The Olympic Games always bring the highest of the highs and the lowest of the lows for athletes who have trained their whole lives for one moment. There are incredible front-page news stories on the glitz glamour of the gold medalists. On the contrary, I wanted to explain some of the injuries sustained at the start of the Rio Olympic Games. (Of note, I am not the physician taking care of any of the below athletes).
Dr. Lars Engebretsen is the head of medical sciences for the International Olympic Committee and reports that the Summer Games has on average 13 injuries per 100 athletes. His team will be tracking the injuries sustained in these games.
Samir Aït Saïd, a French gymnast sustained an open fracture of his tibia and fibula (the two bones of the lower leg) during the men’s vault qualification. As the tibia sustains the great majority of the weight through our lower leg, it typically requires emergent surgery to clean the wound, correct the deformity and stabilize the leg. From an orthopaedic surgeon perspective, a large metal rod is placed down the tibia (through the center of the cylinder of the bone) and screws help to lock it in place. He is at risk for an infection due to the poking of the bone through the skin. Surgery will allow him to start putting a moderate amount of weight on the leg with crutches. His recovery; however, will be around 6-12 months to consider competing again.
Andranik Karapetyan, an Amerneian weightlifter, experienced an elbow dislocation while competing in the “clean and jerk” event. He was attempting to lift 195 kg, but the weight forced his arm and elbow in a hyperextension direction. His muscles were not able to combat that extreme of force and so it caused his elbow to dislocate. If the injury was not completely able to be diagnosed at the venue, X-rays would be taken to confirm the elbow dislocation. Then depending on how relaxed the muscles are, a reduction (putting the elbow back in place) can be attempted right away or with sedation (relaxing medication). More imaging may be required, such as an MRI, to evaluate for injury to the ligaments of the elbow and any small fracture fragments that may be missed on X-ray. He may be able to recover without surgery, depending on how his ligaments heal.
Cycling had its share of injuries with Richie Porte of Tasmania, Australia fracturing his scapula (shoulder blade) upon crashing at a high speed. The scapula is an important bone as 18 muscles attach to it. The good news with that is when the bone is fractured, many muscles hold it in place so that it can be more stable upon fracturing than your tibia or shin bone. If his fracture does not go into his shoulder joint, then it is likely it can be treated with a sling, rest and eventually physical therapy. He may be able to return in 4-6 weeks.
Vincenzo Nibali, a cyclist from Italy, crashed during the men’s road race and suffered a clavicle (collarbone) fracture. It fractured in a couple different locations, making it more difficult to heal on its own. He will have surgery to either put a plate or a rod to move the pieces into alignment. He may be up and cycling in 4-6 weeks, depending on healing.
Dutch cyclist Annemiek van Vleuten, crashed in the women’s road race. She fractured three vertebrae and suffered a major concussion in this catastrophic crash. She was evaluated and followed in the hospital’s intensive care unit. It is likely that she had X-rays and CT scans to evaluate the extent of the fractures. If the fractures do not involve more than 25-30% of the width of the vertebrae and do not cause impingement on the spine canal nor nerves, then she may be able to recover with a corset like brace
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