Nathan Cleary is looking at a long recovery after suffering a compound fracture to his lower left leg in Sunday’s preliminary final, with one expert saying injuries of this magnitude can result in anything from a six-month recovery period to being career-ending.
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injuries → look → period
Cleary suffered the injury in a hip-drop tackle by Newcastle’s Phoenix Crossland with five minutes remaining in the first half of the Panthers’ defeat to the Knights.
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minutes → suffer → Knights
Sideline reports said his broken bone had pierced through his sock, while Penrith sources likened the damage to a “bullet wound”.
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sources → say → wound
Panthers coach Ivan Cleary said afterwards his son was waiting for surgery and would have to “get the other foot done as well”, revealing the fifth metatarsal in his right foot had been broken heading into Sunday’s game.
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metatarsal → say → game
Andrew Higgs, an orthopaedic surgeon at Sydney’s St Vincent’s Hospital, said Cleary’s recovery time would be largely dependent on the exact location and degree of the fracture, although he said it was entirely possible that the halfback could be back for round one of the 2027 NRL season.
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halfback → say → season
That’s because while fractures that pierce the skin look more grisly than closed-wound breaks, the biggest complicating factor is the risk of infection in the open wound rather than the process to repair the broken bone.
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factor → ’ → bone
“Normally, for an ankle fracture, you probably quote about 1.5 per cent infection rate after treatment whereas with an open one, you’re probably anywhere from 10 to 27 or 30 per cent range,” Higgs said.
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Higgs → quote → one
When Cleary was taken into the theatre on Sunday night, it was likely that the first priority was to clean the wound.
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priority → take → wound
“You wash the bone ends out – what we call ‘delivering the bone ends’ – and make sure they’re clean and there’s no sock or clothing or any dirt, any part of the ground in the wound there,” Higgs said.
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Higgs → wash → wound
“And then you fix the fractures as per normal, pretty much.”
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you → fix → fractures
Sometimes if the wounds are really heavily contaminated, multiple surgeries will be carried out to wash out the wound again instead of fixing the fracture straight away.
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surgeries → contaminate → fracture
Patients are also given antibiotics as soon as possible and continue on a course for 72 hours or until the wound is closed.
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wound → give → hours
Higgs said Cleary would probably be given some heavy painkillers including morphine after surgery, but might be on Panadol and anti-inflammatories by the end of the week.
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Cleary → say → week
Given the injuries to both legs, Cleary will probably be in a wheelchair at first, but Higgs said it was possible he would be able to bear weight on both ankles as early as six weeks after surgery.
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he → give → surgery
That’s because the bone in the middle of the tibia and fibula shafts is more cortical, meaning it’s harder and has less blood supply compared to bone near the ankle, the metaphyseal bone, which has greater blood supply and greater capacity to heal.
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which → ’ → supply
The path to recovery will also be longer for Cleary depending on the grading of the fracture.
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path → depend → fracture
“We grade them one, two and three,” Higgs said.
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Higgs → grade → them
“Whereas a grade three would be the most severe one you’d see – in a wartime environment or a severe motor vehicle accident or a severe fall from a height type of thing – these grade ones can occur even from relatively low-energy injuries.”
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ones → see → injuries
Higgs said that based on the available footage of Cleary’s injury, it was more likely he’d suffered a grade one or two compound fracture.
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he → say → fracture
Physiotherapist Brien Seeney agreed it was possible, but not certain, Cleary would be back for round one next season, despite classing Cleary’s injury as the worst he’d seen in the league this year.
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he → agree → league
“Especially in a situation like a football field, where there’s dirt and grass and bacteria and germs all over the place,” said Seeney, known as the NRL Physio on social media.
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Seeney → ’ → media
“So avoiding infection is almost the No.1 priority in these early stages.
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avoiding → avoid → stages
He also warned against comparing Cleary’s injury to the worst-case scenarios of the past, including the career-ending compound fracture suffered by Jharal Yow Yeh.
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He → warn → Yeh
The former Brisbane Broncos and Queensland State of Origin representative picked up several infections after suffering a compound fracture in round four of the 2012 season.
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Broncos → pick → season
Yow Yeh tried to return to rugby league but retired two years later because of the injury.
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Yeh → try → injury
“There are just so many things that can vary in a case like this,” Seeney said.
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Seeney → be → this
“With the Jharal Yow Yeh one, everything that could go wrong did go wrong.
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that → go → one
“So it just shows you that there can be a worst-case scenario, which can be career ending or even career altering, where he’s never the same player.
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he → show → you
But there are also plenty of positive cases where guys come back in six to eight months, and they do really well.
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they → be → months
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