July 06, 2015 - Dr. David Chao
Monday Morning MD: Jason Pierre-Paul injures hand in fireworks accident
Emergency room personnel see it every July 4th. Hand surgeons have told me they hate being on call during Independence Day for this reason. Unfortunately, the New York Giants star defensive end fell victim to a fireworks hand injury on Saturday. Initial information seemed ominous and included the possibility of Pierre-Paul losing his hand. Later reports indicated the prognosis was not terrible and not career threatening. JPP apparently suffered burns on his hand/fingers and there is concern of nerve damage. Fireworks injuries typically involve the thumb, index and middle fingers. Loss of digits does not appear to be an issue here, but the Pierre-Paul injury remains worrisome. Skin is considered the largest organ of our body. It serves a vital function to protect underlying structures from infection. I don’t know the extent of damage here but exposed nerve, tendon, or bone can put one at extreme risk. Often, skin grafting or flap type procedures are necessary, and sometimes multiple procedures are required. Not saying it will be the case here, but recall the story of Ronnie Lott who had part of his pinkie finger amputated to avoid multiple surgeries. The injury was severe enough for an immediate trip to the hospital but not by ambulance. If reports that Pierre-Paul was still in the hospital at 5pm on July 5th are accurate, that might be a sign of extensive skin damage requiring intravenous antibiotics and/or wound care. At this point, loss of digits does not seem to be the case. Loss of finger function from contracture is a worry. Grip and hands are vital for a defensive end. Fortunately, power grip is usually provided primarily by the ring and pinkie fingers, which are likely sparred. Pierre-Paul has not signed his one-year Giants tender for $14.8 million. It remains to be seen what effect, if any, this injury will have on his contract status. It is too early to speculate whether any laws were broken or if Pierre-Paul might face league discipline. Fireworks, other than sparklers, are not legal in Florida. Self-inflicted injury doesn't exempt one from facing penalties as fellow Giant Plaxico Burress learned. Since deleted pictures indicated JPP had boxes of fireworks in a U-Haul van. The first worry is infection. The next biggest issue after a burn injury is contractures and loss of function from nerve/tendon damage. Although the early reports are good, JPP and Giants' fans are not in the clear yet. Follow David on Twitter: @profootballdoc Dr. David Chao is a former NFL head team physician with 17 years of sideline, locker and training room experience. He currently has a successful orthopedic/sports medicine practice in San Diego.