Lingering pain – part three

Broken bones

The tibia, more commonly known as the shinbone, supports the body’s weight.  People break or fracture the tibia more than any other long bone in the body.  The fibula, a narrower bone, runs adjacent to the tibia on the outside of the leg.  Generally, breaking the tibia or fibula is a severe injury requiring speed and collision, incidents such as car accidents, skiing or football. 

 When the bones break, they can fracture and splinter, often penetrating and damaging soft tissue, muscle, membranes, ligaments and tendons.  The broken bones, particularly in motorcycle accidents, often penetrate the skin, which is known as an open fracture.  In most cases, when a tibia or fibula is broken, surgery is required. 

A procedure known as intrameduallary rodding is major surgery.  To maintain the tibia’s alignment, a rod is inserted into the bone through an incision above the knee joint.  Incisions are also made below the knee and above the ankle to assist with alignment.  Often another incision is made at the fracture to further realign the bones.

Screws or nails secure the rod above and below the fracture. In some cases, the screws or nails are never removed. Intrameduallary rodding generally holds the bone together, but there can be complications, particularly infection.  If the surgery doesn’t respond to antibiotics or a post-operative infection sets in, the rod may need to be removed.

In Round 21, 1994, Geelong’s Barry Stoneham broke his fibula.  A plate was inserted to hasten his recovery.  A month after the break, Stoneham was training in a failed comeback to play in the finals

‘Because they tried to get me back really quickly, they put a plate in it to try to make a speedy recovery,’ Stoneham said.
The decision was wrong.  Training was painful.  He couldn’t walk afterwards.  As his team-mates won the preliminary final, Stoneham’s body was rejecting the metal plate screwed to the bone.  The infection was aggressive, so the plate had to come out.  When it was removed, the infection had gnawed at the bone, further delaying his recovery.

Stoneham underwent four operations, maybe five, he can’t remember.  Eventually, 21 screws held his leg together.  He didn’t play for eighteen months, finally coming back in 1996, always looking proppy, unable to regain the form that saw him named as an All-Australian in 1993.

In 2005, Stoneham discussed his injury on Channel Seven. ‘Do everything to the letter as far as recovery goes,’ Stoneham said.  ‘If you worry too much about it, it can really get hold of you.’

Bond worried about his injury when he trained and played, psychologically it damaged me.  Though finals are a stunning lure, the message is obvious; don’t worry about playing until the bone is strong.  Early attempts at coming back can be ruinous. 

Plates and screws used to repair broken tibia or fibula, as in Stoneham’s case, is usually the preferred method when the injury is closer to the knee or ankle.  In these injuries, the bones usually line up well.  Being closer to a joint, the fracture gets more support in recovery than a break toward the middle of the bone.  Simply, a small plate or plates are inserted and screwed to the bone.  The plate can be removed when the injury has healed or left inside to offer further support.

In more severe fractures, particularly open fractures where the bone penetrates the skin, external fixators are used.  The fixator looks like a cage held together with bolts and screws.  Pins penetrate the skin and pierce the bones, holding them in place.  Though an intrameduallary rod is the preferred method, fixators are used when the bone has caused too much damage to soft-tissue, muscle and skin. The external fixator immobilises the bones and lets the doctor treat the open wound.

Following Bond’s second operation, the surgeon used an external fixator to hold the bones in place, proof the break was bad.  The tibia might be the most commonly broken long bone in the body, but it’s also one of the worst to break.  

When Mark Harvey kept breaking his leg in 1987, his weight ballooned.  It wasn’t long before he developed bulimia, an eating disorder linked to depression.  The illness arose because of his inability to regain full fitness.  Through 1987 to 1991, he averaged 13 games a year, his body wracked by bulimia and soft tissue injuries.

Harvey recovered from injury and illness to play in Essendon’s 1993 premiership.  He retired in 1997, having played more than 200 games for the Bombers.  Broken legs don’t always kill off a career.  Certainly they can complicate things, and many footballers come back.  Some, though, are never the same.  Just as many footballers can’t come back.  If they do, often they’re not the same.

Melbourne’s Gary Lyon broke his leg against Footscray at the Western Oval in round 21, 1987.  In the immediate seconds after the incident, Lyon knew something bad had happened.

‘I lifted my leg and it went three ways,’ he said. 

Footage of Lyon getting carried off on a stretcher is either harrowing or hilarious, depending on your perspective.  Lyon was lambasted on The Footy Show a few years ago after bragging about staying calm during the trip off the ground.  He wasn’t calm.  His head was in his hands, face agonised, letting go the sound of horror as he looked at his busted leg.  Lyon battled injury the rest of his career.  The broken leg led to knee problems, but a chronic back injury was worse.

Peter Jonas was a South Australian with a big reputation when he debuted for North Melbourne in 1981.  Unfortunately, reputation counts for nought when injury strikes.  Jonas broke his leg in his first season then broke it again in 1982.  What he might’ve been he never was.  In eight seasons he played 82 games, kicking 115 goals, unable to play as he should’ve, his career ruined by a broken leg and a spate of soft tissue injuries.

In 2005, Richmond’s Nathan Brown broke his leg against Melbourne in round 11.  In a tackle, Brown’s leg buckled under weight of an opponent, the tibia and fibula snapping.  Vision of the injury is shocking.  During surgery, Brown had a 32 centimetre rod inserted into the tibia.  The injury ruined his career.  Prior to the break, Brown had kicked 266 goals in 167 games.  In four seasons following the injury he managed 83 goals from 52 games.  When Fremantle’s Michael Barlow broke his leg in 2010, Brown talked to the Herald-Sun about caution, about being careful while attempting to rebuild a career after surgeons rebuilt the leg.

‘He broke his leg in a very similar way to how I did,’ Brown said. ‘The leg bent right back and it’s a disaster for him and a disaster for Fremantle.  My only advice I could give him is not to rush it.’

Brown tried to come back too soon.  Bond, it seems, did too.  Like most footballers, they wanted to play.  In 2006, Brown’s form was dreadful, ten games for eleven goals.  There were reports he could barely walk after training and playing.  Eventually he was dropped, not just because of poor form, but for pain management.  Bond experienced the same issues.

In 1998, Brisbane was in the middle of a horror streak, two wins from ten games.  In round 11 against Fremantle in Perth, the Lions were behind early.  Voss, trying to set the example for his hapless team-mates, leapt for a contested possession he was never going to get and collided with an opponent.  He heard a loud crack.  The clash, at the 29-minute mark of the first quarter, left him with a broken tibia and fibula.  Naturally, vision of the incident is shocking.

‘When I landed and looked at my leg, the bottom half of the leg swung at a 90-degree angle and then I knew I was in trouble,’ Voss told the ABC’s Stateline program in 1999.

Every footballer who breaks a leg vividly remembers the incident.  The recollections are similar, a loud crack, the leg at right angles, seeing the foot go sideways then feeling the pain.  Voss said he could remember the incident, frame by frame, like watching the replay whenever he wanted.

Bond can do the same.  Whenever he sees a footballer break his leg, that loud crack must resonate through his psyche.

In the aftermath of Voss’s injury, there were legitimate concerns he would never play again.  After five days in a Perth hospital, Voss flew home to Brisbane.  It wasn’t long before he began the comeback.  With the training came the pain.  Running was almost impossible.

‘With every running step I take, it’s sort of like having a metal bar banging up against another metal bar,’ Voss said.  ‘I’d love to train, but I just can’t train.  It’s just too painful.’
Doctor Jim Fardoulys is an orthopaedic surgeon who operated on Voss.  Fardoulys said Voss experienced intense pain during the comeback but was mentally strong enough to play through it.  ‘It’s normal, at this stage,’ Fardoulys said of the pain Voss felt in 1999.  ‘It’s a combination of the pin, which he feels (and) the fracture itself that’s uniting.’

The injury caused Voss problems with the ligaments and muscles in his right leg.  When he played in 1999, his whole leg seemed to ache.  He spent time in a pool to assist with aerobic capacity, rode the exercise bike and used the treadmill.  For a few seasons he barely ran at training because of the pain.  Voss didn’t care.

‘That’s what drives you,’ he said of the ache.  ‘Like that premiership that you want so badly. If you’re in a little bit of pain, then you can put up with that.’

Fardoulys described Voss’s comeback as an amazing achievement.  ‘It was a bad injury,’ he said.  ‘Most people make a comment on how they feel in the stomach when they watch, that’s exactly how bad it was.’

Every broken leg is different.  Some, obviously, are much worse than others.  Bond, like many footballers before and since, tried to come back quickly, chasing the ultimate dream, a premiership.  Playing three months after surgery might’ve seemed premature, but North was second on the ladder with a genuine chance at playing off for the flag, what every footballer wants.  He believed he could help the campaign.  Playing again, so soon and having surgery was a risk, but it might’ve contributed to the issues he’s had later in life.  After his comeback game, he needed more surgery, a heavy price for a chance at glory.  He said it didn’t matter.

‘If House and Oakley carried me off correctly that night I may not have the problems I’m having right now,’ he said.  ‘They had a duty of care to treat me in a proper and meaningful fashion and they didn’t and that’s caused underlying issues ever since.  They really should’ve had me on a stretcher.’

While Bond writhed on the ground in agony, the game went on without him.  None of the players or umpires would’ve been aware of the severity of the injury, the football their focus.  But House and Oakley, both veteran trainers, would’ve recognised the fear in Bond’s eyes.  Within seconds they must’ve known about the ankle.  Surely they could see the break and recognise the sound of a man in agony. 

Without the benefit of vision, it is difficult to understand what happened.  As House and Oakley tended to Bond, the ball might’ve been at the opposite end of the ground.  It might’ve been close.  It is irrelevant.  House and Oakley decided to get Bond off the ground quickly, and that meant carrying him like a chair with his ankle flapping loosely.  Their decision might’ve been made compassionately, a fast attempt at getting him into the rooms for treatment, but holding up the game, immobilising the joint and getting a stretcher, as hundreds of trainers have done throughout history, is best practice for broken legs.  No one playing or watching the night match would’ve begrudged a break in play as Bond was carried off.

‘They should have stopped the game,’ Bond said.  ‘If it was Alex Jesaluenko, Michael Tuck, David Dench or Keith Greig they would’ve stopped the game.’

Robyn said it shouldn’t have mattered who broke their ankle at VFL Park on that cold, May night.  ‘They did the wrong thing and the AFL should offer compensation.  It was a long time ago but it shouldn’t matter.’

In 1958, Ron House joined North Melbourne as trainer to the reserves.  House studied first aid, talked to medical professionals, took night courses and learned how to treat injuries.  During the seventies, North’s golden era, House was the club’s head trainer, urging the players on at training and during games, tending to their aches and pains and repairing injuries.  An experienced and much respected trainer, the Arden Street medical rooms are dedicated to his memory.  The night he ran onto VFL Park to assist Bond, he’d been at North for twenty-two years.  The reasons he decided to carry Bond off instead of calling for a stretcher will never be known.  House died from cancer in 1985. 

By 1985 Kevin Oakley was North’s head trainer.  He’s a life member too, but he’s also dead.  His recollections of Bond’s injury can’t be told.

A basic search of websites produces ample links to AFL footballers breaking their legs.  The vision is compelling and sickening.  Each footballer quickly goes into shock, curled up on the ground, looking in disbelief at their leg, holding it, yelling obscenities and calling for help.  In about twenty seconds, a trainer stands over the stricken man.  Players nearby alert the umpires and the game is stopped at the next available break in play.  In one, maybe two minutes an electric cart comes onto the field and the man is stretchered off.  The process takes about four minutes, maybe five.  In the seventies and eighties, when someone went down, a man carrying a canvas stretcher sprinted onto the ground.  The process, without the cart, didn’t take much longer than five minutes.

With memory and the internet as a guide, through forty years of VFL/AFL football it is difficult to recall a footballer with a broken leg getting chaired off the ground.  It is difficult to recall an incident where the game wasn’t stopped and a stretcher or cart came onto the field.  Club professionals have been adept at diagnosis for decades.  A simple question, what happened, is enough to provide a simple answer, I think I broke my leg.  It is obvious when a man has broken his leg, more obvious than a sprained ankle or ruptured knee.  It is obvious when a man needs a stretcher.

House and Oakley must’ve known Bond’s leg was broken.  Despite all their experience they chaired him off the ground instead of calling for a stretcher.  Bond might be the last, or one of the last VFL/AFL footballers who broke his leg and was chaired off the ground instead of being laid on a stretcher.

  

September 2010

Football was good to Bond.  He played in two grand finals and a night premiership. In the early eighties he was a life insurance agent for VFL Insurance.  Despite getting sacked by North at the end of 1980, his contract was paid out.  In the mid-eighties Bond coached the amateurs for a season and a club in the Essendon District Football League for three seasons.  From 1995 until 1999 he coached the rookie list at Collingwood under Leigh Matthews and Tony Shaw, training about sixty kids, getting them ready to play.  He enjoyed coaching but isn’t interested anymore.

‘I’ve been out of it too long,’ he said.

He doesn’t go to the football much, the disinterest fuelled by the ankle injury, but his frustration with the game is evident, the uncontested possessions, marks and backward kicking.  It’s nothing like the old days, but nothing ever is.  He watches football on television, maintaining a soft spot for Collingwood and North Melbourne.  The achievement, getting selected to play in a grand final, is downplayed.   

‘I’m just one of many guys who played footy and was lucky enough to play in a grand final,’ he said.  ‘It was nice to be involved with it.  I did my best.’

In 1977, the VFL introduced the grand final parade, a motorcade of players and officials up Bourke Street.  The inaugural parade became an instant tradition and is now a major event in the build up to the grand final.  Being part of the first parade is a fond memory.  ‘The Collingwood supporters were fantastic,’ Bond said.  ‘The parade was great.’

The last game he went to was Collingwood and Geelong at the MCG in round nine, 2008.  Bond was one of 88-thousand people who saw the Cats lose their only game for the home and away season.  ‘I didn’t really want to go,’ he said.  It was a work function.  Food and beer was expensive.  The best place to watch football, he said, is at home.  He hasn’t been to a grand final since 1989.  Had it not been for his injury, his career would’ve been different, maybe his passion too. 

Following his fourth operation, Bond needed ten weeks off work.  If the operation isn’t successful, he’ll need an ankle replacement, major surgery where the bones forming the joint are cut out and a metal joint inserted.  The surgery involves a bone graft, metal plates and screws.

‘The AFL should be made to do something,’ Bond said.  ‘House and Oakley failed in their duty of care.’

There is precedent, however different.  Adrian Whitehead was the youngest member of Carlton’s 1995 premiership team, a player on the rise who wasn’t able to live up to his potential.  Two seasons later, in round 20 against Geelong at Kardinia Park, Whitehead injured his foot.  He was treated in the rooms and ran back on.  Following the loss, scans showed major nerve and tendon damage.
Whitehead needed surgery to repair the foot and missed all of 1998.  He came back for one game in 1999 against North at the MCG in round thirteen and retired immediately afterwards.  Two years later, he sued Carlton for negligence.  Integral to his claim for damages was a pain-killing injection he received from the club doctor during the Geelong match in 1997.  The injection numbed his foot.  When he returned to the field, Whitehead was unaware his foot was seriously damaged.  The affidavit said he was unable to protect his foot because of the painkilling injection.

Justice David Byrne handed down his verdict in the Supreme Court in July, 2005, finding there was an entitlement to compensation.  Justice Byrne said the Carlton Football Club wasn’t liable and told Whitehead to seek compensation through the Workers Compensation Act. By 2006, an agreement with Carlton had been reached.  The settlement details remain confidential.

Given the constraints of time, the lack of vision and deaths of House, Oakley and Grant, if Bond were to secure compensation it might set a precedent.  Hundreds of former footballers at every level of competition suffer daily from old injuries, recurring calf tears, swollen knees, hampered shoulders and aching backs.  Bond would have to prove failure in duty of care, that his career was cut short and his life affected because of a decision to chair him off instead of calling for a stretcher.  He’d need to argue his comeback, after twelve weeks, was based on medical advice and not an attempt to play in the finals.  He would need to make examples of footballers who made successful comebacks from broken legs and suggest his career could’ve been the same.

The deaths of House and Oakley might make the case harder, but their testimony isn’t crucial.  If Bond wants to make a case against North Melbourne and the AFL, the vision of him being carried off VFL Park with his ankle flapping should be sought, but it mightn’t be necessary.  Robyn watched on television as her husband was chaired off.  Thousands of people would’ve been watching.  There are living witnesses.  A search of newspaper archives would reveal a story on the game, perhaps with photographs of Bond.  The evidence will be found.  Though some of the principals are dead, many others would give testimony.

‘Find the vision,’ Robyn said at the party.  Integral it may be, thousands of court cases have been successfully won without vision.  To date, it can’t be found.  It might never be found.  It mightn’t matter, not if Bond can prove he was the last, or one of the last footballers with a badly broken leg to be chaired off the ground instead of being rolled onto a stretcher.  Vision of footballers getting treated properly on the internet could be evidence enough.  Testimony from medical professionals would provide further evidence, that best practice dictates a man with a broken leg should be stretchered off instead of carried like a chair.

More than three decades since he was injured, questions about why Bond was chaired off with his ankle flapping need to be addressed.  He could ask former footballers who broke their legs how many operations they had, and at what intervals.  Bond broke his leg in 1979.  More than three decades later, he underwent his fourth operation.  It’d be interesting to see how many others have suffered the same.  It’d be interesting to know if those who didn’t need four operations across three decades were stretchered off instead of chaired off.

Shane Bond played football in a tough era.  He wasn’t a star, but he was good enough to play for Collingwood in two grand finals, good enough to play at North under Barassi.

Injury doesn’t discriminate.  It ruins careers, shattering dreams and causing lingering pain.

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