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Still Speedy, Thanks To Surgery

Marisa Gilbert loves to play volleyball, and she’ll be playing this fall with an extra dollop of enthusiasm and gratitude. To be on the court at all, she’s already triumphant—never mind the score.

Last November, driving home from a visit to the Storm King Art Center, Gilbert and four of her fellow Marist College students were struck by another car at a country road intersection. The car hit them in the passenger-side front door—where Gilbert was seated. She blacked out momentarily, and when she woke up, she found herself pinned in the car, blood streaming down her face and a large, unusual bump in her right thigh. “I didn’t feel it then, but I knew that it was broken,” she says.

That would be traumatic for anyone, but for Gilbert, 21, it had added significance. The junior digital-media major is a star on the Marist volleyball team. A scholarship to the Division 1 program brought the six-foot-tall middle blocker to Marist from Pflugerville, Texas, near Austin. She made her conference’s All-Rookie team as a freshman and twice was named to the All Academic Team. But now, her season and possibly her career were in jeopardy.

Gilbert’s friends were uninjured, and managed to scramble out of the car and call 9-1-1, parents, coaches, “anyone they could reach,” she says. But it took the jaws of life to pry off the car’s roof to get Gilbert out. The first responders took her by ambulance to a nearby parking lot, while they attended to the five-inch gash in her forehead and stabilized her leg. Then a helicopter arrived to fly her to Westchester Medical Center for emergency surgery. She still didn’t feel much pain—“it must have been the adrenaline or something,” she says—and even managed to joke with the paramedics on the flight. “They asked me my address and I was trying to spell ‘Pflugerville’ for them,” she recalls with a laugh.

In the meantime, her friends had called her coach, who called the Marist athletic director, who in turn called Dan Zelazny, M.D., an orthopedic surgeon who serves as the Marist team physician and also practices at the Medical Center. “He asked me to manage the case, and even though I wasn’t on call that night I was happy to pitch in,” Dr. Zelazny says. Ironically, Gilbert had in fact met him before in his Marist role.

“With athletes you are always worried about peak performance, so there’s a lot riding on everythIng.”
—Dan Zelazny, M.D.

Once she arrived at the hospital, X-rays revealed that her fracture wasn’t particularly bad, Dr. Zelazny says. She also had a tiny fracture in her cervical spine, which did not need surgery but would require a neck brace for a while, an even smaller crack in her lumbar spine that would heal on its own, and the head gash that needed about 10 stitches to close. Her season was definitely over, but none of her injuries were career-threatening.

Still, the broken femur had to be repaired carefully to ensure that she would have the same strength and power she had before the accident. “With athletes you are always worried about peak performance, so there’s a lot riding on everything,” says Dr. Zelazny. If the leg healed improperly, it could end up slightly shorter than the other or rotate off-center. “Inadequate leg length or rotation can affect performance,” he says.

He decided that a titanium rod, placed inside and screwed to the femur, would best prevent such damage. And with minimally invasive surgical techniques, he could implant such a rod using just five very small incisions. The largest, just 2 centimeters across, allowed insertion of the 1-cm.-thick, 40-cm.-long rod. He placed that into the center of the two sections of femur and lined them up, using real-time X-ray fluoroscopy to align them precisely for proper leg length and rotation. He then threaded screws through the other four incisions and into pre-drilled holes in the rod to hold it in place.

Gilbert spent a day and a half in the Intensive Care Unit so doctors could be certain her neck fracture was stabilized, and another day and a half in the main hospital. She was walking, with crutches, the day after her surgery as part of her rehabilitation. “The bone is actually the least of the issues with rehab,” Dr. Zelazny says. He explains that it takes a lot of energy to fracture a femur, the largest bone in the body. “Much of that energy has gone through the entire leg, so many of the muscles and other structures are damaged too. The bone will heal. The rehab is for the muscles and soft tissues, to help them regain flexibility and strength.”

Gilbert missed almost two weeks of class in the fall but has made it all up since. She has continued physical therapy every day at Marist since the accident and, by March, was almost back to full strength. She even joined her teammates for off-season practices. “I still do PT to help with running and jumping, but it doesn’t hurt anymore and there are no limitations,” she reports. “By August, when the season starts full-time, I’ll be ready to go.”

She may have the rod in her leg removed in the future. But that decision can wait, at least until Gilbert finishes her final season on the court, back playing the sport she loves. —D.L.

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