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Kevin Ware. RIGHT TIBIA FRACTURE, FROM THE INJURY AND BACKTO THE GAME Neema Mushi, Caressa Heyward-Bey. Introducing Kevin. Plays basketball for the Louisville Cardinals 20 years of age and was born in The Bronx, New York City, NY He stands at 6’ 2’’ and weighs in at 174 lbs
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Kevin Ware • RIGHT TIBIA FRACTURE, FROM THE INJURY AND BACKTO THE GAME • Neema Mushi, Caressa Heyward-Bey
Introducing Kevin • Plays basketball for the Louisville Cardinals • 20 years of age and was born in The Bronx, New York City, NY • He stands at 6’ 2’’ and weighs in at 174 lbs • He is a back up guard for Peyton Siva and Russ Smith • Suffered from serious injury to his right tibia (oblique fracture)
Details of The Injury • Kevin Ware broke his tibia bone and his fibula while playing in a game on March 31,2013 against Duke University. • He jumped to try to block a shot and when he came down his tibia snap and cut right through his skin. • This injury is one of the most horrific ones we have ever seen on national television
First Response • The head coach (Rick Pitino) quickly covered the leg with a towel and made sure Kevin stayed still and did not move. • His teammates and the opposing team were all in shock and had trouble looking at what just happened. • Kevin was surrounded by teammates that supported him and kept him calm.
http://www.youtube.com/watch?feature=player_detailpage&v=LehpX9bI7rMhttp://www.youtube.com/watch?feature=player_detailpage&v=LehpX9bI7rM • This video is very graphic and may cause some cringing or nausea.
KEVIN WARE • TREATMENT
INITIAL TREATMENT • First step someone should take is to cover the injury to avoid exposure to microorganism and stare. • The athlete should be restricted from movement • Athlete should not be given anything by mouth
LBB(LONG BACK BOARD) • Kevin was secured on the LBB before Hare traction, Normally, You put Hare Traction first and Place the patient on the long back board; the reason the hare traction has to be placed first is to avoid movement of the leg or to avoid further injury of the leg. • There was no excuses but I think they just acted out of shock. • Patient should not be moved or put in any type of medical device without a professional person on scene. • If paramedic present on scene, should act as a CPR provider and not act as a paramedic unless medical command on scene or on the radio operating with him/her
CAVIN WARE’S UNJURY SPLINT • Kevin Ware was splinted with wooden padded boards. • This is good way of securing but Hare traction could done a better job • It wasn’t the best way due to the nature of injury because no circulation restoration and if there was a bleeding, it was going to be hard to control or gauze up the injury • If I was on scene medical provider, I was going to use a Hare traction for optimal care.
EMS ON SCENT • Hare traction • Is the most effective Treatment for Tibia and Femur fractures; Hare traction works in both Open and Close fractures. • Hare traction restore blood circulation distal to the injury and reduce pain. • Hare traction prevent further injury and stabilize the leg • Hare traction make easy to transport the patient to the hospital • Hare traction reduce exposure of the open fracture and make easy to bandage the leg. • http://youtu.be/F0C8-XEu64M
HOSPITAL • Once in the hospital, the patient will be taken for MRI and then Operating Room. For Kevin’s case, OR is necessary.
WHAT HAPPEN IN OR • http://youtu.be/idAqeTHmIf8 • Rodding Intramedullary (IM) In this process, physicians place a metal rod at the center f the tibia t align the bone. • Screws and PlatesDoctors prefer Intramedullary rods than plates for this type of injury but they use plates when necessary . • External FixatorThe external fixation is the final step after the screws and plates. The leg will be put together with the casting • Pain Management. • Kevin Ware will be in pain management medication or treatment from the day of injury to the time he is almost pain free.
AFTER OR TO REHABILITATION. • KEVIN WARE REHABILITATION PERIOD.
The Rehabilitation Process • Regaining range of motion(ROM) • Initial exercises • this is very important because the joints and muscles must regain movement in order to function properly. • Up, down, side to side and circular movements are great given there is no pain. These exercises should be performed at least three times daily.
MORE TIBIA PHYSICAL THERAPY • more advanced exercise should include stretch bands of different resistance.
Rehabilitation Cont. • After restoring range of motion the athlete will be ready to restore flexibility, core stability, balance, muscle strength, endurance and power. • Isometric, isotonic, isokinetic and plyometric exercises will benefit tremendously. • Isometric- muscular contractions against resistance without movement. This is the first phase of rehabilitation • isotonic-opposing muscles contract and there is controlled movement, tension is constant while length of muscle changes. This is the second phase of rehabilitation
isokinetic-uses the weight force of gravity to oppose the force generated by muscle through concentric or eccentric contraction • plyometric-muscles exert maximum force in as short a time as possible, with the goal of increasing both speed and power. This is the last phase of rehabilitation and it will determined when the athlete will go back to work according to his/her performance. • Kevin Ware must work on the strength of his hamstring and quads to carry the leg that was injured.
Rehabilitation Cont. • Reestablishing neuromuscular control • the mind’s attempt to teach the body conscious control of a specific movement. • Doing exercises in front of the mirror so the athlete can see what's being done wrong and the bodies attempt to fix the movement so the mind remembers the correct way. • Mental health or counseling is part of the athlete rehabilitation from the time of the injury through out his/her recovery. This procedure can be continued until the athlete and his/her physician is comfortable to discontinue this treatment.
In Conclusion • Always remember to maintain cardiovascular fitness and incorporate sport specific activities. • As the rehab progresses, make sure the athlete is in good spirits and continue to keep him involved with the sport and the team. • These things are crucial to the return of the athlete and in due time he will return to the sport.
References: • http://www.physioadvisor.com.au/13120850/tibia-fracture-broken-tibia-physioadvisor.htm • http://espn.go.com/blog/collegebasketballnation/post/_/id/84252/one-on-one-kevin-ware-on-his-road-back • http://www.youtube.com/watch?v=LehpX9bI7rM • http://youtu.be/idAqeTHmIf8 • http://youtu.be/F0C8-XEu64M