October may have kicked my proverbial derriere. And there hasn’t been an injury update for a few weeks. However, don’t think some of the more odd and potential serious injuries afflicting the NFL’s start have escaped my attention. Fear not my friends, as we will now delve into those injuries which may have been lost amongst the plethora of ACL tears, broken bones, concussions and hamstring strains.
Michael Pittman Jr – Compartment Syndrome
Michael Pittman Jr, the Colts rookie wide receiver, made his return to their line-up this week in their impressive 41-21 win over the Detroit Lions. He had been sidelined since week 3 following surgery for a potentially devastating injury.
Pittman went down in week 3 with an unspecified lower leg injury. He tried to retake the field before finally calling it a day. According to head coach Frank Reich, it wasn’t until after the game Pittman felt the full of effects of the injury. Then the diagnosis emerged – Compartment Syndrome.
So what exactly is compartment syndrome? It is not the run of the mill injury that most sports fans will have heard of. But is, if not treated early, potentially a lot more devastating that some more commonly known problems.
Groups of organs or muscles are organised into specific areas, or “compartments”. Tough, fibrous tissue called fascia form the walls of these compartments.
After an injury, blood or inflammatory fluids can accumulate in the compartment. Fascia does not easily expand. So pressure within a compartment can rise. This may then prevent adequate blood flow to tissues inside the compartment. Severe tissue damage can result. With loss of body function, limb or even death if not treated urgently.
Compartment syndrome is often characterised by the ‘5 P’s’. Pain, Pulselessness, Pallor (pale skin), Paraesthesia (numbness), Paralysis (weakness of limb usually).
So how is it treated? Essentially the only way to treat acute Compartment Syndrome is via surgical intervention. Surgeons are required to release the pressure quickly. Via a procedure known as fasciotomy. Which, in simple terms, involves making long incisions along the skin and opening the fascia to released the pressure – as shown below.
So Pitman may have some nasty scars to contend with. But he still has his limb and is back playing in Week 8 of the season – fantastic!
Trent Brown – Air Embolism
Whilst Michael Pittman’s injury may fall into the ‘rare but unlucky’ category, the recent admission of Trent Brown to hospital is a little more murky.
It emerged that the Raiders monster offensive tackle was wheeled out of the locker room to the Emergency Department just prior to the Las Vegas sides matchup against the Cleveland Browns.
Initial reports suggested that there had been a complication from a pre-game IV. Several NFL teams (up to 75% reported) use pregame intravenous fluid hydration. This is commonly used for players who are known to be fluid sensitive. And are therefore at risk of dehydration associated cramps. It should only be used in these conditions, and when careful monitoring can be undertaken.
IV drips require careful preparation to ensure that no air bubbles are present prior to insertion. Those experienced in administering IV fluids will, or should be, very used to this.
When air is injected into the blood stream it can cause an issue known as an air embolus. An embolus is something that lodges or sticks in blood vessel. Then disrupting or completely blocking blood through that particular vessel. Depending on where this embolus lodges it can have devastating effects. Such as a stoke, heart attack or even prove fatal.
Although Brown has been discharged from the hospital, The Raiders have yet to confirm Brown’s condition. It did prompt Head Coach Jon Gruden to say:
“I’m very glad to report he’s up and seems to be doing well. We’re waiting the results of some of the extensive tests he did today and yesterday.
I don’t have anything to report other than he had an issue. I want to really thank our medical staff. What a job they did in an emergency situation. We’re just happy he’s up and around. Once we get the official word as to what’s wrong with Trent, we’ll let you know.”Yahoo News
Clearly something went wrong. I’m sure the Raiders medical staff will hold a full debrief into the situation. All I can say is I wish Trent Brown well in his recovery
Banner image: Pittman on the ground. Image from trojanswire