By now everyone has heard of Kevin Ware, the unfortunate basketball player who landed while trying to block a shot and fractured his tibia. It is not the play that has made the news but the type of injury that he sustained that has gotten such attention. His injury has been likened to the injury sustained by Joe Theismann, a career ending injury for the quarterback of the Washington Redskins. Both players sustained not only a fractured tibia but an open fracture which means the fractured bones have penetrated the skin and are exposed. How could this happen? What does this mean for Kevin Ware's future?
This injury was caused by the amount of weight placed on his tibia, the weight bearing bone of the lower leg, and then angle in which he was landing. The tibia snapped like a pencil causing the fracture to pierce through the skin. What can make these such concerning injuries are a number of things. First has the blood supply been disrupted at the level of the fracture? Second, has there been nerve damage? Has the skin been compromised, will the skin be too damaged to repair and need skin grafts to heal over the bone? Lastly, with the bone exposed there is a concern of developing an infection. For all these reasons an open fracture is considered a surgical emergency. The blood supply and nerves must be evaluated and repaired if necessary. Antibiotics must be immediately started. The bone must be stabilized. The time to treatment is extremely important in these cases. "The Golden Hour" is the period of time after an injury is sustained that prompt medical treatment will result in the best outcomes from the injury.
|Example of rod used in repair|
Dr. Alexandra 'Sandie" Grulke