OnTheSnow.com—March 14, 2011
Skiers and riders should consider traveling with contact information for an orthopedic surgeon at home they use, and, wherever they are treated initially, arrange to get “clinical notes, reports or X-rays or MRIs, and operation notes. The most important thing is our talking to the doctor at home.”
Dr. Frank Cordasco is a sports medicine and shoulder surgeon at the Hospital for Special Surgery in New York City who had replaced my left shoulder, damaged in a mountain biking accident at Loon Mountain, N.H.
He sees the folks who return to NYC from Alyeska or Loon or anywhere else with a mountain-related injury.
Cordasco said, “The biggest concern regarding a flight after a lower extremity injury is the potential for a deep venous thrombosis (DVT). This can lead to a fatal pulmonary embolus. This may occur as a result of immobilization of the leg and the effects of a pressurized cabin. Many of these skiing or riding injuries involve the knee. The athlete has often been immobilized in a brace with the knee placed in extension (straight).”
Cordasco and Mills agree, “In general the individual should try to obtain a bulkhead seat or preferably one in business or first class. It would be best to perform some ankle flexion and extension exercises to keep the blood flowing from the leg back to the heart and less likely to form a clot in the leg. Thus, sleeping for the whole flight should be avoided.
“Medications that compromise platelet (factors in the blood that cause clotting) function such as aspirin are recommended as well,” Cordasco said. “If the injury is one where increased bleeding is a risk, the use of these medications should be discussed with the doctor beforehand.
“The risk of DVT is also present with upper extremity injuries such as a shoulder fracture or dislocation, but to a lesser extent. The recommendations above apply.
“The athlete should certainly see an orthopaedic surgeon within one or two days of arrival home.”
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