KUBICA REHAB COULD BE SIX MONTHS OR MORE

Hand reconstruction specialists in Italy are working hard to save the functionality of Robert Kubica’s right hand tonight after a high speed accident in a rally car this morning.

There were reports initially that the Pole risked losing the hand, but that risk has now passed. However it seems that the rehabilitation from a crush injury such as this can be six months or more, which means that the Renault driver may miss the bulk of the season.

Tonight I called a friend in London, Richard Young, who is a plastic surgeon specialising in hand reconstruction at Chelsea and Westminster Hospital, for some insight into hand crush injury, of which he has extensive experience.

I wanted to know what the risks are in a situation such as this and likely recovery times. The caveat for all of what follows is that we do not know the precise details and therefore this is not a specific prognosis on Kubica, more some general medical principles for background understanding.

Apparently when they say a hand is at risk of amputation it is because the blood supply, via blood vessels, to the hand has been severed. That is the first thing to restore and that has clearly been done. So now it’s a question of whether the doctors can restore full functionality, to the level which an F1 driver needs. This means repairing the nerves and tendons and their work will determine whether Kubica will race again. How long the recuperation will take depends on how severe the injury was in the first place.

The first point is that the energy in the accident was clearly very great if it also caused long bone injury such as the broken leg and arm which Kubica suffered. Kubica’s hand appears to have been crushed by some armco entering the cockpit. So the extent of the hand crush injury is likely to be severe.

The hand has many small muscles, tendons and nerves which if crushed are likely to reduce the ability to roll the fingers in and to make fine movements, such as picking up a pin or in the case of an F1 driver, operate the buttons and dials on the steering wheel. Damage to the nerves will impair feeling and this can take at least three months to return.

As for rehabilitation it is long – maybe six months or more depending on the severity of the crush – and crucially there is no short cut. Sometimes when athletes break a bone they can speed up the repair by sitting in a chamber to boost oxygen or blood flow, but that will not apply in this case.

Here we are dealing with tendons and these must be protected for up to three months before any effort can be put through them, otherwise the tendons rupture again. Also if there is severe damage to nerves in the forearm the ability to make fine movements can be lost.

As I said, we haven’t heard from the medical people yet, but these are some of the thoughts and insights of an experienced and active hand reconstruction surgeon.

Source: James Allen on F1