A video diary of a 21-year-old Colorado college student detailing her time stranded in the Wyoming mountains with a fractured ankle has gone viral.
Watch the video.
The star of the video, Lexi DeForest, was hiking with her friend when she attempted to jump across a gorge, fell 8 feet, and fractured her ankle. Her friend immediately went to find help and DeForest turned on her camera to document the ordeal.
Dr. Silverman Comments
This video shows a young girl with a foot bent 90 degrees inwards. This is termed a “supination adduction mechanism”.
The injury is most likely an open (compound) ankle fracture. The most typical fracture would be a bimalleolar fracture in which both the tibia and the fibula bone are broken.
What’s troubling about this video is that she has this dislocated foot position and she is not attempting to self reduce it. The first rule of orthopedics, wilderness medicine, ER medicine, etc. is to realign an injury if possible. In this position, the blood supply of her foot is blocked. If it remains that way for more than 6 hours she will likely lose the foot and end up with a below the knee amputation. Luckily, according to reports, she was found in one hour.
As soon as possible she needs:
- Realignment
- Temporary stabilization
- Appropriate x-rays and possibly a cat scan
- Urgent aggressive surgical debridement of all dirt and dead necrotic tissue
When the tissues are clean and the skin can tolerate it she then needs surgery to stabilize the bones with plates and screws to permit best healing.
These open fractures can take 2-3 times as long to heal as closed fractures because of the damage to the blood supply. Weight bearing needs to be held with such a high energy injury well beyond skin healing (around 3 weeks) and more likely 8-12 weeks. Her doctor needs to worry about infections, nerve injuries, failure of the bone to heal (nonunion), and arthritis.
After the fracture heals, she will need physical therapy to help her return to top strength, balance, and function.
While this horrific event seems like something that could only happen in wilderness terrain, this kind of injury is very common on icy steps and slick city roads.
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