Alex Smith - "Devastating Complications" Re: To His Injury

[Wally Pryor 5,261]

Ugh.

Washington quarterback Alex Smith‘s recovery from the broken tibia and fibula he suffered last month is reportedly being complicated by an infection.

Eric Bickel of 106.7 The Fan reports that Smith has had “devastating complications” after having surgery on his leg because of a post-op infection. Burgundy Blog reports that Smith will likely require further procedures in order to get rid of the infection.

The team released a statement Thursday saying that Smith and his family “remain strong” and asking others to respect their request for privacy.

Bickel adds that the complications have put his return to the field in jeopardy, although Ian Rapoport of NFL Media reports that it is too early to know about those ramifications.

It’s a serious issue in any event and we hope to hear better news about Smith’s help in the near future regardless of whether it means he’ll be back on the field in 2019.

https://profootballtalk.nbcsports.com/2018/12/06/reports-alex-smith-dealing-with-post-op-infection-in-leg/

 

[NAVY 6,740]

Damn. Alex is a class act. Feel better bra 

 

[Underdog 28,685]

Always liked him, hope things get better for him. 

[Patrick Bateman 3,916]

Sucks for Smith, who always seemed like a good egg.  71 million in injury guarantees, so it may wreck the Snyders for the next 2 seasons with salary cap.

[SHOOTER12 8,810]

If I remember correctly I believe he had a compound fracture correct?  If so, that's what had me worried.  From what I remember (about my own leg and the explanations for ensuing problems) osteomyalitis is all around us, in the air, everywhere.  When you have a compound fracture or open surgery and the bone is exposed there is a very high risk of contracting it.   I thought my infection was gone several times (so did doctors) only for it to come back along with multiple bouts of gangrene.

Hope this is not what Alex is facing, but damn it makes me sick to think he might be.

Edited December 6, 2018 by SHOOTER12

[runthebone 7,989]

That's terrible, I hope they can save the leg and that he can walk normally.  He's a likeable guy.

[Hurtlocker 2,212]

7 minutes ago, runthebone said:

That's terrible, I hope they can save the leg and that he can walk normally.  He's a likeable guy.

This.

[Goo Punch 4,275]

Soccer star Santi Cazorla had his career in the Premier League ended due to similar circumstances. After surgery on his achilles he got a terrible infection and i believe he ended up getting an additional 5-7 surgeries, including taking skin grafts from his arms where he had tattoos of his children's names to repair the damage. Very scary stuff. Sounds like Smith may be in a similar situation. Hope it works out better for him than it did Santi.

Edited December 6, 2018 by Goo Punch

[C-Man 27,230]

MRSA, I presume?

[capnamerca 571]

My cousin had an open radius-ulna compound fracture, in BOTH ARMS simultaneously (yes, you're reading that right). Gymnastics fall from the uneven bars. AFter everything was set, she developed compartment syndrome. Miserable, something I wouldn't wish on an enemy. She had to have both arms with the wounds left open for like, two weeks, so the doctors could immediately address any infection/gangrene and ensure the mylein (I think that's right - the muscle sheath) was healing correctly. Also, so much infection. So much.

Not sure that's what Alex Smith is battling specifically, but compound fractures suck in general. More power to him, that's for sure.

[Bone3421 716]

Sucks for smith....hope it goes well and nothing major happens

[Tex Long 4,400]

You definitely don't want your meso sticking out through your ecto. Bad Thing™

[futureman 22,468]

18 minutes ago, C-Man said:

MRSA, I presume?

decent chance as he probably picked this up in the hospital.  he may lose some bone and possibly his career.  sad set of circumstances here. 

[SHOOTER12 8,810]

16 minutes ago, capnamerca said:

My cousin had an open radius-ulna compound fracture, in BOTH ARMS simultaneously (yes, you're reading that right). Gymnastics fall from the uneven bars. AFter everything was set, she developed compartment syndrome. Miserable, something I wouldn't wish on an enemy. She had to have both arms with the wounds left open for like, two weeks, so the doctors could immediately address any infection/gangrene and ensure the mylein (I think that's right - the muscle sheath) was healing correctly. Also, so much infection. So much.

Not sure that's what Alex Smith is battling specifically, but compound fractures suck in general. More power to him, that's for sure.

Both arms?  Holy crap, even after all I've been through that about made me hurl thinking about it.

Be leaving the wound open to treat the infection and help drainage is the worst nightmare. After my amputation I still had infection so they had to leave it open for about 10 days and would come in Daily to do a high pressure water debridement on the dead tissue. that was the one and only situation where I was trying to find a way to kill myself. Initially they gave me very little for pain other than morphine and I was literally blacking out from the pain so they started giving me Twilight sleep so I would not go into shock.

Your cousin is one tough son of a gun going through all the way out in one piece

[SHOOTER12 8,810]

14 minutes ago, futureman said:

decent chance as he probably picked this up in the hospital.  he may lose some bone and possibly his career.  sad set of circumstances here. 

All the prayers I can muster for that man.

[capnamerca 571]

4 minutes ago, SHOOTER12 said:

Both arms?  Holy crap, even after all I've been through that about made me hurl thinking about it.

Be leaving the wound open to treat the infection and help drainage is the worst nightmare. After my amputation I still had infection so they had to leave it open for about 10 days and would come in Daily to do a high pressure water debridement on the dead tissue. that was the one and only situation where I was trying to find a way to kill myself. Initially they gave me very little for pain other than morphine and I was literally blacking out from the pain so they started giving me Twilight sleep so I would not go into shock.

Your cousin is one tough son of a gun going through all the way out in one piece

She is indeed the toughest person I know. You want to know the best part? She's now a nurse, in the ICU that took care of her (Houston area). 

[SHOOTER12 8,810]

Just now, capnamerca said:

She is indeed the toughest person I know. You want to know the best part? She's now a nurse, in the ICU that took care of her (Houston area). 

Did she plan on being a nurse beforehand or did her injury kind of guide her in that direction to helping others?

[capnamerca 571]

1 minute ago, SHOOTER12 said:

Did she plan on being a nurse beforehand or did her injury kind of guide her in that direction to helping others?

I've actually never asked her the question in that context. I think the answer is both, tbh. But I know that since the injury, her goals in life were VERY clear. She's committed to returning to the universe what she was given.

[SHOOTER12 8,810]

Just now, capnamerca said:

I've actually never asked her the question in that context. I think the answer is both, tbh. But I know that since the injury, her goals in life were VERY clear. She's committed to returning to the universe what she was given.

Yes, sometimes wonderful endings start with the roughest of beginnings...

[DigglerontheHoof 21,202]

Man, sorry to read about that.  Hope he can make a full recovery.

I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

[SHOOTER12 8,810]

16 minutes ago, DigglerontheHoof said:

Man, sorry to read about that.  Hope he can make a full recovery.

I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

Honestly, there's no words to describe it and the hell that goes with it.

Edit..I should say when things go bad, they don't always though.

Edited December 6, 2018 by SHOOTER12

[BlueGreySky 1,011]

Yeah, had a few broken bones myself (not compound) and reading about compound fractures and the complications is just making me feel nauseated.  Damn.  T&P for the guy.

Edited December 6, 2018 by BlueGreySky

[Chad 1,728]

Initially there was a lot of speculation that the injury Alex suffered would end his career. Hate to see a classy player go out that way if that's the case, regardless he'll still be getting paid the big bucks.

[Deej 76,800]

Too bad they can't remove the infection and insert it into Joe Theismann.

[Zepol87 9,188]

God damn that sucks

[SHOOTER12 8,810]

5 minutes ago, Deej said:

Too bad they can't remove the infection and insert it into Joe Theismann.

Man, I know you're kidding but I wouldn't wish that on Kim Jon Ill or Un or whatever his name is.

[Richard Kimball 1,495]

IIRC, Tom Brady was reported to have gotten a staph infection after his knee surgery when he tore his ACL/MCL. He made a full recovery. Hope Smith does, also. If I was him, though, I would hang it up. 

[UTGrad98 2,276]

He is being pumped full of vanc levo and zosyn right about now. Depending  on cultures most likely one of those for about 8 weeks will get him where he needs to go. Good luck to the guy . 71 million is a nice consolation.

[Hanrahan 1,306]

Man, I know you're kidding but I wouldn't wish that on Kim Jon Ill or Un or whatever his name is.

But Theismann deserves it.

[Gaelic 63]

4 hours ago, SHOOTER12 said:

Man, I know you're kidding but I wouldn't wish that on Kim Jon Ill or Un or whatever his name is.

I wouldn't even wish it on Kim Jon IV 

[52-80 19,161]

 

[52-80 19,161]

10 hours ago, Chad said:

Initially there was a lot of speculation that the injury Alex suffered would end his career. Hate to see a classy player go out that way if that's the case, regardless he'll still be getting paid the big bucks.

he's had a long career of over a decade, and solid performance on the back half of it.  wasnt going to achieve more success with the washington squad, compared to kansas city...good career fulfilled id say

[G650 14,263]

15 hours ago, DigglerontheHoof said:

Man, sorry to read about that.  Hope he can make a full recovery.

I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

 

Yeah, me as well. Two vertebra included. Damn glad no open compound fractures.

[bluto 4,929]

Some voodoo shit... a close friend of mine makes drunken bar bet with a coworker 4 yrs ago "I bet you $500 alex Smith will be out of the league in 5 years"

my friend tried buying his way out on more than one occasion over the last 18 months as Smith performed well/big contract. Then this shit happens and he's offering a buyout to coworker, who's refusing. 

[Murfdogg21 4,412]

Hospital sterility is no joke. These kinds of orthopedic infections are hard to kill, and if/when they napalm the area with high dose strong antibiotics, those drugs are often toxic to the adult stem cells in the marrow, the osteoblasts that remodel bone, and the chondrocytes that remodel cartilage and ligaments. 

[Wally Pryor 5,261]

18 hours ago, DigglerontheHoof said:

I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  

Dayum.

[Liquor and Poker 3,659]

For the Surly TV doctors, a question.  I understand what a compound fracture is, but why does that translate to so much more complication and diciness in terms of the healing process?  I understand why the bone might heal wrong or crooked or somesuch like that, but why does it seem to be orders of magnitude more life and limb threatening?

[Gaelic 63]

3 hours ago, Murfdogg21 said:

Hospital sterility is no joke. These kinds of orthopedic infections are hard to kill, and if/when they napalm the area with high dose strong antibiotics, those drugs are often toxic to the adult stem cells in the marrow, the osteoblasts that remodel bone, and the chondrocytes that remodel cartilage and ligaments. 

Damn.   So I was lucky to not contract anything after my ACL reconstruction.  

[Gaelic 63]

Not gonna lie.  He's retiring with $71mm and and  a hot ass wife he gets to bang on the reg.   He's got it made.  

[ztejas 43,457]

2 minutes ago, Gaelic said:

Damn.   So I was lucky to not contract anything after my ACL reconstruction.  

Dude enough with the rep shilling. You aren't getting crowdsourced. No one gives a fuck. Just stick to one account. 

[Dennis Taylor 18,829]

[Gaelic 63]

4 minutes ago, Dennis Taylor said:

Torbush

[Magus Ossis 2,800]

Open ("compound") fractures carry higher infection risk because of exposure of normally sterile parts of the body to the unsterile world. Without knowing exactly what was done when for Smith, I am a little limited. A danger is that he was treated like someone with a sports injury when what he needed was to be treated like a trauma patient. Sports surgeons can be jealous of their players and try to manage everything themselves much like they would with an ACL tear.

An open fracture needs early (ASAP) empiric IV antibiotics and fairly early (next day actually OK in many cases, but ASAP not a bad idea) surgery. They need continued antibiotics for days after surgery, unlike the average fracture or other sports surgery. At the time of fixation, they generally should have some debridement (at least exposure and curettage) done in the zone of fracture, as opposed to the typically minimally invasive sports procedure. Bad luck can pull anyone down, but a low-energy open fracture without intrusion in a healthy, young patient is not a super-high infection risk with normal care. Sports is considered low-energy, and under 40 is pretty young still. I am guessing he had a Gustilo grade 2 open injury, for which infection rates have been documented at 2-7% among all comers.

For breaks that look like they are at higher risk of infection, a trauma trick is to put it in an external fixator for a while and come back later for definitive fixation-- I am almost certain that this was not done. There is certainly no shame in proceeding directly to internal fixation, but it can have consequences. The usual way to treat a fracture through the shaft of the tib/fib is a nail ("rod") in the tibia +/- a plate and screws for the fibula, depending on pattern/location of its break. When you have an infection in the tibia and a nail in the tibia, you have infection all the way up and down the medulla ("hollow middle") of the bone. Bad. Antibiotics won't clear an infection in bone with metal still in it.

How "bad" an infection is depends on where it is and how aggressive it is, and to a lesser degree on antibiotic sensitivities. We have antibiotics to kill the more resistant bacteria like MRSA (for now, at least); we just don't like to use them. In the bone (osteomyelitis) and aggressive enough to require cutting out affected tissue are both bad. When we don't know the bug, a common regimen now is Vancomycin and Rocephin for 6 weeks. This is IV. This can destroy kidneys. Once the hardware has been removed from his leg, the tough question becomes whether, when, and what to reimplant based on presumed progress in treating the infection.

I would be surprised to see Smith play another down of football. This looks like Tyrone Prothro redux.

[MacLaren 62]

11 minutes ago, Magus Ossis said:

Open ("compound") fractures carry higher infection risk because of exposure of normally sterile parts of the body to the unsterile world. Without knowing exactly what was done when for Smith, I am a little limited. A danger is that he was treated like someone with a sports injury when what he needed was to be treated like a trauma patient. Sports surgeons can be jealous of their players and try to manage everything themselves much like they would with an ACL tear.

An open fracture needs early (ASAP) empiric IV antibiotics and fairly early (next day actually OK in many cases, but ASAP not a bad idea) surgery. They need continued antibiotics for days after surgery, unlike the average fracture or other sports surgery. At the time of fixation, they generally should have some debridement (at least exposure and curettage) done in the zone of fracture, as opposed to the typically minimally invasive sports procedure. Bad luck can pull anyone down, but a low-energy open fracture without intrusion in a healthy, young patient is not a super-high infection risk with normal care. Sports is considered low-energy, and under 40 is pretty young still. I am guessing he had a Gustilo grade 2 open injury, for which infection rates have been documented at 2-7% among all comers.

For breaks that look like they are at higher risk of infection, a trauma trick is to put it in an external fixator for a while and come back later for definitive fixation-- I am almost certain that this was not done. There is certainly no shame in proceeding directly to internal fixation, but it can have consequences. The usual way to treat a fracture through the shaft of the tib/fib is a nail ("rod") in the tibia +/- a plate and screws for the fibula, depending on pattern/location of its break. When you have an infection in the tibia and a nail in the tibia, you have infection all the way up and down the medulla ("hollow middle") of the bone. Bad. Antibiotics won't clear an infection in bone with metal still in it.

How "bad" an infection is depends on where it is and how aggressive it is, and to a lesser degree on antibiotic sensitivities. We have antibiotics to kill the more resistant bacteria like MRSA (for now, at least); we just don't like to use them. In the bone (osteomyelitis) and aggressive enough to require cutting out affected tissue are both bad. When we don't know the bug, a common regimen now is Vancomycin and Rocephin for 6 weeks. This is IV. This can destroy kidneys. Once the hardware has been removed from his leg, the tough question becomes whether, when, and what to reimplant based on presumed progress in treating the infection.

I would be surprised to see Smith play another down of football. This looks like Tyrone Prothro redux.

Prothro almost lost his leg as well.  He was certainly done with football.  I wonder if Alabama is compensating him in some form?

[SHOOTER12 8,810]

20 hours ago, Magus Ossis said:

Open ("compound") fractures carry higher infection risk because of exposure of normally sterile parts of the body to the unsterile world. Without knowing exactly what was done when for Smith, I am a little limited. A danger is that he was treated like someone with a sports injury when what he needed was to be treated like a trauma patient. Sports surgeons can be jealous of their players and try to manage everything themselves much like they would with an ACL tear.

An open fracture needs early (ASAP) empiric IV antibiotics and fairly early (next day actually OK in many cases, but ASAP not a bad idea) surgery. They need continued antibiotics for days after surgery, unlike the average fracture or other sports surgery. At the time of fixation, they generally should have some debridement (at least exposure and curettage) done in the zone of fracture, as opposed to the typically minimally invasive sports procedure. Bad luck can pull anyone down, but a low-energy open fracture without intrusion in a healthy, young patient is not a super-high infection risk with normal care. Sports is considered low-energy, and under 40 is pretty young still. I am guessing he had a Gustilo grade 2 open injury, for which infection rates have been documented at 2-7% among all comers.

For breaks that look like they are at higher risk of infection, a trauma trick is to put it in an external fixator for a while and come back later for definitive fixation-- I am almost certain that this was not done. There is certainly no shame in proceeding directly to internal fixation, but it can have consequences. The usual way to treat a fracture through the shaft of the tib/fib is a nail ("rod") in the tibia +/- a plate and screws for the fibula, depending on pattern/location of its break. When you have an infection in the tibia and a nail in the tibia, you have infection all the way up and down the medulla ("hollow middle") of the bone. Bad. Antibiotics won't clear an infection in bone with metal still in it.

How "bad" an infection is depends on where it is and how aggressive it is, and to a lesser degree on antibiotic sensitivities. We have antibiotics to kill the more resistant bacteria like MRSA (for now, at least); we just don't like to use them. In the bone (osteomyelitis) and aggressive enough to require cutting out affected tissue are both bad. When we don't know the bug, a common regimen now is Vancomycin and Rocephin for 6 weeks. This is IV. This can destroy kidneys. Once the hardware has been removed from his leg, the tough question becomes whether, when, and what to reimplant based on presumed progress in treating the infection.

I would be surprised to see Smith play another down of football. This looks like Tyrone Prothro redux.

Thank you for a very very excellent and informative post reading that I remember how much I heard that I had forgotten thanks again

[Trey3216 15,346]

20 hours ago, Gaelic said:

Not gonna lie.  He's retiring with $71mm and and  a hot ass wife he gets to bang on the reg.   He's got it made.  

You haven’t read through the “wives” thread, have you?

[Murfdogg21 4,412]

22 hours ago, MacLaren said:

Prothro almost lost his leg as well.  He was certainly done with football.  I wonder if Alabama is compensating him in some form?

I’m too lazy to look it up, but I seem to remember some Bama alum hiring him to work at as a bank teller or realtor. Not exactly the glorious end for their best all-time pre-Julio receiver. 

[Mileslong 4,727]

Man, sorry to read about that.  Hope he can make a full recovery.
I've broken a lot of bones in my day; hip, collarbone, ribs, nose, fingers, toes,  and a femur spiral fracture but I've never had a compound fracture.  After reading this page, I feel damn lucky. 

I’ve never heard from an actual human cannon ball before, how does one actually join the circus?

[Ldogg53 514]

She is indeed the toughest person I know. You want to know the best part? She's now a nurse, in the ICU that took care of her (Houston area). 

Pics of badass ex-gymnast cousin....

[Vic Mackey 47,054]

3 hours ago, Trey3216 said:

You haven’t read through the “wives” thread, have you?

Bad thing is, now he's going to be stuck with her all day every day. He is going to miss being with the boys (teammates) and the traveling that comes with football. Some of these athletes don't know what to do with themselves when it's all over. Football has been all they've known their whole lives. It's one thing to mentally prepare for retirement and go out on your own terms. But it sucks when the one thing you love is taken away in an instant. Doesn't matter how hot his wife is or how much money in the bank he has. He's going to be depressed for awhile.