As Dr. Vieira mentioned in his blog yesterday, Tiger woods was involved in a serious motor vehicle accident in California two days ago. Initially, news reports mentioned Tiger to have sustained serious injuries to both lower legs, the latest information however seems to indicate his right lower extremity was the primary source of injury.
Tiger was brought to UCLA Medical Center, a level one trauma center and underwent extensive emergency surgery on that right lower leg. Certainly, what they describe is a life-altering combination of injuries that will involve extensive recovery but overall does not seem life-threatening.
A statement was released by Chief Medical Officer at UCLA, Anish Mahajan MD, outlining some details of his operative management. I would like to dissect some of the statements to give better clarity.
Dr. Mahajan’s statement is as follows, “TigerWoods suffered significant orthopaedic injuries to his right lower extremity that were treated during emergency surgery by Orthopaedic trauma specialists at Harbor-UCLA Medical center…”. “Comminuted open fractures affecting both 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 of the leg required surgical release of the coverings of the muscles to relief pressure due to swelling”.
This statement provides amazing insight as to the anatomical areas involved and what the initial procedures addressed. At first glance, we know the fractureswere comminuted, meaning not a simple break andactually involved “shattering” of the bone into multiple small fragments. Obviously, this is more serious than a linear break of the bone and usually will involve a lengthier recovery. We know that the fractures involved the upper portion and lower portions of the lower leg, meaning he can have soft tissue injuries to the knee and/or ankle in addition to possible disruption of the cartilage in the ankle and/or knee. When a break exits through the ankle cartilage this is termed a “pilon” fracture and this will certainly be life altering for Tiger and may require future surgery. We also know the fracture was “open” , meaning the bone did penetrate through the skin which significantly increases the chance for infection as debris from the car accident could enter the body and contaminate his leg. I am sure he is receiving the appropriate antibiotics and an extensive washout of the area was performed. They were able to stabilize the Tibia with a rod, a metallic implant that is inserted into the medullary canal of the bone, that will stabilize his fractures to allow for healing to start. This is good news for Tiger.
Also, his statement indicates Tiger woods had a condition called “Compartment Syndrome”. When he describes surgical release of the coverings of the muscles, this is known as a fasciotomy and the necessary treatment to release elevated muscle compartment pressures. Compartment Syndrome in addition to the fractures being “open” are both surgical emergencies in the orthopaedic world. If fasciotomy is not performed, the blood vessels to the muscles close down from excessive pressures and the muscles can actually die off very quickly.
Lastly, although there was not a great amount of detail, he may have sustained fractures to bones in the foot. It appears they were fixed with screws and plates but I cannot comment on which bones were involved.
We do know he is awake, responsive and recovering at this time and the surgery seemed to go well. Based on the information given, I know Mr. Woods is in good hands with a team of excellent specialists there at UCLA. I wish him a speedy recovery, one without pain and good function. I will keep our patients and followers updated with more details as they come in.