Broken skin is a big deal in Tiger Woods comeback

More will be revealed about Tiger Woods’ condition in the days and weeks to come, including his quality of life going forward, not to mention any questions as to whether he might at some point be able to resume. his golf career following a disaster. rollover car accident.

The following statement from Dr. Anish Mahajan, chief medical officer and acting CEO of Harbor-UCLA Medical Center, was posted on Woods’ Twitter account on Wednesday, describing his condition:

“Mr. Woods sustained significant orthopedic injuries to his lower right limb which were treated in emergency surgery by orthopedic trauma specialists at Harbor-UCLA Medical Center, a Level 1 trauma center. The open comminuted fractures affecting the upper and lower portions of the tibia and fibula bones were stabilized by inserting a rod into the tibia.

“Additional injuries to the bones of the foot and ankle were stabilized with a combination of screws and pins. Trauma to the muscle and soft tissue in the leg required surgical release of the muscle blanket to relieve pressure from the swelling.

Dr. Kenneth Jung, Orthopedic Foot and Ankle Surgeon, provided further explanation on this summary. Although Jung was not involved in Woods’ treatment, he spoke in general terms of the type of injuries described, which usually occur in high energy car crashes.

The fact that the injuries occurred to Woods’ lower right leg is not surprising, Jung said, because it usually happens when a driver slams on the brake, as opposed to the left leg, which could be on. the side. The demolished front end of the SUV Woods was driving appeared to have been squeezed and given in by the crash.

The tibia and fibula are the two bones in the lower part of your leg, and a comminuted fracture refers to a bone broken into multiple fragments, as opposed to a clean fracture.

The term “open” means that the bone has pierced the skin and has been exposed to the outside world. This dramatically increases the risk of infection, as happened with Washington football quarterback Alex Smith who suffered a horrific fractured leg which, after subsequent infections, resulted in risk of amputation and was life threatening.

“A lot of people focus on bone injuries, but that’s only part of the story,” said Jung of the Kerlan-Jobe Institute in Los Angeles. “The soft tissue envelope, or skin, is also very important. If you don’t have skin covering the bone, it doesn’t matter how the bone looks or heals.

With Woods, or anyone suffering from an open fracture, those first few days after an accident are essential in charting the way forward.

“It’s usually quite common in the first 24 to 48 hours to bring someone back to the operating room to wash the tissue, rewash the wounds, re-inspect the tissue for necrosis or death. tissue, ”Jung said.

The shin is the shin that you can feel under your skin. If the wounds have trouble healing, doctors may use skin grafts or transfer muscles from other parts of the body to cover this bone.

In his statement on Woods, Mahajan described trauma to the muscle and soft tissue in the leg that required “surgical release” of the fascia covering the muscles. This surgery is done to release the pressure that results from swelling after trauma.

“I tell patients that your muscles are basically in these compartments, almost like sausages,” Jung said. “Imagine boiling a sausage and the meat starts to grow. When you make a slit in the casing of the sausage, the meat swells. It’s similar to what they do with these compartment versions.

Jung said compartment syndrome can occur almost immediately and lead to uncontrollable pain.

A combination of screws and pins were used to stabilize the bones of Woods’ foot and ankle. While screws are typically used to secure fractured bones, pins are often used to stabilize joints that may have been dislocated.

Jung said a common concern is a Lisfranc joint complex injury in the midfoot, again common in car crashes when a driver presses the brake pedal upon impact.

“These injuries are strongly associated with post-traumatic arthritis,” he said. “It would raise concerns in my mind not only for golf but for the future as well. This would manifest as pain and stiffness in the joints of the foot.

Jung said even for the doctors working on Woods, it was far too premature to predict an outcome. At the moment, it all depends on the skin and preventing infections.

“He can have the most perfectly aligned bones, some orthopedic surgeons, they’ve done the greatest job in the world to get everything aligned,” he says. “But if he unfortunately developed an infection, everything would be in danger.”

The road to recovery is probably long. The first few days after this type of injury usually require antibiotic treatment and monitoring for infection and blood flow, according to Dr. Gregory Tennant, orthopedic surgeon at Kaiser Permanente Medical Center in Fontana.

Over the next six to nine months, the focus will likely be on healing bones and wounds, followed by a recovery phase of physiotherapy and rehabilitation.

“I expect me to not wait for him and for him to walk around for a while,” Tennant said.

Although the majority of injuries described by Woods’ doctors are in his lower limbs, the golfer recently had his fifth back surgery. It is possible that the accident affects his recovery.

“Trauma is never really an isolated event,” Tennant said. “It’s not uncommon to identify injuries – even serious injuries – days later when the initial high-energy injuries are being treated.

Ultimately, however, Tennant said Woods is in excellent hands at Harbor-UCLA, which deals with these types of injuries all the time, and that he’s optimistic about the legendary golfer’s recovery.

“Tiger Woods has been a winner his whole life,” he said, “and one thing I’ve learned is that you don’t bet against winners. You are not betting against Michael Jordan. You are not betting against Tiger Woods.