Details on Bono’s Bike Accident- OUCH!

You have no doubt heard that Bono had to cancel U2’s gig on The Tonight Show this week because he had to undergo surgery on his arm after a”cycling spill” in Central Park.

Details on the extent of that injury and the surgery required are now coming out, and there is only one word to describe them- OUCH! is reporting that Bono had a “high energy bicycle accident” and:

“The singer suffered numerous serious injuries, including a ‘facial fracture involving the orbit of his eye,’ three separate fractures of his left shoulder blade and a fracture of his left humerus bone in his upper arm. The latter injury was particularly damaging, with the bone shattering in six different places and tearing through his skin.”

Orthopedic surgeon Dean Lorich, MD, described the 5 hour procedure, during which Bono’s “elbow was washed out and debrided, a nerve trapped in the break was moved and the bone was repaired with three metal plates and 18 screws..” He underwent a second surgery on Monday to repair a fractured left pinky finger.

Although he is expected to make a full recovery, Bono will have to undergo “intensive and progressive therapy.”

A few words about fractures

All fractures can be broadly described as:

Closed (simple) fractures are those in which the skin is intact
Open (compound) fractures involve wounds that communicate with the fracture. This frequently occurs when the fractured bone pokes through the skin. This break in the skin can expose the bone to contamination. Open injuries carry a higher risk of infection. According to the above report, Bono had an open fracture.

Other considerations in fracture care are displacement (the  gap between the bone fragments) and angulation. If angulation or displacement is large, reduction (manipulation) of the bone may be required and, especially in adults, may require surgical care. These injuries may take longer to heal than injuries without displacement or angulation.

Compression fractures usually occurs in the vertebrae, for example when the front portion of a vertebra in the spine collapses due to osteoporosis (a medical condition which causes bones to become brittle and susceptible to fracture, with or without trauma).

Other types of fracture are:

  • Complete fracture: A fracture in which bone fragments separate completely.
  • Incomplete fracture: A fracture in which the bone fragments are still partially joined. In such cases, there is a crack in the osseous tissue that does not completely traverse the width of the bone.
  • Linear fracture: A fracture that is parallel to the bone’s long axis.
  • Transverse fracture: A fracture that is at a right angle to the bone’s long axis.
  • Oblique fracture: A fracture that is diagonal to a bone’s long axis.
  • Spiral fracture: A fracture where at least one part of the bone has been twisted.
  • Comminuted fracture: A fracture in which the bone has broken into a number of pieces.
  • Impacted fracture: A fracture caused when bone fragments are driven into each other.
  • Torus fracture: A greenstick, buckle or torus fracture is a fracture in a young, soft bone in which the bone bends and partially breaks.

Fractures of the Humerus (upper arm)

The elbow is a joint where three bones come together. Your upper arm contains one long bone called the humerus and your lower arm contains two long bones called the radius and the ulna. The pointy tip of your elbow is actually part of the ulna and this part is called the olecranon. The close part of the radius bone that makes up part of the elbow joint is called the radial head.

Fractures of the distal humerus (i.e. a break at the end of the humerus closer to the elbow) are fairly uncommon. They account for about 2% of fractures in adults and  may occur in a number of ways:

  • A direct blow. This can happen during a fall (landing directly on the elbow) or by being struck by a hard object (baseball bat, car dashboard or door during a crash).
  • An indirect fracture. This can happen during a fall if a person lands on his or her outstretched arm with the elbow locked straight. The ulna is driven into the distal humerus, causing it to break.

Xrays of:

  • a normal humerus/elbow
  • a distal humerus fracture
  • surgical repair of the injury

Source: American Academy of Orthopedic Surgeons

Scapula Fractures

humerus_and_scapula_posterior_A scapular fracture is a fracture of the scapula, the shoulder blade.

The scapula is the bone that connects the humerus with the clavicle (collar bone). It is a roughly flat triangular bone, which lies over the upper ribs of the back.

The scapula is sturdy and located in a protected place, so it rarely breaks. When it does, it is an indication that the individual was subjected to a considerable amount of force and that severe chest trauma may be present. High-speed vehicle accidents (such as car accidents, motorcycle crashes, or high speed bicycle crashes) are the most common cause.    Occasionally, falls and/or blows to the area can also be responsible. Signs and symptoms are similar to those of other fractures: they include pain, tenderness, and reduced motion of the affected area.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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