Many Americans recently witnessed one of the most gruesome sports injuries during this year’s NCAA basketball championship. Kevin Ware, a guard for the University of Louisville, shattered his right lower leg leaving the bone protruding through the skin.
The tibia and fibula are the bones that make up the lower leg. The tibia is larger and is subject to the most pressure. These bones provide support for the muscles that allow ankle mobility.
Bones consist of two principal components. The outer, cortical layer consists of dense, compact bone. The inner, trabecular portion of bone is less dense and consists of a porous structure that contains blood vessels and bone marrow. Bone is primarily made up of calcium phosphate. The structure of bone allows excellent resistance to compressive forces with poor resistance to torsional pressure.
Despite intense physical training, fractures are not uncommon in athletes due to demands placed on the skeletal system and previous injuries that result in micro fractures. Vitamin D deficiency is another potential risk factor in the general population as well as in athletes.
The injury suffered by Kevin Ware involved multiple forces. Landing firmly on the foot produced a compressive, vertical force on the tibia. Unfortunately, there was also an angular, horizontal force that produced torsional pressure. This combination resulted in a severe, displaced fracture.
The injury was further complicated when the fractured bone tore through the skin. A compound fracture like this now creates an opportunity for infection.
Treating a fracture like the one suffered by Kevin Ware consists of immediately protecting the open wound to avoid infection and immobilizing the limb so that the sharp bone edges do not tear into vital blood vessels and nerves.
Surgical repair includes connecting the fractured segments and allowing them to fuse. Early, partial weight bearing will hasten the healing process and allow rehabilitation to begin.
After witnessing the injury suffered by Kevin Ware, it will be exciting to follow his recovery and return to playing basketball at a high level.