Embiid Update II – Exit Surgery Enter Sports Science

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November 16, 2014; Los Angeles, CA, USA; Los Angeles Lakers trainer Gary Vitti treats guard

Kobe Bryant

(24) for an injury suffered against the Golden State Warriors during the first half at Staples Center. Mandatory Credit: Gary A. Vasquez-USA TODAY Sports

Modern Miracle Medicine

Fortunately for Joel Embiid, the science of treating Naviscular stress fractures had advanced many times over.

In the past, it was simply considered a simple “car repair” and they bolted bones together as best as they could and sent the athlete back out to smash the bone once more. Now the treatment has improved greatly. What have doctors learned about the injury?Well, breaking down the components, there are three areas to be addressed in the injury.

The first is the diagnosis. Due to the area, and the complexity, of the injury, the imaging of the injury requires more detailed process. A simple XRay may appear completely normal. A true diagnosis can optimally be made with an MRI, a CT scan, or a bone scan. An MRI or a CT scan will allow the fracture orientation to be identified. In addition, those studies will allow determination of whether the fracture is complete or incomplete.

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The second is the injury itself. Due to the location, size, and load bearing features of the foot skeleton, the slightest misalignment of any bone or bones in repair can be devastating. The injury is either “undisplaced” or “displaced”. In an undisplaced injury, the fracture occurs without reorienting the alignment of the bones. Simply casting the foot and staying off that injured foot for the first six weeks can achieve a 90% rate of fully healing after a four month process. Sometimes in an undisplaced injury, surgery is still the best option. This assures the bones remain in alignment throughout the time required to heal the fracture.
In a displaced injury, surgery is required.  The surgeon must now reduce the fracture (set it into exact position), hold it in place with screws, and introduce a bone graft to promote healing of the bone back to full strength.

The third is the vascular system – the blood flow system. The foot is not a well nourished area of the human body in terms of the blood supply it receives. It is at the farthest point from the life giving lungs and blood pumping heart, so it tends to be the least satisfied when the body is subject to any stress.  If you’ve stood outside in the winter for long, you may have experienced a pins and needles feeling in your foot.  That’s just the body cutting blood off to the feet so that more vital organs remain warm and nourished. But that blood is imperative to heal a fractured bone.   So what is there to do…. um…


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