jon-jones-54.jpgFew recent MMA scenes can churn a stomach like the sight of Jon Jones‘ mangled big toe following his win over Chael Sonnen in Saturday’s UFC 159 headliner.

In our latest installment of “Ask the Fight Doc,” MMAjunkie.com medical columnist Dr. Johnny Benjamin explains why the immediate care for Jones could have presented problems.

When it comes to “open fractures” like the one Jones suffer (warning: it’s graphic), cleanliness is key.

* * * *

Doc – Did you see that Jon Jones’ toe injury sustained during his fight with Chael Sonnen at UFC 159? Is that an injury that might alter his career a bit? – Steve M. from Austin, Texas

Did I!

The probable diagnosis was easy but the immediate treatment, which is crucial, leaves me scratching my head.

The Internet had multiple pictures of Jon Jones’ left great toe open injury – a fracture, dislocation or both. Then I viewed a pic of Jones with the injury reduced (straightened) and closed with stitches wearing one of his sporty new signature Nikes on his uninjured foot. The caption from his twitter account read, “Got my big toe back intact :).”

As Jones walked around with his bone exposed on a filthy cage mat that had seen tens – possibly hundreds of – pairs of shoes spread bacteria all over it, I pray that happy face doesn’t turn to a frown.

I think most sports fans heard some mention of a similar injury that occurred during the NCAA Division I men’s basketball tournament. Kevin Ware, a player for the University of Louisville, jumped to block a shot, landed a bit awkwardly, and found a broken bone sticking though the skin of his lower leg. It was what we as orthopedic surgeons call an “open fracture” – open in the sense that his bone is exposed (open) to the outside and often-filthy world.

The injured Ware had excellent care at the scene and immediately had the wound covered to limit further exposure to outside contamination. He also had immobilization and rapid transport to the hospital. This type of open injury, whether it involves a bone in the leg or foot, requires proper immediate care at the scene and surgical intervention within eight hours to limit the chances of serious infection. Surgery usually consists of a thorough wash and inspection with removal of any foreign bodies (dirt, sand, clothing fibers, etc.) that may have been introduced into the open wound, strong antibiotics, and hardware to fix the bone injury (pins, plates, screws, rods, etc.).

Unfortunately, Jones was allowed to give a post-fight interview in the cage, and then he went to the dressing room, where someone closed the wound with stitches, possibly trapping dirt and bacteria inside, and fashioned a rudimentary splint. He then sat through some portion of the post-fight press conference to answer questions – all with the eight-hour clock ticking away.

I have a question: Where was the UFC orthopedic surgeon or medical director during the immediate on-scene triage, care and medical decision-making process of one of the promotion’s and MMA’s greatest stars?

Jones’ future is relatively easy to predict: very, very bright if he does not get an infection, but not so much if he does.

But please, please, please don’t start pointing fingers at New Jersey State Athletic Control Board officials. They did their job on Saturday night.

For complete coverage of UFC 159, stay tuned to the UFC Events section of the site.

Dr. Johnny Benjamin is MMAjunkie.com’s medical columnist and consultant and a noted combat-sports specialist. He is also a member of the Association of Boxing Commissions’ MMA Medical Subcommittee. Dr. Benjamin writes an “Ask the Doc” column approximately every two weeks for MMAjunkie.com. To submit a question for a future column, email him at askthedoc [AT] mmajunkie.com, or share your questions and thoughts in the comments section below. You can find Dr. Benjamin online at www.drjohnnybenjamin.com, and you can read his other sports-related articles at blog.drjohnnybenjamin.com.

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