David Chao, MD: Multiple Broken Bones May Be The Least of Tiger's Worries, Expect More Surgery to Come

As shocking details of the single car crash involving Tiger Woods continue to emerge, it seems the original assessment of a long recovery and no golf in 2021 may unfortunately be true.

Woods and his people released this statement late Tuesday evening, and below is my interpretation of what it means.

This confirms the significance of his injuries, but thankfully they are not life-threatening, despite an emergency "long surgical procedure." Although the public is focused on the multiple fractures in his right leg, ankle and foot, the real worry is the associated soft tissue injury. The ability for the bones to heal is not the biggest concern here.

The statement acknowledges the "trauma to the muscle and soft-tissue," and this is what needs to be watched carefully. Even complex comminuted (multiple fragments) fractures can heal reliably. However, if the covering around the bone is not viable, that creates an even bigger problem of infection.

The statement acknowledges "comminuted open fracture" where bone fragments punctured through the skin in two different places on the shin. It also indicates there was enough crush injury and force that there is significant worry for swelling such that "surgical release of the covering of the muscle" (fasciotomy) was performed, which means Woods currently still has open wounds to his leg. Thus, the story is not over.

Woods will likely have several additional surgeries, at least to keep the wound clean, to debride dead/damaged tissue and eventually to close the wounds. In such cases, the damage is often so great that there is not enough healthy muscle or skin to cover the bone, and therefore a flap or tissue transfer is needed.

All of this is not to discount the significant bone injury. By report, Woods has a segmental (broken in two separate areas) tibia fracture that is shattered in many pieces. The possibility of further definitive fixation of the bones in the leg/ankle/foot also exists.

The statement does not indicate the presence or absence of nerve or artery injury, and the hope is that this implies there was none. It also makes no mention of the left leg, despite early reports of both legs being injured.

There is no question there was more force and initial damage here than when Washington quarterback Alex Smith suffered an open fracture that needed 17 surgeries and two years of recovery. The hope is that early action for Woods prevents an infection and the resultant complications, but no question this will involve more upcoming surgery and a long road to recovery.

Let's get Tiger out of the hospital and walking before we discuss his golf future. He has beaten long odds to return before with his five back surgeries and spine fusion, but his odds are even longer now.