Medical analysis: Lucas Torreira’s right ankle fracture, return timeline, & impact on his career


Hi it’s Raj from 3CB Performance. First and foremost, with the current COVID-19
pandemic ongoing, I’m wishing you, your family, and friends all the best. For more information, you can check out the
video I made with the help of an infectious disease expert or, even better, go to the
World Health Organization (WHO) website. In the meantime, with the sports and footballing
world on indefinite hiatus, I hope updates on key players and injuries may bring you
much needed distraction and normalcy. Without further adieu: Arsenal and Uruguayan holding midfielder Lucas
Torreira fractured his right ankle vs Portsmouth on March 2nd when his right ankle got caught
between a searing scissor challenge from Portsmouth defender James Bolton. No foul was called and VAR was unavailable. In this video, I’ll explain the ankle fracture
& diagnostic process, Torreira’s return timeline, and if it’ll impact his career
moving forward. The way Torreira’s ankle was caught between
Bolton’s legs indicates that Torreira’s ankle was forced into external (outward) rotation
while taking a direct impact force. This mechanism of injury typically results
in a “Weber type B” fracture. According to a trusted orthopedic surgeon
I regularly consult with, the first priority – and key diagnostic factor – is to assess
the stability of Torreira’s right ankle. The fact that he was able to bear weight through
the ankle and leave the grounds in a walking boot and crutches was an early positive indicator. In the following days, Lucas likely went through
a battery of tests that firstly included an x-ray to assess the type of fracture. If the pattern appeared stable, he underwent
a “stress radiograph” in which the ankle was manually rotated outwards (external rotation)
during an X-ray. If this stress radiograph showed significant
medial (inner aspect of the ankle) gapping – typically anything over 5 mm is considered
significant – then the fracture was considered unstable with surgery indicated. If the imaging suggests a stable fracture
– or borderline – you’re placed into a CAM boot, directed to bear weight as tolerated,
and come back within a week’s time for follow-up xrays in a weight-bearing position. This timeline may help explain Torreira’s
extended consultation with a specialist. Once his follow-up imaging indicated a truly
stable fracture, Lucas went into non-operative protocol. Arsenal gave an initial return to play timeline
of 8 to 10 weeks for Torreira which lines up with the typical RTP timeline after a non-operatively
managed Weber type B fracture. In the following weeks, Lucas will continue
to undergo regularly scheduled CT scans to assess fracture healing. Torreira’s ankle will remain in a CAM boot
until the bone is sufficiently healed with physio focusing on ankle mobility, strength,
and fitness. Prior to the COVID-19 outbreak and delay of
the Premier League season, it was very likely that Torreira’s season was all but over
barring a quicker bone healing response. Now, if the Premier League season does return
– which it sounds like the FA is focused on doing but will ultimately depend on how quickly
the UK implements stricter quarantine – then Lucas could potentially be ready by mid-May. That being said, his rehab process and return
may take longer than normal due to quarantine restrictions and limited access to medical
and training staff, equipment, and Arsenal training grounds. Regardless of what happens to the Premier
League season, the excellent news is that with appropriate rehab and gradual ramping
up of activity to allow for mental and physical re-acclimation, Torreira shouldn’t have
any long-lasting issues. He may experience some ankle stiffness and
discomfort in the short-term but that’s part and parcel with this injury. All in all, he was fortunate to not have a
higher severity, unstable fracture which would’ve required surgery & potentially longer-lasting
implications. That’s a wrap for this video. Thanks for watching. My goal is to provide you with in-depth, evidence
based, narrative free analysis and you can always find me on IG and Twitter @3CBPerformance. Please take care of yourselves and follow
basic precautions to limit your exposure to and spread of COVID-19. Make sure to sub to the channel and follow
along on all social media for the latest updates. 3CB out.

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