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Friday, October 17, 2014

The Mechanics of the Dupuis Injury by @ChicksDigHockey

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Last night, Penguins’ fans held their collective breath as Pascal Dupuis lay on the ice being attended to by medical personnel. We were worried, taking our cues from the faces of Pens and Stars players as they stood looking stunned while Dupuis remained on the ice. 

The injury occurred after Dupuis was checked from behind by former Penguin Alex Goligoski. When Dupuis fell, he went forward with his shoulders over his knees. He appeared to see the Letang shot that ultimately hit him coming. He tucked his head down exposing his neck to the force of the puck. 

He was talking to teammates, was able to make a fist and moved his legs. He did complain of numbness which is a sign of nerve involvement. Standard precautions for an injury that involves the spinal column is to immobilize and transport.

Via Trib Total Media/Christopher Horner

At its worst, an injury such as that could have caused a fracture. At it’s best, it was a ‘Stinger’.

Stingers are the result of traction or compressive forces on the brachial plexus or cervical nerve roots. The force of the puck strike literally stuns the nerve resulting in stinging, burning or numbness. Weakness may be present at the time of the injury. Some will report the arm feels and appears to be dead. This paralysis and other symptoms may be transient or temporary. They may only last a few seconds or minutes. For most, the healing takes days or weeks. Rarely it is permanent. 

What happens in an injury like Dupers?

The puck struck his neck. Because his head was tucked down, his vertebrae were spread further apart and the whole area was more vulnerable. In short, the nerve plexus was less protected. A nerve plexus is an area where nerves branch and rejoin. The brachial plexus is a group of nerves in the cervical spine from C5 to C8-T1. This includes the lower half of the cervical nerve roots and the nerve root from the first thoracic vertebra.

The brachial plexus begins with five roots that merge or join together to form three trunks.

At the hospital, Dupuis likely had imaging such as an MRI to evaluate the structures surrounding the injury. A physical exam was conducted to evaluate nerve function and reflexes. 

The evaluation was obviously positive as Dupuis took the ice this morning to skate on his own prior to the team's practice. It's hard to say when the medical team will feel comfortable with him practicing with the team let alone playing. As for long term symptoms, that remains to be seen as well.

What is a certainty is that Dupuis will give his recovery 100% of his effort and focus.That's who he is and what he does.

He is, after all, Super Duper.

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