Vincenzo Nibali’s or Samir Ait Said’s fracture: which one is worse?

These days, emotions of joy, discouragement, victory, defeat keep following each other unremittingly, at Rio 2016 Olympic Games.

Unfortunately, injuries occur too, and the italian and the french have paid for it.

But beyond any misfortune or the spectacular nature of the injury, who hurt himself the most, and when will they be able to compete in the respective sports again?

Clavicle fracture

Clavicle fracture is a very common event between cyclists.

Often, for a normal person, having a surgery might be not so necessary: there will be just a small, little bit anti-aesthetic humpback in the fracture area.

In a cyclist body, instead, repairing the clavicle as soon as possible becomes a priority, in order to go back to forcing the handlebars again: during a final sprint, in the mountains, downhill.

Nibali will get by with a plaque, some screws and probably, in less than 40 days, he will carefully go back to cycling! Good luck to the “Squalo dello Stretto”!

Two-bone fracture, tibia and fibula

But, undoubtedly, the French athlete wins the award for the unluckiest one.

A two-bone leg fracture is a very serious trauma.

During the vault routine, Samir landed badly and we all clearly saw his leg bending in an unnatural way. The result: a two-bone leg fracture, with a following significant risk of post-traumatic ankle arthrosis.

The surgeon’s challenge

The gymnast will undergo surgery, and the surgeon’s challenge will be to restore the length of both tibia and fibula completely!

It is a problem which goes even further beyond the leg restoration. On the contrary, the main problem lies in restoring correctly the connection between tibia and fibula.

In case of failure, the risk is a deformity.

A too-long fibula means a risk of developing an arthritic valgus ankle.

On the other hand, a too-short fibula increases the risk of having a valgus ankle; enlarged pincers placed between fibula and tibia (syndesmosis) and a progressive, painful and pathologic flat foot: we are talking about patients who manage to walk with feet turned outward, reporting claudication and pain.

Good luck!

We wish Samir Ait Said that it will not be a case of open fracture (that is, when we see the bone breaking through the skin) and that it will be treated with a pin procedure (nail): today, it is possible, without any significant incision and without widening the fracture focus, by increasing the healing velocity.

We can imagine that the French athlete may go back to putting his foot on the ground completely in about 50 days and that he might go back to training in 6-months’ time.


Cartilage damage

The most significant problem he may find during late rehabilitation will be the acknowledgment of a cartilaginous damage (osteochondral lesion of tibia or talus).

In that case, a biological cartilage reconstruction procedure might be necessary, and the recovery would be postponed by some months.

During his physical therapy, we will see the ill-fated champion working in water to restore his walk first and his proprioception at a later stage.

We will see him working with elastic bands and then on floor.

Physiotherapists’ role will follow the surgeon’s one when the bone healing process will be completed.

Good luck to the athlete, the surgeons and physiotherapists!