President-elect Joe Biden suffered hairline fractures in his midfoot over the weekend after slipping while playing with Major, one of his two German Shepards.
According to Dr. Kevin O’Connor, Biden’s physician, the PEOTUS will “likely require a walking boot for several weeks,” meaning there’s a chance he could still be dealing with the injury on January 20, 2021 when he is sworn in as president.
Biden said he twisted his ankle while playing with Major and decided to be examined by an orthopedist “out of an abundance of caution.”
Dr. Silverman Explains Joe Biden’s Midfoot Fracture
It seems likely that there was a little more to this injury than just a slip and a twist, and we believe this based on our knowledge of the anatomy of the foot.
Think of the foot like a giant pretzel that you might buy from Auntie Anne’s at the Mall of America. Now, imagine you are tasked with breaking the middle section of the giant pretzel, but the caveat is that you can only do this by twisting the pretzel. It’s impossible to get a break in this middle section without ripping an outer portion of the pretzel with twisting alone. The midfoot is similar, meaning there likely needed to be additional trauma as opposed to a simple twist of the ankle. We’re not saying he’s lying about how the injury occurred, but we believe the mechanism of injury was more than just a simple twist.
The PEOTUS has suffered some variant of a Lisfranc midfoot fracture, with the article noting fractures to the lateral and intermediate cuneiform bones in the midfoot. Interestingly, missing this injury is the number one cause of medical malpractice lawsuits involving the foot and ankle. The treatment of these injuries is almost never non-surgical and certainly not just limited weight bearing in a boot.
If the ligaments that stabilize the foot are torn, they will need rigid immobilization with plates and/or screws to heal, otherwise the foot arch can collapse, leading to midfoot arthritis. In patients deemed too unhealthy to benefit from surgery, non-operative treatment can be used, but it involves a well-molded cast to make the area non-weight bearing, but it is not expected to adjust the natural history described above in regards to potential arch collapse and midfoot arthritis. If they are just going to put him in a walking boot, it means they expect the foot arthritis to proceed and hope the arch doesn’t collapse and affect Biden’s ability and tolerance of walking.