I think that Anderson Silva’s injury will go down in MMA history as the most notorious and gruesome, freak loss of all time. Silva lost by TKO against Chris Weidman in the second round at MGM's UFC 168 after checking Silva's leg kick. Despite being knocked down in the first round by Weidman, Silva's lost by TKO as a result of a defense tactic. This is the second time in UFC history that a basic Thai block ended with an offensive kncokout. If you are grossed out easily, I would not suggest viewing the images and video links below. After viewing the pictures of these breaks, I think Muay Thai should be defined now as the art of 10 weapons, not 8 (elbows, knees, legs, fists, lower legs).
This fight will be discussed and played over and over in highlight reels and reviews of the year. Everyone writing on the incident is re-capping the fight and fighter's history. Truth be told, I experience no joy watching this injury. However, I am always drawn to the medical procedures used to repair injuries and the path to recovery. The impact of this lower leg contact broke Silva's lower left leg, bending his lower leg in half, almost as if his leg was made of rubber. Silva naturally dropped to the mat is agony. A horrible thing to watch.
Anderson Silva's Leg Break
According a statement made by Dr. Steven Sanders, the UFC’s orthopedic surgeon, “…an intramedullary rod was inserted in Andersons Silva’s tibia. The fibula was stabilized and will not require a separate surgery.”
An intrameduallry rod is also referred to as an inter-locking nail. This metal rod is inserted into the medullary cavity (see photo) of the shin bone (tibia). An incision is made below the knee cap and a hole is made on the top of the tibia bone. Since the tibia is some-what hallow, the surgeon is able to insert the rod, using an X-ray machine to assist with insertion. As the rod is snaked through the cavity it is inserted down the shaft, also re-aligning the broken bones back together. The procedure has been used since 1939, when it was first performed on World War II soldiers for broken femurs(thigh bones). The value of the rod is that it shares the responsibility of the load (or weight of the body) with the damaged bone; instead of fully supporting the bone. This shared responsibility actually promotes a faster recovery. Often an injury like Silva’s is further complicated by the break coming through the skin (which would have been more gruesome), the bones having fragments shattered inside the leg, nerves being severely damaged or displacement/angulation of the fracture itself. Based on what is being reported, it appears as though Silva’s crazy shin break is not as bad as it could have been. Dr. Stevens also reported that no additional surgeries are planned as of early this morning (December 29, 2013), when the rod was inserted post fight.
Clear breaks like this have occurred in many sports. A lower leg break can occur more easily in younger athletes. Impact injuries from sports like football and soccer have lead to many incidents where metal rods were necessary to repair the broken bones (tibia and fibula) of the lower leg.
So what now?
Is it really possible for Silva to come back and fight in 3 to 6 months like some are reporting. Some are comparing this injury to Corey Hill’s leg break in 2008, when he fought in UFC’s Fight for the Troops. The 6’4 Dale Hartt checked Hill’s leg kick, which resulted in a full break of the tibia and fibula, resulting in metal rods and pins surgically implanted in his leg. Hill returned to functional activity after being bedridden for about 3 months. According to a report from MMAJunkie.com, Hill returned to training about 8 months after the pins were removed. It was about 13 months before Hill stepped into the octogon agains stating that, “"The UFC was awesome throughout this whole thing and was so good to me, I feel indebted to them."
Although I doubt much new information will be revealed about the state of his injury, I am hopeful that Silva is going to have a successful recovery. According to Sefany Sarelas, Owner of Telos Physical Therapy in Chicago, " If he (Silva) doesn't have any nerve damamge as a result of the break, he should make a full recovery…It will probably take a year to get back into fighting shape, but 6 months alone to get back to regular activities." Thankfully, the break did not come throught he skin causing severe soft tissue damage on top of the break itself. As with any surgery, the goal is avoid infection and observe the required time needed for stabilization and immobility for the rod and screw to set.
More to come on the type of exercises that first accompany the rehabilation process of a lower leg fracture of this type.