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Kevin Ware’s Injury Breakdown

Kevin Ware’s Injury Breakdown

Kevin Ware sustained one of the most gruesome injuries in basketball history during the Louisville-Duke matchup in the Elite 8.  During the first half, Ware leaped out to the 3 point line to attempt a block.  Upon landing, he broke his right tibia, which is typically an excrutiatingly painful and visually disturbing injury.  I won’t show a picture or clip here as you may have a weak stomach, but here is a link to the clip.  If nothing else, you can tell by the reaction of the players and coaches around him – tears, shock, falling to the ground, even some reports of vomiting – that it wasn’t pretty.  The best way to describe it is that it appeared Ware had another knee in the middle of his lower leg.

The tibia is a very important bone, as it is the primary weight bearing bone in the lower leg (its your shin).  The fibula, the thinner bone adjacent to it, is a much easier fracture to handle as it mainly serves as an attachement point for muscles and has much less responsibility in holding us upright.  Tibia fractures are more painful and harder to rehabilitate.  Moreover, Ware had a compound fracture, meaning that the bone broke through the skin.  This invites the possibility of an infection entering the fracture site and, more concerning, the bone itself.  A bone infection is called osteomyelitis and lead to a host of complications. As if that weren’t enough, Ware also has to worry about nerve and blood vessel damage in the lower leg as a result of the fracture.  A compartment syndrome can occur, during which blood accumulate in the leg, choking off nerves and causing permanent damage. In the worst case scenario with poor emergency management, this combined with blood vessel damage can lead to losing a limb.

Here is roughly what the before and after surgery will look like.

Immediately after Ware’s injury, trainers and doctors have 3 main goals: to prevent infection, to ensure the integrity of the nerves and vasculature, and reduce (put back in place) the fracture.  From all reports, they were quite successful at accomplishing this and Ware has already had surgery that went very smoothly. Kudos to the medical staff on hand for a fantastic job. The surgery involved cleaning the site, reducing the bone, and placement of an intermedullary rod, which is a fancy term for using a large nail thorough the shaft of the tibia in order to hold it in place.  Ware will be able to put weight on his leg very soon.

Where my people come in is the rehabilitation, which will be tough but doable.  Ware will have a hard time as a tibia fracture can affect the knee and ankle joint simultaneously.  Fortunately, from what I saw it did not appear to do much damage to the joint surfaces of the bone.  That would only cause even more problems.  Like just about any other surgery in the leg, he will work on range of motion, swelling, strength, balance, agility, endurance, and returning to his sport. I anticipate Ware will try to return for his senior year at Louisville (he is currently a sophomore).

Our prayers go out to Kevin Ware because, quite frankly, that injury sucks.  However, I think eventually he will be OK.  From what it seems, he has a great medical staff to get him through it.

Having these guys around won’t hurt either.

 

 

 

 

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Steve Caronia is a New York City based physical therapist. He hit his shin on an exposed pipe once and nearly passed out. He is not as tough as Kevin Ware.

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