Is it October yet? Part 3: Bob Baun

This is the third (and last) in a series of posts looking at historic hockey injuries, intended to keep me busy and you interested while we wait for October to get here.

The history was provided by Jen aka @NHLhistorygirl. Jen is a librarian and graduate student at the University of North Dakota in the last stage of her MA in history: writing her thesis on the 1972 Summit Series, media, and notions of national identity.

Badass Bobby Baun

The history…

Bob Baun is not afraid of pain. During Game 6 of the 1964 Stanley Cup Final, he was hit in the ankle by a Gordie Howe shot. He continued playing, but when he circled to clear the puck from the zone, he heard an audible pop and went down.

The trainers carried Baun off the ice on a stretcher, and an examination of the ankle in the dressing room revealed major swelling and a large welt. Baun insisted the trainer inject painkillers and tape the leg to keep the swelling down. With his leg wrapped from foot to nearly his knee, Baun squeezed back into the skate and finished the period.

For whatever reason though, the painkiller wore off quickly, and so Baun needed several more shots. When he returned to the bench in overtime after one of the shots, coach Punch Imlach was sending Carl Brewer and Kent Douglas onto the ice. Baun took Douglas’ place, caught the pass from Bob Pulford, and scored the game winner, tying the series with Detroit at 3-3.

On the train back to Toronto, Baun knew his leg was broken. Imlach knew it too, ordering Baun to see the team doctor at 9 am the next morning. Rather than see the doctor and sit out Game 7, Baun packed an overnight bag and went to a friend’s farm to hide out. He refused to even tell his wife where he was.

After almost two days of hiding, rest, and ice, Baun appeared at Maple Leaf Gardens 30 minutes before Game 7, because he knew that was “too late for them to check me out and stop me from playing.” He suited up and played a shift or two in the 4-0 victory over the Red Wings. He wasn’t allowed to celebrate much, as he was sent almost immediately to hospital, where x-rays revealed a jagged fracture immediately above the ankle, in the fibula.

The medicine…

As broken legs go, fibula fractures are among the most interesting, and yet they get the least attention. Poor fibula fractures. No respect.

Fibuwhat?

The fibula. It’s that other bone in your lower leg. The one you don’t think about. It’s not part of your shin, it doesn’t bear much weight, and when it breaks it doesn’t look anywhere near as spectacular as a broken tibia. It’s also fairly scrawny.

Tibiwho?

The tibia. It’s the bone in your lower leg that you know and love. It’s your shin. It’s the weight-bearer. It’s the one you whack on the coffee table in the dark. When it breaks, it’s generally pretty obvious, and pretty gross.

Anterior (front) view of the right leg

The question is how Bob Baun could last two days and a hockey game with a broken leg. The answer is because it was his fibula that was broken, and because he was an enormous badass. Generally when you break your lower leg, you break the tibia, or the tibia and fibula (which we call a tib-fib fracture because that sounds cooler). The tibia and fibula are attached together by a flat ligament (the interosseous membrane), which is why they’re frequently broken together. In Baun’s case, the isolated lateral force from Howe’s shot resulted in just a fibular fracture.

Treatment

Fibular fractures are fairly easy to treat assuming they’re not open (bone poking through skin), displaced (bone going somewhere it shouldn’t), or comminuted (bone broken into multiple pieces). The first order of business is pain control. Bones are covered by periosteum, a membrane that has the distinction of being lousy with pain receptors. That would be why broken bones hurt so much (SCIENCE!).

Since the fibula is non-weight-bearing (or minimally weight-bearing – a distinction we won’t get into, but that orthopods love to fight about), simple fractures are treated with a cast for the first two or three days, and a pair of crutches if needed. That gives you time to get into the ortho office, where they’ll put you in a walking cast or a cam walker, which you can buy on Amazon, but probably shouldn’t.  They’ll also take away your crutches if you’re still using them. After three to four weeks of immobilization, the cast comes off, and a splint is used on an as-needed basis for exercise. Athletes can generally return to light training after just a few weeks, but full recovery is a six- to eight-week process. Sports that consist of a lot of twisting and trauma to the leg (like hockey or soccer), however, can require a much longer healing period (as much as 18 to 24 weeks) in order to prevent refracture.

As with any injury, the healing process for fibula fractures is helped along by physical therapy, consisting of strengthening exercises and getting yelled at.

The Take-Home

Basically, Bob Baun was a complete animal. He had a fracture that you can walk on, but broken bones HURT. He sucked it up and hid out so he could play in game 7. Smart decision? No, probably not. Understandable? Yes, probably.

Oh, and in case you weren’t aware – hockey season starts again soon. I know, I know, I’m excited too. Many thanks to Jen for collaborating on this series!!!

How Taylor Hall’s Ankle Got High

Thursday, March 3rd Edmonton rookie Taylor Hall had his first career NHL fight against Derek Dorsett of the Columbus Blue Jackets.  The end result was, at best, lame as hell.  After much sweater-holding and getting whacked by Dorsett, the two fell and Hall’s left ankle twisted in a truly awful way.

John Ulan - The Canadian Press/AP

The upshot of all of this is Hall’s season is likely over, and an MRI the day after the fight showed he has a high ankle sprain.  This of course begs the question…

What’s a high ankle sprain, exactly?

Let’s start at the beginning.  A sprain is a stretch or tear in the ligaments that hold a joint together.  Sprains can be mild (just a stretch), or catastrophic – completely torn ligaments, resulting in joint instability.

Ankle sprains are pretty common – usually a result of a twist or misstep – and generally mild. The average ankle sprain is to the anterior talo-fibular ligament, or ATFL – which is fancy talk for “the little ligament that connects the leg bone to the foot bone on the outside of the joint”.  Generally mild sprains heal in a few weeks with no problems and little intervention – rest, ice, maybe an ace wrap, keeping your foot propped up while you mope around the house itching to get back on the ice.

Severe ankle sprains are a different (and ugly) animal.  When ligaments are torn and joints are unstable you’re looking at several weeks of immobilization, medications, and rehab.  Weeks can often extend into months.  Therapies can sometimes extend to surgery.  People who’ve had severe sprains will tell you they can be harder to heal than fractures.

The high ankle sprain in particular is tricky, because it involves several ligaments that actually hold the two bones in the lower leg (the tibia and fibula) together.  The injury is usually because of an outward rotation of the lower leg (see above – feet aren’t supposed to do that).  The problem with a severe high ankle sprain is that obviously you’re going to have a leg that not only hurts, but that can be very, very unstable. Those two bones in the lower leg need to work together as a unit, and if you tear the ligament that holds them together (the interosseus ligament) you’re left with a leg that’s very painful and weak, especially with any kind of twisting motion.

Tearing this is bad news.

A regular ankle sprain can often be braced so that an athlete can return to action sooner with added support in the injured area.  Tape or a plastic brace are used to minimize ‘rolling’ of the ankle joint.  With a high ankle sprain, trying to stabilize the connection between those two bones verges on the impossible – you can’t just squish them together, you have to account for rotational forces as well.  If the damage in a high ankle is bad enough the repair can involve casting the lower leg for several weeks, or a surgical repair (using a screw, wire, or thick suture to fix the tibia and fibula together until the ligaments heal).

Obviously we don’t know how extensive the damage to Hall’s ankle is.  All we know is the basics of the injury.  With luck it’s not severe, and after a few weeks of immobilization and rehab he’ll be back to skating.  It’s safe to assume he’s done for this season, though.  Sorry, Edmonton.

– Jo