A traumatic injury refers to a severe physical injury that occurs suddenly, such as from a vehicle accident or fall, and requires immediate medical attention. These kinds of injuries can range from a single bone fracture to complex injuries, including multiple bones, joints, tendons, ligaments, nerves and/or vascular structures.
A new sub-specialty of surgeons called orthopedic traumatologists, who are specialty trained in treating traumatic injuries of the bones, muscles and soft tissues (orthopedic) has emerged in the United States. Orthopedic traumatologists are surgeons who have chosen to complete additional surgical training in this complex area of medicine.
Northern Arizona University professor Jean Balestrery understands all too well how an orthopedic trauma can be life-threatening and life-altering. She says she owes the use of her left ankle and her ability to walk with an almost-perfect step to Flagstaff orthopedic traumatologist Brandon Clark, D.O., who moved to Flagstaff in 2016, joining the team of surgeons at Northern Arizona Orthopedics.
On July 24, 2017, Balestrery and three friends, one of whom was a wilderness guide, descended into the Grand Canyon, eventually arriving at their destination. The next day, the group hiked to the top of Havasu Falls then took the trail down to the base of the falls to swim in the world-famous pools.
Balestrery left one of the larger pools to enjoy a nearby smaller pool where earlier she had seen others swimming and walking. As she stood to walk across the edge of one of the pools toward the opposite river bank, the unexpected strong current suddenly swept her feet out from under her and within a split second, she found herself grasping to a slippery edge. Balestrery tried to pull herself up and back over the ledge, but the current was too forceful. She could see her friend running toward her to help, but could not hold on and dropped to the fast-moving water far below.
She recalled the traumatic event. “As water slammed me down, the incredible force of the current on top of my body was like a monster. As my body hit the bottom of the deep pool, all I knew to do was thrash my arms, get out of the current and swim upwards. I finally surfaced. I looked at the falls and literally said aloud, ‘That was my life!’
“My friend was yelling at me to swim to him as he extended his hand and then helped me pull myself more than three feet up a ledge and out of the water.”
There was blood in the water and her left foot was dangling to the left, a visible deformity. Balestrery could barely move. Her friends and other hikers carried her on a cot up to the upper trailhead above the pools and falls to wait for help. Nearly an hour later, the village doctor arrived via ATV.
Balestrery was helped onto a metal stretcher, which was strapped on the back of the ATV for the two-mile, 30-minute bumpy crawl up the trail to the small clinic. As she laid on the exam table, she realized just how fortunate she was. Not only could she have drowned but she could have been more severely injured, and now it was time to get to a hospital.
“As a crisis intervention instructor at NAU and with doctorate degrees in anthropology and social work, I knew it was up to me to manage my own crisis and to navigate the challenges associated with getting out of the canyon,” she said.
Approximately four hours after the fall, a Department of Public Safety helicopter arrived to transport her to the trauma center at Flagstaff Medical Center (FMC).
Orthopedic Traumatologist Brandon Clark, D.O., and physician assistant Mike Brown, P.A.-C., were waiting for Balestrery when she arrived at the hospital. Both Dr. Clark and Brown practice at Northern Arizona Orthopaedics, and they also care for patients at FMC.
Tests revealed she had a compound ankle fracture, broken heel and dislocated ankle, as well as numerous cuts over her body. Shortly after arriving at the hospital, Dr. Clark performed the first of three surgeries on her ankle. This first surgery allowed Clark to determine the extent of the injuries and begin to clean the wounds, which were at a high risk of developing infection because of the open wound, protruding bone and bacteria from the water and dirt. The following day brought another similar surgery.
A few days later, Balestrery underwent a lengthy surgery to repair and reconstruct the ankle.
Clark told her that in all his years as an orthopedic traumatologist and surgeon, he had not seen this level of complications in an ankle break.
Eight days after the fall, Balestrery was able to leave the hospital and begin the long rehabilitation process. She needed help at home and could not put any weight on the ankle for several months.
“Dr. Clark had the expertise to put me back together again and he did,” Balestrery said. “Then it was all about physical therapy to get me walking again.”
More than eight months after the traumatic fall, she is still doing intense physical therapy. It may take up to two years of consistent therapy to gain full mobility of the ankle.
“I often heard PT meant for pain and torture. But for me, PT means perseverance and trust. I am so grateful for my physical therapists who have worked with me and encouraged me throughout my rehabilitation and recovery. I know there are no guarantees, but with continued hard work, I plan to fully recover.”
Balestrery says she has had very little pain, except during physical therapy and as she works to stretch the scar tissue, both of which help her increase flexibility and the strength needed to walk as she did before the fall.
“If it was not for Dr. Clark, Mike Brown, Northern Arizona Orthopaedics, Flagstaff Medical Center and DeRosa Physical Therapy, I literally would not be able to walk, much less, walk as well as I do,” she said. “I am so grateful for everyone’s care in getting me back on my feet again, although I may avoid waterfalls from now on.” FBN
By Starla S. Collins, FBN
Orthopaedic Traumatologist Dr. Brandon Clark exams Jean Balestrery’s ankle. Both are pleased with the progress.