Surgeons: Tiger Woods’ return to elite golf will be ‘very challenging

Tiger Woods has triumphed over the greatest challenges possible on a golf course. But he has never faced a test like the one that’s before him now.

Woods suffered severe injuries to his legs in a one-car rollover on a Los Angeles area street Tuesday morning. He was driving on a winding residential road when his SUV hit a sign, a curb, crossed over two lanes of oncoming traffic, traveled down into a gully and ended up driver’s-side down. The fact that Woods survived that initial impact was the first good sign.

Woods was conscious when first responders arrived on the scene, and “awake” and “responsive,” according to his team, late Tuesday evening. Between those times, though, he underwent hours of extensive surgery, the first steps in what will be a long and arduous recovery.

Two questions face Woods, one immediate and crucial, the other long-term and aspirational. First, can Woods have a normal life, with typical mobility and freedom from pain? Second, can one of the world’s best-known athletes ever return to competitive golf?

Yahoo Sports spoke to several surgeons with extensive experience in treating injuries similar to those Woods suffered. Without having reviewed Woods’ specific case file — and with the caveat that there may be undisclosed elements of Woods’ case that could impact any prognosis — all agreed that a return to a normal life is highly likely, and a return to elite-level golf isn’t out of the question.

“Tiger has a very, very, very long road to recovery ahead,” said Dr. Kirk Campbell, an orthopedic surgeon at NYU Langone Health, “and based on the information we have, returning to being an elite golfer would be very challenging. But I would not root against him.”

The simple fact that Woods is in treatment at all, given the way his SUV left the road and came to rest, is good news.

“Any time there is a rollover accident where the car gets off four wheels, you can die,” said Dr. Brian Polsky, an orthopedic surgeon at the Centers for Advanced Orthopedics in Washington, D.C. “The trauma involved in that is very unpredictable, even with seatbelts and airbags. From that standpoint alone, he’s fortunate.”

Late Tuesday evening, Woods’ team released a statement documenting the extent of his injuries. Dr. Anish Mahajan, CMO and interim CEO at Harbor-UCLA Medical Center, indicated that Woods suffered “significant orthopaedic injuries to his right lower extremity.” In detail, those known injuries and treatments included:
Comminuted open fractures on both the tibia and fibula.
“Comminuted” means Woods’ bones broke into more than two pieces. “Open” means the bones broke through the skin.

“The bone saw the outside world, which is very bad,” Polsky said. “That means there’s a significant increase of infection.”
Insertion of a rod to stabilize the tibia.

Doctors inserted an intramedullary nail in Woods’ tibia, running it from his knee toward his ankle. The nail is 12 to 16 inches long, depending on the length of the patient’s tibia, and will remain in place. This is a standard procedure in cases of this type, and long bones typically heal well.

Insertion of screws and pins to stabilize the foot and ankle.
“This may be the bigger issue,” said Dr. James Gladstone, chief of sports medicine at The Mount Sinai Health System in New York. “If it’s a simple ankle fracture, those can get fixed, and people do very well. If it’s complex or severe, the risk is that the ankle gets stiff during the course of the healing process.”

Surgical release of the covering of muscles of the leg.

“Any muscle has a covering over it like skin,” Gladstone said. “If you’ve had trauma, the muscle swells, and you may have to do a fasciotomy, where you cut that covering to keep the muscle from being strangled.” Fasciotomies often require the wound to be left open in order to let the muscle subside, which in turn increases the risk of infection.

All of these procedures will require a minimum of several days in the hospital, and possibly much more once the trauma team sees how Woods responds to initial treatment. Antibiotics will be a necessity, and likely additional surgical treatments.

“Open fractures can require multiple debridements, which is a fancy word for cleanups,” Polsky said. “That’s not uncommon. He could potentially require additional procedures for skin coverages, skin grafts and muscle grafts, depending on how bad it is.”

Then Woods will leave the hospital, and the real work will begin.

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