Tua Injury

[docrugby1]

Being used to NU's approach to injuries, I was surprised to see the details of Tua's injuries outlined in a fair amount of detail.

He had a fracture dislocation of his hip. This is similar to the old dashboard injuries(prior to seat belts) in which a direct blow to the knee, with the hip flexed , drives the femoral head against the rear wall of the acetabulum, resulting in a fracture, allowing the hip to dislocate posteriorly

This is a devastating injury for the long term health of the hip. Avascular necrosis of the femoral head(1-20%) and occasionally sciatic nerve injuries, primarily or iatrogenically during surgery, can occur. Emergent reduction of the hip is required. Xrays and CT scans are necessary to see if the femoral head has been fractured or fracture fragments remain in the acetabulum. The posterior wall fragment usually requires internal fixation and that is when the sciatic nerve is at greatest risk because of the distorted anatomy

The finer details of Tua's injuries have not been published such as femoral head fractures or nerve injuries. The reported prognosis of "full recovery" would suggest that neither of these occurred.

After ORIF of the wall fracture, weightbearing can be started after the fracture heals. AVN usually occurs within 2 years of the accident, if it is going to happen at all. Chondrolysis is a rarer problem but that ended Bo Jackson's career-rather than the bone dying , the cartilage coating the femoral heads dies

Let's hope for the best for Tua

 

[Purple Pile Driver]

Being used to NU's approach to injuries, I was surprised to see the details of Tua's injuries outlined in a fair amount of detail.

He had a fracture dislocation of his hip. This is similar to the old dashboard injuries(prior to seat belts) in which a direct blow to the knee, with the hip flexed , drives the femoral head against the rear wall of the acetabulum, resulting in a fracture, allowing the hip to dislocate posteriorly

This is a devastating injury for the long term health of the hip. Avascular necrosis of the femoral head(1-20%) and occasionally sciatic nerve injuries, primarily or iatrogenically during surgery, can occur. Emergent reduction of the hip is required. Xrays and CT scans are necessary to see if the femoral head has been fractured or fracture fragments remain in the acetabulum. The posterior wall fragment usually requires internal fixation and that is when the sciatic nerve is at greatest risk because of the distorted anatomy

The finer details of Tua's injuries have not been published such as femoral head fractures or nerve injuries. The reported prognosis of "full recovery" would suggest that neither of these occurred.

After ORIF of the wall fracture, weightbearing can be started after the fracture heals. AVN usually occurs within 2 years of the accident, if it is going to happen at all. Chondrolysis is a rarer problem but that ended Bo Jackson's career-rather than the bone dying , the cartilage coating the femoral heads dies

Let's hope for the best for Tua

I have no idea what you just said, but this is exhibit A to let kids earn off their likeness and make money before they are incapable of playing.

 

[FanatiCat]

He is an incredible athlete and QB. Truly hope he can get back to full strength.

 

[Hungry Jack]

Wow. I had assumed a “simple” dislocation based on the reports. That’s a devastating injury. It will cost him dearly, I’m afraid. Hope he makes a full recovery.

 

[d'son d]

Being used to NU's approach to injuries, I was surprised to see the details of Tua's injuries outlined in a fair amount of detail.

He had a fracture dislocation of his hip. This is similar to the old dashboard injuries(prior to seat belts) in which a direct blow to the knee, with the hip flexed , drives the femoral head against the rear wall of the acetabulum, resulting in a fracture, allowing the hip to dislocate posteriorly

This is a devastating injury for the long term health of the hip. Avascular necrosis of the femoral head(1-20%) and occasionally sciatic nerve injuries, primarily or iatrogenically during surgery, can occur. Emergent reduction of the hip is required. Xrays and CT scans are necessary to see if the femoral head has been fractured or fracture fragments remain in the acetabulum. The posterior wall fragment usually requires internal fixation and that is when the sciatic nerve is at greatest risk because of the distorted anatomy

The finer details of Tua's injuries have not been published such as femoral head fractures or nerve injuries. The reported prognosis of "full recovery" would suggest that neither of these occurred.

After ORIF of the wall fracture, weightbearing can be started after the fracture heals. AVN usually occurs within 2 years of the accident, if it is going to happen at all. Chondrolysis is a rarer problem but that ended Bo Jackson's career-rather than the bone dying , the cartilage coating the femoral heads dies

Let's hope for the best for Tua

Great description, doc. Unless you are a physician or an orthopod the description, while exact in its nomenclature and process, is not clear to the uninformed. However, hopefully he does not suffer the consequences of this injury and heals to lead a normal like. Whether he returns to greatness is another issue that only time will tell. Hoping for the best, but feel his star is descending.

 

[its_the_sauce]

If this were you or me with no athletic aspirations would they immediately look at hip replacement?

 

[NJCat]

If this were you or me with no athletic aspirations would they immediately look at hip replacement?

I'm not an orthopod.

But I had a hip replacement in my late 50's, and odds are I will need a revision (second hip replacement) at some point according to my doc. They don't last forever. Doing a hip replacement to someone in their 20's would be a last resort option since even a second hip replacement is difficult; three or more during his normal lifespan would be ugly.

 

[Frabjous]

If this were you or me with no athletic aspirations would they immediately look at hip replacement?

A doctor friend says the femoral head becomes necrotic within 24 hours of this kind of injury so, yes, the average person is more likely to have a hip replacement. Tua had surgery in Houston already and he probably got plates & screws put in. Whether he can play football with plates & screws in his hip is another matter.

 

[techtim72]

Reminds me of Robert Griffin's injury history with Washington. He came back early from an injury for a game - at his insistence and with the coach's semi-reluctant concurrence - and got hurt. Never was the same. Tua had a bad ankle injury addressed with what sounded to me like an aggressive surgical repair. No way was he as nimble as normal, mentally or physically. Alabama never should have allowed him on the field and my guess should have shut him down for the year. All for their sacred National Championship. They owe Tua a well paid life pension.

 

[willycat]

Great description, doc. Unless you are a physician or an orthopod the description, while exact in its nomenclature and process, is not clear to the uninformed. However, hopefully he does not suffer the consequences of this injury and heals to lead a normal like. Whether he returns to greatness is another issue that only time will tell. Hoping for the best, but feel his star is descending.

Does that mean the Bears will trade numerous draft picks to move up and draft him?

 

[charcat]

There was speculation Tua would leave for the pros after this year. I wonder if Tua got insurance on his future NFL career? That seems to be a thing these days for expected high draft choices playing another season

 

[hdhntr1]

Does that mean the Bears will trade numerous draft picks to move up and draft him?

Bears will end up without a draft pick for 5 years

 

[docrugby1]

If this were you or me with no athletic aspirations would they immediately look at hip replacement?

No-hip replacement would be considered in a young patient if the femoral head(ball) dies or chondrolysis occurs. Hip replacement usually occurs later in life if arthritic changes occur

 

[EvanstonCat]

Tua plays QB though, so the hip maybe less of an issue than it was for Bo Jackson. Actually, while I'm speaking as if I know what I'm talking about, I completely don't. I'm just speaking out of my ass as usual.

 

[willycat]

I have no idea what you just said, but this is exhibit A to let kids earn off their likeness and make money before they are incapable of playing.

Yep and it looks like Colter was right.

 

[docrugby1]

Reminds me of Robert Griffin's injury history with Washington. He came back early from an injury for a game - at his insistence and with the coach's semi-reluctant concurrence - and got hurt. Never was the same. Tua had a bad ankle injury addressed with what sounded to me like an aggressive surgical repair. No way was he as nimble as normal, mentally or physically. Alabama never should have allowed him on the field and my guess should have shut him down for the year. All for their sacred National Championship. They owe Tua a well paid life pension.

Reminds me of Robert Griffin's injury history with Washington. He came back early from an injury for a game - at his insistence and with the coach's semi-reluctant concurrence - and got hurt. Never was the same. Tua had a bad ankle injury addressed with what sounded to me like an aggressive surgical repair. No way was he as nimble as normal, mentally or physically. Alabama never should have allowed him on the field and my guess should have shut him down for the year. All for their sacred National Championship. They owe Tua a well paid life pension.

Tua suffered a rupture of the distal tibiofibular syndesmosis, possibly resulting in disruption of ankle congruity. This would be the worst type of high ankle sprain. Historically, this injury has been treated with a screw holding the fibula to the tibia, crutches for 3 months , followed by screw removal before the screw breaks
Tua had a newer technique using a device known as a "Tightrope". Instead of a screw, a modern "super" suture replaces the screw. If this was done prophylactically to prevent a high ankle sprain from disrupting the ankle joint then maybe return to play was reasonable(not my patient though) but if the ankle alignment had been altered , then I believe he returned prematurely

 

[docrugby1]

A doctor friend says the femoral head becomes necrotic within 24 hours of this kind of injury so, yes, the average person is more likely to have a hip replacement. Tua had surgery in Houston already and he probably got plates & screws put in. Whether he can play football with plates & screws in his hip is another matter.

Once the fracture of the acetabulum(socket) heals, Tua can begin vigorous rehab. I don't know whether he will make Spring ball but he will be running long before summer camp.

If avascular necrosis or chondrolysis occurs, his career is over

 

[Hungry Jack]

Tua suffered a rupture of the distal tibiofibular syndesmosis, possibly resulting in disruption of ankle congruity. This would be the worst type of high ankle sprain. Historically, this injury has been treated with a screw holding the fibula to the tibia, crutches for 3 months , followed by screw removal before the screw breaks
Tua had a newer technique using a device known as a "Tightrope". Instead of a screw, a modern "super" suture replaces the screw. If this was done prophylactically to prevent a high ankle sprain from disrupting the ankle joint then maybe return to play was reasonable(not my patient though) but if the ankle alignment had been altered , then I believe he returned prematurely

"disruption of ankle congruity" is a great euphemism for "dislocated ankle"