Yankees Pitcher Joba Chamberlain Fractures Ankle on Trampoline
The injury was an open dislocation of Joba’s right ankle. The bone broke through the skin and caused a good amount of blood loss. He was flown to St. Joseph’s hospital in Tampa, FL and immediately underwent surgery.
Many speculate that this may be the end of Joba’s baseball career.
Dr. Silverman Comments
Joba sustained what is reported to be an open ankle fracture. The media reports are full of quotes about how this is a career threatening injury. I tend to disagree as not enough information about this ankle injury has been presented.
Let’s break this down:
Joba was jumping on a trampoline and sustained an open ankle fracture.
If this was a rotational injury (twisting), then it’s good news. The open laceration was most likely on the inside of the ankle. He was fixed within a few hours of the injury (lowering infection rates), and this type of fracture heals rapidly. Rehabilitation is delayed only a little bit longer than a “closed” (not associated with a skin) injury. I would expect him to begin walking on this type of fracture at 4-6 weeks and training by 8 weeks from now. I wouldn’t expect him to miss much of the season at all.
On the other hand, if this injury was associated with higher energy forces, like a direct compression ‘Pilon fracture,’ then all bets are off. Open Pilon fractures are bad actors. They are incredibly hard to predict but they rarely have excellent results. So much energy is concentrated on the ankle joints that the cartilage is damaged beyond repair and joint stability is hard to maintain. They are also much more likely to result in post-traumatic arthritis leading to ankle fusion or ankle replacement.
I expect that Joba sustained the former injury and will recover just fine. At my MN Ankle & Foot Clinic, I really enjoy fixing ankle fractures and use techniques to permit early weight-bearing whenever possible. One of my favorite techniques involves anti-glide plating. This type of fixation uses the force of weight bearing to enhance fracture surface compression, thereby speeding up the healing process. Certain ankle fractures are being treated with arthroscopic techniques to more easily identify and treate chondral (cartilage surface) injuries. Identifying occult ligament injuries are the most challenging aspects of this type of fracture.
I know this will make all adults think twice about jumping with our kids on trampolines. Trampolines are fun but they are dangerous. An article in the British Journal of Bone and Joint Surgery reviewed the recreational use of a trampoline as a significant cause of childhood injury. Nearly 1/3 of all the injuries were to the lower leg and ankle. Most pediatric fractures are treated non-surgically but, in this study, 40% of the children needed surgery. This indicates that the energy of the injury is higher than a similar mechanism of ground level falls.