2023-10-13 06:00:00
France holds its breath. Victim of a fractured zygoma on September 21, Antoine Dupont underwent emergency surgery the next day by Professor Frédéric Lauwers, head of the maxillofacial and facial plastic surgery department at the University Hospital Center (CHU) of Toulouse, in view of the Rugby World Cup and the fateful quarter-final against South Africa, next Sunday evening in Saint-Denis. While he had the green light to resume training on Tuesday, will he be able to be on the field to guide France to victory?
While waiting for the response on Friday, with the announcement of the composition by the coach Fabien Galthié, Roman Hossein Khonsari, surgeon in the maxillofacial surgery and plastic surgery department of the Necker hospital – Sick Children (Public assistance – Hôpitaux de Paris ) and professor at the Faculty of Medicine of the University of Paris, answers us.
Point : Antoine Dupont received the green light from the surgeon who operated on him on September 22 to resume “directed progressive physical activity”, under the “control of the medical staff of the XV of France”. Does this mean he is fit to return to competition now?
Dr Khonsari: He is fit for competition. Antoine Dupont suffers from a fractured zygoma which was operated on by my colleague from Toulouse. This divide is quite limited. It is certain that the fracture is not completely healed, but all decisions in medicine are a matter of benefits and risks.
In the worst case, if there is a blow to the operated area, the fracture will shift and it will eventually be necessary to operate again. But there can’t be any big drama. In a context like the Rugby World Cup and a quarter-final against South Africa, it is possible to take the risk that he plays. This is not an area where shifting the fracture could result in a big disaster.
One of your colleagues recently explained to us that a new shock could possibly cause him to lose his sight. In your opinion, is this risk now excluded?
Everything is possible in medicine, but cases of blindness after zygoma fractures are rarely noted. It’s unlikely in my opinion. There may be a fracture of the floor of the eye socket, the bone under the eye. Generally, these fractures do not cause visual disturbances. Possibly oculomotor disorders, that is to say eye movement. We can reasonably think that even in the event of another shock, Antoine Dupont is not likely to lose his sight.
This is a fairly common situation in maxillofacial surgery. Outside of the sporting context, we regularly see patients in this case, with a facial fracture. These are often patients who have fought. It often happens that these people recur, with a recurring trauma, because the patients received another blow before the fracture was completely united.
We saw Antoine Dupont training this week with a helmet. Do you know this type of protection? Is it effective?
These are effective protections and they also have a psychological effect. When we wear protective equipment, we tend to put ourselves in less dangerous situations. It has a double effect: protective and deterrent. All it takes is shock absorption and all structures that respond to that are protective.
Antoine Dupont underwent surgery on September 22. The match takes place on October 15. Can we talk about express recovery?
Patients recover quickly from facial fractures. The theoretical duration of bone consolidation, however, is six weeks. That is, the bone has returned to a “like before” state. Antoine Dupont’s bone is therefore not yet consolidated.
READ ALSO Rugby World Cup: 3 questions about Antoine Dupont’s injuryI add that the cheekbone is not an area subject to mechanical stress. Consolidation is therefore rapid; he doesn’t walk on it, etc. In general, patients with this fracture, who play combat or team sports such as rugby, are recommended to wait six weeks to two months to resume.
In your opinion, is Antoine Dupont able to play in the quarter-final of the World Cup on Sunday?
It really depends on the associated lesions, which I don’t know about. If he also suffered a concussion, he may need more rest. If it is indeed an isolated zygoma fracture, without damage to the floor of the orbit and which was operated on and reduced satisfactorily as is the case, theoretically – outside the context of sporting competition – it would have been exempt from contact activity for six weeks.
But as I tell you: everything is a matter of balance between benefit and risk. To the extent that even if he receives a shock, his life will not be in danger, nor his visual functions, we can take the risk, in this exceptional circumstance of a World Cup quarter-final, that he resume sport. If he plays Sunday night, the risk seems reasonable.
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