Basketball fans, not only in
America, but throughout the world, witnessed the “gruesome” injury of Louisville
guard Kevin Ware last week.
And since this kind of injury is one of the
common injuries orthopedic surgeons deal with, allow me to discuss a few things
about this.
Reports showed how the player came
down wrong on his leg as he tried to block the shot of an opponent player. His
right tibia, or shinbone, broke through the skin in what is called an open or
compound fracture. This caused fans and
players alike to shut their eyes in horror and disbelief. Some nearly hurled. (Just look at the reaction of the bench of
Ware’s team in the above YouTube clip. (Napaiktad sa gulat!)
So what happens in
open fractures?
Not only does the bone get broken,
open fractures often cause damage to the surrounding muscles, tendons, ligaments,
and more importantly, blood vessels. The
usual concern here is infection because once the skin is broken, harmful germs
or bacteria may prevent the wound and the bone to heal.
I am not privy to the exact
treatment that the player got, but the typical procedure for this kind of
injury, is that the patient will be immediately brought to the hospital. After
thoroughly cleaning the broken soft tissues (muscles, ligaments, etc), the bone
will be reset and a metal rod will be inserted into the shin bone. That’s either
a stainless steel or titanium placed inside the hollow leg bone to reconnect it
where it broke. After surgery, we place
patients on antibiotics to lower the risk of infection.
Although the fracture looked gruesome and extraordinary,
orthopedic surgeons like me see this often, especially if you trained in a
major government hospital like PGH (Philippine General Hospital) or POC (Philippine Orthopedic Center).
The thing here is that open fractures are usually the result
of a "high-energy" trauma, such as a vehicular accident or a fall
from a height. The injury was extremely unusual given the circumstance (jumping in basketball). The
player may have twisted his leg as he landed, causing the bone to snap. It's
possible Ware had a “stress” fracture or benign bone tumor that weakened the
tibia before his fall. This is called a ”pathologic
fracture. As I’ve mentioned, I am not
involved in his care so I am just stating my own personal opinion here.
Can the player go
back to playing basketball again?
A good friend of mine from High
School asked me this.
My answer?
Ware’s doctors probably got him up
and moving the day after surgery. And with intensive daily physical therapy, he
could be back on the basketball court in six months to a year, barring any
complications. In a "best-case scenario," Ware would begin to show
signs of healing within 8-12 weeks. In other words, the injury is not likely a
career-ending one.
However, the three most common
complications for open fractures are infection, difficulty healing and a
condition called acute compartment syndrome. That develops when pressure builds
in the muscles surrounding the injury. This very painful and can cause tissue
death if the pressure is not relieved.
If Ware's leg doesn't heal
properly, he may need more surgery.
Should we be more
concerned now and discourage our children from playing basketball since these
injuries occur?
Before leaving the court on that
fateful day, Ware reportedly told his teammates to focus on winning the
game. “Win the game. Just win the game!”.
The gruesome injury and words
apparently left his teammates in tears, and they went on to win the game.
A photo
posted on the Internet shows his jubilant teammates holding up Ware's jersey as
they celebrated their win. Another showed Ware in his hospital bed, holding the
trophy his teammates brought to him.
www.grizzlybomb.com |
So my
answer to the question is NO. We should not get disheartened when injuries like
these happen. Because we all know that everything happens for a reason.
Kevin
Ware himself was not disheartened. Remember he was more concerned for his team
to win. It can serve as an inspiration to any injured player. As a good friend of
mine from Medical school commented, “If you'll pardon the expression, Ware has
balls of titanium and now a leg to match”.
And besides, you can always call
your friendly and well-trained orthopedic surgeon to put back your bones (and
possibly your life) together again.