Jump to content

Alex Smith - "Devastating Complications" Re: To His Injury


Wally Pryor

Recommended Posts

Ugh.

Washington quarterback Alex Smith‘s recovery from the broken tibia and fibula he suffered last month is reportedly being complicated by an infection.

Eric Bickel of 106.7 The Fan reports that Smith has had “devastating complications” after having surgery on his leg because of a post-op infection. Burgundy Blog reports that Smith will likely require further procedures in order to get rid of the infection.

The team released a statement Thursday saying that Smith and his family “remain strong” and asking others to respect their request for privacy.

Bickel adds that the complications have put his return to the field in jeopardy, although Ian Rapoport of NFL Media reports that it is too early to know about those ramifications.

It’s a serious issue in any event and we hope to hear better news about Smith’s help in the near future regardless of whether it means he’ll be back on the field in 2019.

https://profootballtalk.nbcsports.com/2018/12/06/reports-alex-smith-dealing-with-post-op-infection-in-leg/

 

Link to comment
Share on other sites

If I remember correctly I believe he had a compound fracture correct?  If so, that's what had me worried.  From what I remember (about my own leg and the explanations for ensuing problems) osteomyalitis is all around us, in the air, everywhere.  When you have a compound fracture or open surgery and the bone is exposed there is a very high risk of contracting it.   I thought my infection was gone several times (so did doctors) only for it to come back along with multiple bouts of gangrene.

Hope this is not what Alex is facing, but damn it makes me sick to think he might be.

Edited by SHOOTER12
  • Like 3
Link to comment
Share on other sites

Soccer star Santi Cazorla had his career in the Premier League ended due to similar circumstances. After surgery on his achilles he got a terrible infection and i believe he ended up getting an additional 5-7 surgeries, including taking skin grafts from his arms where he had tattoos of his children's names to repair the damage. Very scary stuff. Sounds like Smith may be in a similar situation. Hope it works out better for him than it did Santi.

Edited by Goo Punch
  • Like 1
Link to comment
Share on other sites

My cousin had an open radius-ulna compound fracture, in BOTH ARMS simultaneously (yes, you're reading that right). Gymnastics fall from the uneven bars. AFter everything was set, she developed compartment syndrome. Miserable, something I wouldn't wish on an enemy. She had to have both arms with the wounds left open for like, two weeks, so the doctors could immediately address any infection/gangrene and ensure the mylein (I think that's right - the muscle sheath) was healing correctly. Also, so much infection. So much.

Not sure that's what Alex Smith is battling specifically, but compound fractures suck in general. More power to him, that's for sure.

Link to comment
Share on other sites

16 minutes ago, capnamerca said:

My cousin had an open radius-ulna compound fracture, in BOTH ARMS simultaneously (yes, you're reading that right). Gymnastics fall from the uneven bars. AFter everything was set, she developed compartment syndrome. Miserable, something I wouldn't wish on an enemy. She had to have both arms with the wounds left open for like, two weeks, so the doctors could immediately address any infection/gangrene and ensure the mylein (I think that's right - the muscle sheath) was healing correctly. Also, so much infection. So much.

Not sure that's what Alex Smith is battling specifically, but compound fractures suck in general. More power to him, that's for sure.

Both arms?  Holy crap, even after all I've been through that about made me hurl thinking about it.

Be leaving the wound open to treat the infection and help drainage is the worst nightmare. After my amputation I still had infection so they had to leave it open for about 10 days and would come in Daily to do a high pressure water debridement on the dead tissue. that was the one and only situation where I was trying to find a way to kill myself. Initially they gave me very little for pain other than morphine and I was literally blacking out from the pain so they started giving me Twilight sleep so I would not go into shock.

Your cousin is one tough son of a gun going through all the way out in one piece

  • Like 6
Link to comment
Share on other sites

Just now, capnamerca said:

She is indeed the toughest person I know. You want to know the best part? She's now a nurse, in the ICU that took care of her (Houston area). 

Did she plan on being a nurse beforehand or did her injury kind of guide her in that direction to helping others?

Link to comment
Share on other sites

1 minute ago, SHOOTER12 said:

Did she plan on being a nurse beforehand or did her injury kind of guide her in that direction to helping others?

I've actually never asked her the question in that context. I think the answer is both, tbh. But I know that since the injury, her goals in life were VERY clear. She's committed to returning to the universe what she was given.

  • Like 2
Link to comment
Share on other sites

Just now, capnamerca said:

I've actually never asked her the question in that context. I think the answer is both, tbh. But I know that since the injury, her goals in life were VERY clear. She's committed to returning to the universe what she was given.

Yes, sometimes wonderful endings start with the roughest of beginnings...

  • Like 1
Link to comment
Share on other sites

16 minutes ago, DigglerontheHoof said:

Man, sorry to read about that.  Hope he can make a full recovery.

I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

Honestly, there's no words to describe it and the hell that goes with it.

Edit..I should say when things go bad, they don't always though.

Edited by SHOOTER12
Link to comment
Share on other sites

10 hours ago, Chad said:

Initially there was a lot of speculation that the injury Alex suffered would end his career. Hate to see a classy player go out that way if that's the case, regardless he'll still be getting paid the big bucks.

he's had a long career of over a decade, and solid performance on the back half of it.  wasnt going to achieve more success with the washington squad, compared to kansas city...good career fulfilled id say

Link to comment
Share on other sites

15 hours ago, DigglerontheHoof said:

Man, sorry to read about that.  Hope he can make a full recovery.

I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

 

Yeah, me as well. Two vertebra included. Damn glad no open compound fractures.

Link to comment
Share on other sites

Some voodoo shit... a close friend of mine makes drunken bar bet with a coworker 4 yrs ago "I bet you $500 alex Smith will be out of the league in 5 years"

my friend tried buying his way out on more than one occasion over the last 18 months as Smith performed well/big contract. Then this shit happens and he's offering a buyout to coworker, who's refusing. 

Link to comment
Share on other sites

Hospital sterility is no joke. These kinds of orthopedic infections are hard to kill, and if/when they napalm the area with high dose strong antibiotics, those drugs are often toxic to the adult stem cells in the marrow, the osteoblasts that remodel bone, and the chondrocytes that remodel cartilage and ligaments. 

Link to comment
Share on other sites

For the Surly TV doctors, a question.  I understand what a compound fracture is, but why does that translate to so much more complication and diciness in terms of the healing process?  I understand why the bone might heal wrong or crooked or somesuch like that, but why does it seem to be orders of magnitude more life and limb threatening?

Link to comment
Share on other sites

3 hours ago, Murfdogg21 said:

Hospital sterility is no joke. These kinds of orthopedic infections are hard to kill, and if/when they napalm the area with high dose strong antibiotics, those drugs are often toxic to the adult stem cells in the marrow, the osteoblasts that remodel bone, and the chondrocytes that remodel cartilage and ligaments. 

Damn.   So I was lucky to not contract anything after my ACL reconstruction.  

  • Like 1
  • Fuck You 2
Link to comment
Share on other sites

Open ("compound") fractures carry higher infection risk because of exposure of normally sterile parts of the body to the unsterile world. Without knowing exactly what was done when for Smith, I am a little limited. A danger is that he was treated like someone with a sports injury when what he needed was to be treated like a trauma patient. Sports surgeons can be jealous of their players and try to manage everything themselves much like they would with an ACL tear.

An open fracture needs early (ASAP) empiric IV antibiotics and fairly early (next day actually OK in many cases, but ASAP not a bad idea) surgery. They need continued antibiotics for days after surgery, unlike the average fracture or other sports surgery. At the time of fixation, they generally should have some debridement (at least exposure and curettage) done in the zone of fracture, as opposed to the typically minimally invasive sports procedure. Bad luck can pull anyone down, but a low-energy open fracture without intrusion in a healthy, young patient is not a super-high infection risk with normal care. Sports is considered low-energy, and under 40 is pretty young still. I am guessing he had a Gustilo grade 2 open injury, for which infection rates have been documented at 2-7% among all comers.

For breaks that look like they are at higher risk of infection, a trauma trick is to put it in an external fixator for a while and come back later for definitive fixation-- I am almost certain that this was not done. There is certainly no shame in proceeding directly to internal fixation, but it can have consequences. The usual way to treat a fracture through the shaft of the tib/fib is a nail ("rod") in the tibia +/- a plate and screws for the fibula, depending on pattern/location of its break. When you have an infection in the tibia and a nail in the tibia, you have infection all the way up and down the medulla ("hollow middle") of the bone. Bad. Antibiotics won't clear an infection in bone with metal still in it.

How "bad" an infection is depends on where it is and how aggressive it is, and to a lesser degree on antibiotic sensitivities. We have antibiotics to kill the more resistant bacteria like MRSA (for now, at least); we just don't like to use them. In the bone (osteomyelitis) and aggressive enough to require cutting out affected tissue are both bad. When we don't know the bug, a common regimen now is Vancomycin and Rocephin for 6 weeks. This is IV. This can destroy kidneys. Once the hardware has been removed from his leg, the tough question becomes whether, when, and what to reimplant based on presumed progress in treating the infection.

I would be surprised to see Smith play another down of football. This looks like Tyrone Prothro redux.

  • Like 3
Link to comment
Share on other sites

11 minutes ago, Magus Ossis said:

Open ("compound") fractures carry higher infection risk because of exposure of normally sterile parts of the body to the unsterile world. Without knowing exactly what was done when for Smith, I am a little limited. A danger is that he was treated like someone with a sports injury when what he needed was to be treated like a trauma patient. Sports surgeons can be jealous of their players and try to manage everything themselves much like they would with an ACL tear.

An open fracture needs early (ASAP) empiric IV antibiotics and fairly early (next day actually OK in many cases, but ASAP not a bad idea) surgery. They need continued antibiotics for days after surgery, unlike the average fracture or other sports surgery. At the time of fixation, they generally should have some debridement (at least exposure and curettage) done in the zone of fracture, as opposed to the typically minimally invasive sports procedure. Bad luck can pull anyone down, but a low-energy open fracture without intrusion in a healthy, young patient is not a super-high infection risk with normal care. Sports is considered low-energy, and under 40 is pretty young still. I am guessing he had a Gustilo grade 2 open injury, for which infection rates have been documented at 2-7% among all comers.

For breaks that look like they are at higher risk of infection, a trauma trick is to put it in an external fixator for a while and come back later for definitive fixation-- I am almost certain that this was not done. There is certainly no shame in proceeding directly to internal fixation, but it can have consequences. The usual way to treat a fracture through the shaft of the tib/fib is a nail ("rod") in the tibia +/- a plate and screws for the fibula, depending on pattern/location of its break. When you have an infection in the tibia and a nail in the tibia, you have infection all the way up and down the medulla ("hollow middle") of the bone. Bad. Antibiotics won't clear an infection in bone with metal still in it.

How "bad" an infection is depends on where it is and how aggressive it is, and to a lesser degree on antibiotic sensitivities. We have antibiotics to kill the more resistant bacteria like MRSA (for now, at least); we just don't like to use them. In the bone (osteomyelitis) and aggressive enough to require cutting out affected tissue are both bad. When we don't know the bug, a common regimen now is Vancomycin and Rocephin for 6 weeks. This is IV. This can destroy kidneys. Once the hardware has been removed from his leg, the tough question becomes whether, when, and what to reimplant based on presumed progress in treating the infection.

I would be surprised to see Smith play another down of football. This looks like Tyrone Prothro redux.

Prothro almost lost his leg as well.  He was certainly done with football.  I wonder if Alabama is compensating him in some form?

  • Like 1
Link to comment
Share on other sites

20 hours ago, Magus Ossis said:

Open ("compound") fractures carry higher infection risk because of exposure of normally sterile parts of the body to the unsterile world. Without knowing exactly what was done when for Smith, I am a little limited. A danger is that he was treated like someone with a sports injury when what he needed was to be treated like a trauma patient. Sports surgeons can be jealous of their players and try to manage everything themselves much like they would with an ACL tear.

An open fracture needs early (ASAP) empiric IV antibiotics and fairly early (next day actually OK in many cases, but ASAP not a bad idea) surgery. They need continued antibiotics for days after surgery, unlike the average fracture or other sports surgery. At the time of fixation, they generally should have some debridement (at least exposure and curettage) done in the zone of fracture, as opposed to the typically minimally invasive sports procedure. Bad luck can pull anyone down, but a low-energy open fracture without intrusion in a healthy, young patient is not a super-high infection risk with normal care. Sports is considered low-energy, and under 40 is pretty young still. I am guessing he had a Gustilo grade 2 open injury, for which infection rates have been documented at 2-7% among all comers.

For breaks that look like they are at higher risk of infection, a trauma trick is to put it in an external fixator for a while and come back later for definitive fixation-- I am almost certain that this was not done. There is certainly no shame in proceeding directly to internal fixation, but it can have consequences. The usual way to treat a fracture through the shaft of the tib/fib is a nail ("rod") in the tibia +/- a plate and screws for the fibula, depending on pattern/location of its break. When you have an infection in the tibia and a nail in the tibia, you have infection all the way up and down the medulla ("hollow middle") of the bone. Bad. Antibiotics won't clear an infection in bone with metal still in it.

How "bad" an infection is depends on where it is and how aggressive it is, and to a lesser degree on antibiotic sensitivities. We have antibiotics to kill the more resistant bacteria like MRSA (for now, at least); we just don't like to use them. In the bone (osteomyelitis) and aggressive enough to require cutting out affected tissue are both bad. When we don't know the bug, a common regimen now is Vancomycin and Rocephin for 6 weeks. This is IV. This can destroy kidneys. Once the hardware has been removed from his leg, the tough question becomes whether, when, and what to reimplant based on presumed progress in treating the infection.

I would be surprised to see Smith play another down of football. This looks like Tyrone Prothro redux.

Thank you for a very very excellent and informative post reading that I remember how much I heard that I had forgotten thanks again

Link to comment
Share on other sites

22 hours ago, MacLaren said:

Prothro almost lost his leg as well.  He was certainly done with football.  I wonder if Alabama is compensating him in some form?

I’m too lazy to look it up, but I seem to remember some Bama alum hiring him to work at as a bank teller or realtor. Not exactly the glorious end for their best all-time pre-Julio receiver. 

Link to comment
Share on other sites

Man, sorry to read about that.  Hope he can make a full recovery.
I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

I’ve never heard from an actual human cannon ball before, how does one actually join the circus?
  • Like 1
Link to comment
Share on other sites

3 hours ago, Trey3216 said:

You haven’t read through the “wives” thread, have you?

Bad thing is, now he's going to be stuck with her all day every day. He is going to miss being with the boys (teammates) and the traveling that comes with football. Some of these athletes don't know what to do with themselves when it's all over. Football has been all they've known their whole lives. It's one thing to mentally prepare for retirement and go out on your own terms. But it sucks when the one thing you love is taken away in an instant. Doesn't matter how hot his wife is or how much money in the bank he has. He's going to be depressed for awhile.

  • Like 1
Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.



×
×
  • Create New...