Thread: Big Bens Injury
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Old 11-15-2012, 01:35 PM   #242
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Default Re: Big Bens Injury

Ed.B. of the P-G recommends this article written by a real doctor (as opposed to sportswriters and bloggers who considered pre-med and thought better of it but are now orthopedic specialists)


Demystifying Ben Roethlisberger’s Injury

Another day, another diagnosis. Roethlisberger arrived at the South Side facility early Wednesday morning for the usual team meetings, sporting a black sling to support his right arm. Around that time, Ed Bouchette, who covers the Steelers for the Pittsburgh Post-Gazette, tweeted the following:
Ed Bouchette ‏@EdBouchette

#Steelers Ben Roethlisberger has a rare rib injury that could kill him by pressing against his aorta. Too big risk. Has to wait until heals
Bouchette followed it up later in the day with an article further detailing the potentially lethal injury. This announcement is exactly the type of drama that Coach Tomlin prefers to avoid, and Big Ben certainly didn’t seem to be on death’s door when speaking with reporters. Allow me to clarify some of the hyperbole…

Roethlisberger was told by his physicians that this injury is so rare that the last known case was seen in 1998 in a rugby player. This is, in fact, the only case report in the medical literature and can be found in the British Journal of Sports Medicine from 1999. It should be noted that the rugby player also sustained a fracture to the posterior sternum, so it was actually a more extensive injury. That player took 12 weeks off, until an Xray showed that the fracture had healed completely. Keep in mind that ruby players wear no padding or protection.

Why was this injury potentially fatal? According to Ben (per his physicians), he had a posterior displacement of the first rib, which attaches to the sternum but curves up behind the clavicle. If the rib is pushed back far enough, it can cause serious injury to major blood vessels or the lung, resulting in significant bleeding or a collapsed lung. That is why the QB was taken to the hospital so expediently. This is different than the injury sustained by St. Louis Rams wide receiver Danny Amendola a few weeks ago. Amendola had a posterior dislocation of the clavicle at the SC joint, also an unusual injury. That, too, could have caused injury to a major blood vessels behind the clavicle, and I’m still surprised that his doctor’s supposedly reduced it in the locker room under sedation rather than in a hospital. It sounds like if Roethlisberger had a dislocation of the clavicle, it was displaced anteriorly instead. You can see the difference here:



The million-dollar (or $102 million question) is how long it will take Roethlisberger to return to playing. Initial treatment for this injury is simply immobilizing the arm and wrapping the chest to prevent recurrent dislocation. Surgical repair is rarely indicated; it’s usually not necessary and has a significant complication rate. If he were dealing with only the SC joint sprain, he would likely be out for a week or two. In 2010, warrior QB Brett Favre’s 297-game consecutive start streak was interrupted by the same injury, but he was able to return under center after missing only 1 game.

The rib dislocation is the complicating factor. Given that it is such a rare injury, Roethlisberger’s physicians can only take a wait-and-see approach. Clearly, they will not allow the QB to return to contact before the rib injury is healed or he will be at risk for a recurrent dislocation and the complications that can arise. In the absence of a fracture, however, it may be difficult to gauge the healing. My guess — and it is, of course, just that — is that his doctor’s will monitor the healing based on his pain level.

A conservative estimate would place Roethlisberger on the bench for 6 weeks, which is nearly the rest of the regular season. Then again, where Big Ben is concerned, all bets are off. He has proven his toughness (making his label of “drama queen” laughable) again and again, playing through foot fractures, a broken thumb on his right hand, a high ankle sprain, and even the broken nose delivered by Ravens DT Haloti Ngata last season. The trainers snapped his nose back in place, packed it, and sent him back out to win the game.

The bottom line is that it’s way too soon to predict when Roethlisberger will resume his QB duties, but Coach Tomlin said it best today during a media session, as reported on twitter by an NFL Network reporter:
Aditi Kinkhabwala ‏@AKinkhabwala

Mike Tomlin asked if he expects Ben back this season. Snorts. Then says: “Next question.”
Melanie Friedlander, MD is a board-certified general surgeon.


http://aeryssports.com/aerys-offside...ergers-injury/
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