Louisville basketball player Kevin Ware underwent successful surgery Sunday night to repair the gruesome open fracture of his right tibia he suffered during the Cardinals' 85-63 win over Duke in the Midwest Regional final, and he is expected to remain in Indianapolis until at least Tuesday, Louisville announced.
Ware had the bone reset, and a rod was inserted into his leg during the operation that lasted about two hours. The wound caused by the bone puncturing through his skin in his lower leg was closed.
Louisville's late-night release said no timetable for recovery has been set, but the early prognosis from sports medicine director Fred Hina - given right after the game while Ware was in surgery - was that Ware is bound for a lengthy recovery, but the injury is not likely a career-ending one.
Hina was part of the team that stabilized Ware's injury on the court as he was removed on a stretcher.
"It's an injury that needs to be dealt with in a swift fashion due to the fact that it was open, and there are infection concerns, and then obviously you need to stabilize that fracture," he said. "One thing you have to establish is, is there circulation below the fracture? Did he disrupt any arteries or veins? Once we establish that, it's stabilizing the fracture as tight as we can so that it doesn't move."
Ware is hopeful he can return to Louisville after Tuesday, then join the Cardinals as they advance to the Final Four in Atlanta, his hometown.
Louisville's team physician traveled with Ware in the ambulance to the hospital after the injury, and Hina and Ware's girlfriend, who was at the game, have been in contact with Ware's mother, who lives in Atlanta.
Ware's mother planned to travel to see him soon, Hina said.
Hina said Ware's recovery time would be based on the nature of the hardware that was inserted in his leg.
"Because it was a weight-bearing bone and it was such a difficult injury, it will take a while," Hina said. "But he will play again."
Hina likened the injury to the season-ending fracture suffered by former Louisville running back Michael Bush in the 2006 season.
Bush recovered to be chosen in the next year's NFL draft and currently plays for the Chicago Bears.
"Once I spoke to the trainer at halftime and he told me it's Michael Bush's injury," Louisville coach Rick Pitino said. "He said it's going to take some time coach, but he'll be fine. Once I knew that, then I could regroup and just get them refocused. ... He's going to be fine. Now if this was a career-ending injury? (But) we all know how good Michael Bush is right now, and it's a Michael Bush injury."
Hina said he's seen similar severe fractures, but there's no getting used to seeing injuries so gruesome.
"It never gets more palatable," he said.
Bush posted on Twitter that he cried after seeing Ware's injury.
"I feel so bad," he wrote. "Flashback of myself."
Dr. Craig Roberts, chairman of Louisville's department of orthopedic surgery, was coming out of an operation when he caught the replay of Ware's injury on TV.
"It was very dramatic, very deformed," Roberts said. "I hate to use the word grisly, but it brought me back to Joe Theismann," he said, referring to the professional football player whose compound fracture in 1985 ended his career.
An open fracture could have been caused simply by the amount of force and the angle at which Ware landed after leaping to challenge a Duke shot, Roberts said.
"It looks like what we call a bending fracture - like snapping a pencil with your finger," he said. "There was a significant amount of force, and the angle looked about right."
Roberts said open fractures of this sort would be treated by intravenous antibiotics and surgery to implant a metal rod within eight hours of the injury. He added that Methodist Hospital "has a very strong group of orthopedic surgeons."
Dr. Tony Wanich, an orthopedic surgeon who specializes in sports medicine at Montefiore Medical Center in New York, said Ware's injury was extremely unusual given the circumstance, and that such severe fractures are usually seen in car crashes.
In such an injury, Roberts said that in the "best-case scenario," a patient would begin to show signs of healing within 8-12 weeks. "With ... physical therapy, top-notch rehab, he may actually be doing quite well by three months or so," he said. "From there, it's a matter of muscle rehabilitation, strengthening, sport-specific rehab."
Dr. Robin West, a Pittsburgh Steelers orthopedic surgeon, said that typically, the best-case scenario to return from such a compound fracture is 6-8 months.
But she said the fact that Ware's bone broke through his skin will likely add to his recovery time.
"The blood supply gets cut off to the bone, and it's an open system," West said. "There can be a pretty significant rate of infection, and the blood supply is worse, so the healing is slower."
Wanich said it will be important to monitor Ware closely during the 24 hours after surgery because of the risk of infection and blood flow problems. Roberts said that possible complications could include slow healing of the bones or soft tissues.
"Sometimes the wound itself is so injured that over time the skin and muscle can die," he added. "The healing itself is sometimes a little delayed on account of its being an open fracture (with) high energy."
As for returning to the sport, Roberts thought Ware's prognosis was good. "There's a very high likelihood that we'll see him play again," he said.
Steven Jones, Matthew Frassica and Adam Himmelsbach write for the Louisville Courier-Journal, a Gannett partner property.