmann gave detailed physical examination, consultation, interpretation of the radiographic images, assessment of the patient’s condition, answered their questions, and put forward suggestions for further plan for treatment or rehabilitation. 

The outpatient service was live-streamed by Henan Radio and Television Station, during which Prof. Lehmann was invited to give general information about amputation and degenerative diseases of the spine to the public.

Prof. Lehmann’s impression form the firt two days is that, the team of orthopedic trauma in Zhengzhou Orthopaedic Hospital has rich experience in handling complex cases, and is able to provide patients with treatments of international standards. He looks forward to having more direct and in-depth exchanges with the team in the operating room on Wednesday.

Department Management and Talent Training

On the morning of May 22, Prof. Lehmann and LV Zhiqiang, Director of Dept. of Minimally Invasive Orthopedics, jointly completed a total hip replacement for a femoral neck fracture and an internal fixation of ankle fracture. They also observed a number of oerations done by the orthopedic trauma team.

In the afternoon, Prof. Lehmann had a discussion on department management and talent training with the directors of the relevant departments of orthopedic trauma. The meeting was moderated by Vice President WANG Yingqiu, who gave a welcoming speech. Prof. Lehmann shared his insights in managing the Department of Trauma, Orthopaedics and Plastic surgery at the University of Gottingen under the title How to Manage an Orthopaedics/Trauma Center.

Prof. Lehmann took over the management in 2016 and has achieved several milestones in the past eight years: the internal research ranking  has rised from one of the last to the fifth, the annual surgical caseload rised from 4,000 to 6,000. For three consecutive years, it has been selected as one of the World’s top 100 orthopedics departments by US Newsweek.

Prof. Lehmann first elaborated the importance of multidisciplinary collaboration between trauma surgery, orthopedics and plastic surgery with a specific case, and then introduced that there are three keys to the success of a department: medical innovation, economy and human resources.

Prof. Lehmann believes that a department chief with heavy clinical workload should select and delegate a specific person to be responsible for managing the research team and the research projects. And one of the research focus should be “innovation”, for example, their team focuses on the development of new implants, new prosthetics, new bone substitute materials and bone glue.

With regards to the issue of cost control which concerns the healthcare systems both in China and Germany, Prof. Lehmann suggested optimal utilization of existing resources, good indication for surgery, low complication rates, shorter length of stay, useful diagnostics and reasonable personnel planning, etc.

Prof. Lehmann set up a team of three within the department dedicated to the paperwork related to the DRG system, which not only reduced the workload of clinical doctors but also better controlled the cost. As for talent training, Prof. Lehmann believes that departments chiefs need to develop a career plan with each young doctor as early as possible, and have regular personal talks. They should also give young doctors more space and opportunities to devote themselves to scientific research, develop a well-structured training curriculum and creat flexible working time models.

After the talk, moderated by Vice President WANG Yingqiu, the directors of the relevant departments of orthopedic trauma discussed with Prof. Lehmann on the multidisciplinary treatment of infection, how to select suitable research chief, how to motivate clinical doctors to engage in research, the similarities and differences in the specialty setting of orthopedics and trauma surgery in China and Germany, the personnel structure, laboratory organization,  rescue procedures for polytrauma patients, branding of hospital and department, continuing education for doctors, etc.

Vice President WANG Yingqiu delivered a concluding speech, envisioning a strengthened cooperation and more exchanges in terms of clinical and scientific research, management and education to better serve patients.

Case Discussion

On the morning of May 23, Prof. Lehmann assisted Prof. WANG Aiguo, chief expert of Zhengzhou Orthopaedic Hospital, in completing an internal fixation of complex tibial plateau fracture. Although it was the first time for them to meet in the operating room, they worked well together. With the joint efforts, a perfect internal fixation was achieved.

In the afternoon, a discussion on key difficult cases was held and moderated by Prof. WANG Aiguo.

Prof. Lehmann shared 3 cases of complicated acetabular fracture and 2 cases of pelvic fractures combined with polytrauma, elaborated techiniques of using AIP approach with demo video, and shared techniques on sacroiliac screws insertion guided by C-arm operations and the surgical instruments commonly used.

Then WANG Qi, Director of the Dept. of Orthopedic Trauma of Zhengzhou Orthopaedic Hospital, reported a case of acetabular fracture treated with lateral rectus approach. ZHU Xiaoguang, Deputy Chief Physician of Dept. of Bonesetting, reported a case of terrible triad of the elbow. LI Xinghua, Director of Dept. of Lower LimbsⅠ, reported a case of pelvic fracture combined with femoral neck fracture. The heated case discussion lasted more than two and a half hours on the selection of the surgical approaches and implants and the surgical timinigs for acetabular fractures and pelvic fractures.

Sino-German Global Webcast on Trauma Surgery

On the morning of May 24, Prof. Lehmann, together with Prof. WANG Aiguo, chief expert of Zhengzhou Orthopaedic Hospital, and LI Xinghua, Director of Dept. of Lower LimbsⅠ, jointly conducted the Sino-German Global Webcast on Trauma Surgery. This live surgery attracted a lot trauma surgeons as online viewers, with more than 85,700 real-time viewers, providing a rare academic exchange and a platform for many trauma surgeons.

The three professors made detailed preoperative plans for the case, and it only took one and a half hours to achieve a good reduction. Prof. Lehmann was impressed by the cooperation between Prof. WANG Aiguo and Director LI Xinghua, and highly acknowledged the expertise of the orthopedic trauma team of the hospital in the minimally invasive treatment of acetabular fractures.

Sino-German Trauma Master’s Public Lecture

On the afternoon of May 24, the Sino-German Trauma Master’s Public Lecture was held in Zhengzhou Orthopedics Hospital on time. The meeting was welcomed by WANG Yingqiu, Vice President of Zhengzhou Orthopaedic Hospital, who said that this meeting was not only the perfect closure of Prof. Lehmann's visit this week but also the peak of the academic exchanges of this week.

It was an honor to invite Prof. Lehmann, Prof. WANG Manyi from Beijing JiShuiTan Hospital, former Chairman of AO Asia Pacific, and dozens of well-known experts in orthopedic trauma in Henan Province to havet in-depth discussions on the current hot topics, international cutting-edge surgical techniques and future development of the field., .

With the titles Management of Pelvic Fractures and Management of Acetabular Fractures, Prof. Lehmann discussed in detail the classifications of pelvic fractures and acetabular fractures, the selection of surgical approaches and implants, the application of intraoperative imaging and surgical techniques, etc. Then, LI Xinghua, Director of Dept. of Lower LimbsⅠ, reported a case of nonunion of acetabular fracture treated with combined anterior and posterior approach, and ZUO Sili,from  the Dept. of Upper Limbs reported a case of proximal humerus fracture with shoulder dislocation.

At the end of the public lecture, Prof. WANG Aiguo concluded that both sides had benefited a lot from this visiting professorship, and he hoped that the host team would take the opportunity of this exchange to improve expertise in clinical care and management to better improve the international medical services for patients in Henan Province.