Yesterday we learned that Paige Pierce had surgery on left lower leg. While she has not specifically said what her surgery was, we can use clues in the picture and from her post to narrow down the likely options.
She posted on Instagram: “Not the post I thought I would be making today. I was very excited to play here in Norway and I know I will get the chance again in the future.
Sometimes life gives you a slippery bridge to cross. I am happy to have such great friends who helped me through the scariest day of my life so far. I am trying to focus on something positive. And for me right now it’s that I am only going to get better starting now, the worst is behind me. That and that I get to see my fur babies a couple months sooner than I thought I would.
To the PP fam- In a few months I’ll be back stronger, with metal plates and screws. Maybe that’ll make me indestructible 😜”
Given the casting and wrapping length, we can easily rule out any knee or higher injuries. If you think about it, splinting the hip for an ankle injury makes as much sense as throwing a Tilt on a distance hyzer line. Sure, you could do it, but it wouldn’t make much sense.
Several types of fractures can require plates and screws. A fracture and a break are the same when talking about bones. Next time you hear someone say, “Fortunately, it’s only a fracture and not broken,” you can giggle to yourself.
The order I’m presenting the information is in a proximal to distal (mid-shin to toes) order and not an order of likelihood. This is also not a commentary on the surgeons, physicians, and other medical professionals that decided to perform the surgery. Several factors can lead to the decision to perform surgery, and neither I nor you are privy to that information. In the United States, HIPPA laws restrict medical professionals from talking about our patients’ private healthcare to anyone they do not authorize us to talk to. Many other countries have similar laws, so we will use our power of deduction to figure this out unless Paige Pierce divulges the information herself.
If you are squeamish, if talking about fractures, blood, and guts makes your stomach turn, you should skip towards the end of the article labeled summary. This is your warning.
SKIP IF SQUEAMISH
If you are still reading, congrats on having an iron stomach; maybe you should consider a healthcare profession.
From what Paige Pierce said in her Instagram post and what Paul Ulibarri said on the Tour Life Podcast, Pierce was walking or running on a wet bridge. Brodie Smith mentioned on the same podcast that this bridge was very slick, and he almost slipped himself. These are all the facts I could find at the time of writing.
Considering what we know, a few scenarios could have happened.
- Pierce started to slip; her shoe caught on a dry patch/crack/edge/something to abruptly stop her foot on the bridge. Her foot could have rotated, causing her to sustain a non-comminuted2 tib-fib fracture.
- Pierce started to slip; her shoe caught on a dry patch/crack/edge/something to abruptly stop her foot on the bridge. Her foot could have rotated, causing her to dislocate her ankle (talus) and likely fracture her tibia and/or fibula.
- Pierce started to slip, tried to catch herself, and sustained an avulsion3 of her peroneus longus tendon4.
Based on the splint length, we can determine that the fracture would be mid-shin at the highest. In that situation, you’re looking at a tib-fib fracture. The tibia is the shin bone you can feel in the front of your leg. The fibula is a bone outside your leg that carries no weight but is an attachment point for muscles and ligaments. In most fibular fractures, the patient is given a walking boot and told to wear it unless showering. There are exceptions to this, but I am presenting the most probable cases.
Paige Pierce could have sustained a few different fractures that would require surgery. One type that would require surgery is a comminuted2 fracture. The surgeon would have to put the pieces back together and hold the pieces together with a plate and screws. However, if a significant amount does not displace the pieces, the doctors may elect to cast rather than surgery.
The second type of fracture requiring immediate surgery is a spiral fracture. If you picture a barber pole, the fracture wraps around the bone in a spiral manner. Because the body tries to splint itself, the muscles would contract, causing the bones to pull together, resulting in her foot not facing forward.
The third type of fracture requiring emergency surgery is an open fracture. An open fracture is where the bone sticks out through the skin. This is a medical emergency because of the high risk of infection and blood loss. Given no posts or stories on social media or podcasts, it’s highly unlikely this happened.
Similar to the first scenario, Paige Pierce slips on the wet bridge. However, rather than sustaining a fracture in the middle of her tibia or fibula, the fracture occurs in the distal portion, down by her ankle joint, of the bone. This can occur because of an ankle dislocation or without the ankle dislocation. In this situation, the tibia, the fibula, or both could fracture. All three options are likely to have surgery and a plate with screws. The talus, one of the ankle bones, is unlikely to have a plate and screws because of the location and contact with other bones.
In this situation, Pierce starts to lose her balance, regains it, and feels a sharp pain outside her foot. This isn’t necessarily a case where a plate would be used, but there are many cases where a screw through the length of the bone would hold the two pieces together.
Those are the likely scenarios that would lead to surgery. Many more factors are considered on top of those listed. I hope this gives you a better idea of the possible mechanism of injury for Paige Pierce. Remember to walk cautiously on wet or uneven surfaces. I wish Paige Pierce a speedy recovery!
1 A non-comminuted fracture is where the bones break into two pieces.
2 A comminuted fracture is one where the bones break into more than two pieces, usually resulting from a car accident or other high-impact trauma.
3 An avulsion means the tendon pulls a piece of the bone away from where it attaches.
4 The peroneus longus is a muscle that runs along the outside of your leg and attaches to the bone that connects to your pinky toe. This is a fairly common fracture in the foot, often referred to as a Jones fracture.