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December 3rd, 2020, 02:27 PM   #1
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Marc Marquez faces six-month layoff after third surgery on arm

https://www.motorsport.com/motogp/ne...rgery/4920698/

Guess we're going to see Andrea Dovizioso for a bit longer?
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December 3rd, 2020, 04:20 PM   #2
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Saw the announcement on Autosport.com. Usually, if there are rumblings about it with the usual denials, then typically, it's eventually announced.

8 hrs of complex surgery. Hopefully he will be fine after this!
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December 3rd, 2020, 08:37 PM   #3
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Quote:
Originally Posted by misfit View Post
Saw the announcement on Autosport.com. Usually, if there are rumblings about it with the usual denials, then typically, it's eventually announced.

8 hrs of complex surgery. Hopefully he will be fine after this!
That he required this procedure strongly suggests minimal if any healing after the second operation, and pretty much bears out your comments about difficulties consequent on stripping the periosteum etc. The early return really was career threatening.

Here’s hoping for the best along with most true motogp fans.
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December 3rd, 2020, 11:29 PM   #4
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Originally Posted by michaelm View Post
That he required this procedure strongly suggests minimal if any healing after the second operation, and pretty much bears out your comments about difficulties consequent on stripping the periosteum etc. The early return really was career threatening.

Here’s hoping for the best along with most true motogp fans.
The early return was unbelievably stupid. That he was allowed to race or be on the bike at all is a huge red flag to me. The early return will likely cost him at least two titles. I’m sure he’ll still get to #10. That misfit was able to successfully explain to us the risks etc and what happened while doctors in contact with him allowed him to do as he pleased is mind blowing. I thought they bought Puig in to not be a ‘Yes Man’?

I dare say if the doctors did not properly or adequately explain the risks to Marquez, Honda and co they are surely liable to be sued for a hell of a lot of money?
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December 4th, 2020, 06:21 AM   #5
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Quote:
Originally Posted by michaelm View Post
That he required this procedure strongly suggests minimal if any healing after the second operation, and pretty much bears out your comments about difficulties consequent on stripping the periosteum etc. The early return really was career threatening.

Here’s hoping for the best along with most true motogp fans.
A friend of mine sent me a link to this Reddit topic this morning. It's from several weeks ago.

https://www.reddit.com/r/motogp/comm...tm_name=iossmf

I'm not a surgeon, medical professional, or anything that would even give me the ability to ascertain if what was written by this poster is true. Perhaps you could discern better than I whether what the poster has written holds any weight?

If what he says is true, it does bring up questions about why the initial surgery was conducted the way it did.

The subsequent comeback attempt and everything that followed that, while easy to blame Marc for it all --and that seems to be what is happening across the internet-- the real blame falls with HRC and Alberto Puig. Puig after all is the same clown who thought putting out a false information pitboard for Pedrosa at the Sachsenring in the rain was a good idea. HRC on the other hand...let's be honest...being that they are heavily invested in Marquez financially, should have done the adult thing and stepped in to say no. Last I looked, it's their team, and they haven't exactly had any issues in bygone years disregarding rider wishes on whatever the subject may be...or continues to be in order to do what they want to do. Marc was deadset on riding no matter what. HRC could have just simply told him it was not going to happen till his physical condition improved further. I don't have a lot of faith in doctors employed by MotoGP given the potential for conflicts of interest. HRC had all of the power to nip things in the bud after the crash, and chose not to.

Whether Marquez comes back successfully from this third surgery or not remains to be seen. I prefer to take the approach of wait and see rather than issue proclamations on his career being over, or whether he'll ever be competitive again if he does get back on a motorcycle. The only people who have any idea as to what the likelihood of a successful comeback are, will not be letting the world know at this present time.
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December 4th, 2020, 10:28 AM   #6
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Hindsight is 20/20. The doctors could've said something different and HRC could've done something different, but ultimately Marc's decision to ride over the limit to attempt to get into the heads of his competitors cost him dearly. His decision to do push-ups on a broken bone was another dumbass decision. He then decided to top that by hopping back on the bike and trying to ride again... his entire career has seen him throwing caution to the wind and taking huge risk. Sometimes those risks paid off and he got to be the hero, this time he's the zero. He would've easily won the championship this year by riding more conservatively and picking the right times to use speed, but that requires a rider with the ability to accurately assess risk vs reward. Marc has to take responsibility for his own actions.
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December 4th, 2020, 11:34 AM   #7
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Quote:
Originally Posted by JPSLotus View Post
A friend of mine sent me a link to this Reddit topic this morning. It's from several weeks ago.

https://www.reddit.com/r/motogp/comm...tm_name=iossmf

I'm not a surgeon, medical professional, or anything that would even give me the ability to ascertain if what was written by this poster is true. Perhaps you could discern better than I whether what the poster has written holds any weight?

If what he says is true, it does bring up questions about why the initial surgery was conducted the way it did.

The subsequent comeback attempt and everything that followed that, while easy to blame Marc for it all --and that seems to be what is happening across the internet-- the real blame falls with HRC and Alberto Puig. Puig after all is the same clown who thought putting out a false information pitboard for Pedrosa at the Sachsenring in the rain was a good idea. HRC on the other hand...let's be honest...being that they are heavily invested in Marquez financially, should have done the adult thing and stepped in to say no. Last I looked, it's their team, and they haven't exactly had any issues in bygone years disregarding rider wishes on whatever the subject may be...or continues to be in order to do what they want to do. Marc was deadset on riding no matter what. HRC could have just simply told him it was not going to happen till his physical condition improved further. I don't have a lot of faith in doctors employed by MotoGP given the potential for conflicts of interest. HRC had all of the power to nip things in the bud after the crash, and chose not to.

Whether Marquez comes back successfully from this third surgery or not remains to be seen. I prefer to take the approach of wait and see rather than issue proclamations on his career being over, or whether he'll ever be competitive again if he does get back on a motorcycle. The only people who have any idea as to what the likelihood of a successful comeback are, will not be letting the world know at this present time.
The person in the post does write like a surgeon.

I too was quite taken by the long plate along the humerus. I too agree that an intramedullary nail would have been optimal adequate fixation and bone healing with minimum disturbance at the fracture site. This is why most long bone fracture are being fixed in this manner once this is a feasible option, MM's fracture being one. The only thing rationale I'd imagine behind the long plate and many screws, was that they wanted him to mobilize early, believing that the construct would hold, allowing an early race return. This I thought very unwise and the same was for Lorenzo with his clavicular #. I thought Lorenzo was playing with fire and he got away with it. MM didn't.

When the plate broke, I thought.. oh dear. The more they mess with the bone ends, periosteum and fracture site, the more likely he is to suffer a non-union,.... which he did (they mentioned him having a pseudoarthrosis which is the what happens when the bone ends completely fail to heal). This was a freakish situation under the circumstances.

The bone grafting they did was fancy and the reason for all the time they took. The harvested bone is taken with attached muscle and blood vessels that supply the bone. Those vessels (vein and two arteries) or pedicle are then attached to vessels within his arm so that the graft has its own blood supply, maximising the chances of healing. The more common graft is avascular or without a pedicle and they did not wish to take chances with that option and I can understand that for sure.

Good luck to MM. I suspect there's a lot happening behind the scenes and the surgeon involved may have been asked to do the most rigid and sturdy fixation he could to allow for an early return to his riding. Unfortunately, this had its downside and MM is unfortunately living it in full.
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December 4th, 2020, 01:49 PM   #8
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Quote:
Originally Posted by p4p1 View Post
The early return was unbelievably stupid. That he was allowed to race or be on the bike at all is a huge red flag to me. The early return will likely cost him at least two titles. I’m sure he’ll still get to #10. That misfit was able to successfully explain to us the risks etc and what happened while doctors in contact with him allowed him to do as he pleased is mind blowing. I thought they bought Puig in to not be a ‘Yes Man’?

I dare say if the doctors did not properly or adequately explain the risks to Marquez, Honda and co they are surely liable to be sued for a hell of a lot of money?
I reckon doctors most likely did give a detailed prognosis. Dorna was probably using 100 Euro notes as ear plugs. That and they allowed themselves to ignore the science and suspend better judgement because they needed to believe that this young kid knew better and that his talent would allow him (no pun intended) to wing it.
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December 4th, 2020, 03:58 PM   #9
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Quote:
Originally Posted by misfit View Post
The person in the post does write like a surgeon.

I too was quite taken by the long plate along the humerus. I too agree that an intramedullary nail would have been optimal adequate fixation and bone healing with minimum disturbance at the fracture site. This is why most long bone fracture are being fixed in this manner once this is a feasible option, MM's fracture being one. The only thing rationale I'd imagine behind the long plate and many screws, was that they wanted him to mobilize early, believing that the construct would hold, allowing an early race return. This I thought very unwise and the same was for Lorenzo with his clavicular #. I thought Lorenzo was playing with fire and he got away with it. MM didn't.

When the plate broke, I thought.. oh dear. The more they mess with the bone ends, periosteum and fracture site, the more likely he is to suffer a non-union,.... which he did (they mentioned him having a pseudoarthrosis which is the what happens when the bone ends completely fail to heal). This was a freakish situation under the circumstances.

The bone grafting they did was fancy and the reason for all the time they took. The harvested bone is taken with attached muscle and blood vessels that supply the bone. Those vessels (vein and two arteries) or pedicle are then attached to vessels within his arm so that the graft has its own blood supply, maximising the chances of healing. The more common graft is avascular or without a pedicle and they did not wish to take chances with that option and I can understand that for sure.

Good luck to MM. I suspect there's a lot happening behind the scenes and the surgeon involved may have been asked to do the most rigid and sturdy fixation he could to allow for an early return to his riding. Unfortunately, this had its downside and MM is unfortunately living it in full.
You actually predicted most of this including the likely problem with vascularisation, said a rod would have been better, and mentioned stripping of the periosteum being problematic, the periosteum being specifically mentioned in the press release in regard to the 3rd operation, from day 1 so I put you ahead of the Reddit surgeon. I must have skimmed the bit on there being a pseudoarthrosis, but as you say this means non-union. The 3rd operation was obviously definitely not merely to remove the plate now we have details of the nature of said surgery.

The retrospectoscope is the most powerful diagnostic tool in medicine, and was employed by the Reddit orthopod, but you raised nearly all of this from the getgo/prospectively, and as has been said the surgeons involved in his management should perhaps have had at least some portion of your insight into the situation.

I am sure the impetus for the early return came mainly from MM btw, his mindset was possibly that Jorge rode 2 days after a having his clavicle plated, I am better and tougher than him, and am not going to let a fracture interfere with my run of successive world titles. The surgeons involved were perhaps misled by the superhuman physical capabilities routinely displayed by gp bike riders, and the unusual nature of the fracture which as you pointed out was not by the usual mechanism/along the lines of stress where humeri usually fracture.
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Last edited by michaelm; December 4th, 2020 at 11:21 PM.
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December 4th, 2020, 09:04 PM   #10
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Originally Posted by michaelm View Post
You actually predicted most of this including the likely problem with vascularisation, said a rod would have been better, and mentioned stripping of the periosteum being problematic, the perisoteum being specifically mentioned in the press release in regard to the 3rd operation, from day 1 so I put you ahead of the Reddit surgeon. I must have skimmed the bit on there being a pseudoarthrosis, but as you say this means non-union. The 3rd operation was obviously definitely not merely to remove the plate now we have details of the nature of said surgery.

The retrospectoscope is the most powerful diagnostic tool in medicine, and was employed by the Reddit orthopod, but you raised nearly all of this from the getgo/prospectively, and as has been said the surgeons involved in his management should perhaps have had at least some portion of your insight into the situation.

I am sure the impetus for the early return came mainly from MM btw, his mindset was possibly that Jorge rode 2 days after a having his clavicle plated, I am better and tougher than him, and am not going to let a fracture interfere with my run of successive world titles. The surgeons involved were perhaps misled by the superhuman physical capabilities routinely displayed by gp bike riders, and the unusual nature of the fracture which as you pointed out was not by the usual mechanism/along the lines of stress where humeri usually fracture.
It's been great to have misfit's insight during this year in regards to MM's injury and I totally agree. He called so much of this well before it all happened. The fact is athletes are generally stupid when it comes to their injuries because winning>quality of life after retirement. The mindset that MM has is the same mindset that set Jordan and Ali apart from their peers but as shone through with Ali it can have it's downsides. Most athletes are goal driven and the next goal is always the most important.
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