Top 5 Wild Injuries: Number 1: Kurtis Foster

March 19th, 2008, Kurtis Foster crashed into the end boards on a touch icing play, breaking his left femur into 3 pieces and also cracked his kneecap. Again, the videos speak for themselves on the injury.

Foster recalls his kneecap taking the brunt of the hit, and then trying to move his leg, and "in my mind it was moving, but when I looked at my leg it wasn't moving." Foster would endure 9 hours of surgery and have a rod, wires and screws placed in his leg.

Now onto the mechanics of the injury. Femur fractures can be transverse (straight across the bone) or comminuted (into many pieces). Occasionally, these fractures will involve the knee and separate the bone into multiple parts, called an intra-articular fracture. Foster would have had a comminuted fracture because the kneecap wasn't completely broken. Fractures are also open or closed, based on whether or not the bone comes through the skin or not. Open fractures are harder to treat because of the damage to the skin and surrounding tissues. I am unsure whether or not Foster's fracture was open or closed.

Femur fractures are usually caused by high energy injuries, such as Foster's high velocity crash into the boards, aided by the push from Torrey Mitchell. The most common symptoms are pain, swelling and bruising, tenderness to touch, and deformity. Tests performed to diagnose a broken leg are x-rays and CT scans.

Nonsurgical treatment for femur fractures includes skeletal traction and casting or bracing. Traction is a pulley system of weights and counterweights that hold the broken bone together. Casts and braces hold the bone together. Patients do best for healing when they can be up and moving, and motion prevents complications such as knee stiffness, bed sores and clots. For this reason, surgery is more often used.

In an open fracture or a displaced fracture, surgery is done as soon as possible. A displaced fracture is an unstable fracture that has the potential to become an open fracture relatively quickly. In a stable closed fracture, surgery is delayed 1-3 days to prepare the patient for surgery and to come up with a treatment plan. Foster was operated on right away.

If the soft tissue is badly damaged, external fixation is used. This does not apply here. Foster had internal fixation. Internal fixation consists of intramedullary nailing (a specially designed metal rod inserted in the marrow canal of the femur to keep it in position) and plates and screws (the bone fragments are repositioned and held together with screws and plates attached to the outer surface of the bone), Foster had the intramedullary nailing, screws and wires inserted. These are done with one large incision or several smaller ones.

Surgical complications include blood clots and blood loss. Foster later said in an interview that blood loss was an issue during his surgery.

Recovery is best helped by early motion, weight bearing and rehabilitation. Complications include some stiffness, possibility for infection, and bone healing problems.

Foster is currently playing for the Philadelphia Flyers and is an outspoken opponent of touch icing.