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Kubica rehab could be six months or more
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Kubica rehab could be six months or more
Posted By: James Allen  |  06 Feb 2011   |  8:21 pm GMT  |  89 comments

Hand reconstruction specialists in Italy have been working hard for seven hours to save the functionality of Robert Kubica’s right hand tonight after a high speed accident in a rally car this morning. After the operation finished, Dr Igor Rossello explained that an amputation was a possibility but that following surgery “the hand is alive,” although he added that ” we will have to wait a week before we will know if it will survive. ” More surgery might well be needed. He added that a recovery period of a year was to be expected.

Tonight I called a friend in London, Richard Young, who is a plastic surgeon specialising in hand reconstruction at Chelsea and Westminster Hospital, for some insight into hand crush injury, of which he has extensive experience.

I wanted to know what the risks are in a situation such as this and likely recovery times. The caveat for all of what follows is that we do not know the precise details and therefore this is not a specific prognosis on Kubica, more some general medical principles for my -and your – background understanding.

Apparently when they say a hand is at risk of amputation it is because the blood supply to the hand has been severed. That is the first thing to restore and that has clearly been done, although it sounds as though there is some waiting to be done to see if the blood vessels will function again properly. Then it’s a question of whether the doctors can restore full functionality, to the level which an F1 driver needs. This means repairing the nerves and tendons and their work will determine whether Kubica will race again. How long the recuperation will take depends on how severe the injury was in the first place. If the doctor is now saying up to a year, it must have been a very severe injury.

Dr Rossello has said tonight that the repair of the nerves in the hand is the big doubt in terms of whether the hand will regain functionality.

The first point is that the energy in the accident was clearly very great if it also caused long bone injury such as the broken leg and arm which Kubica suffered. Kubica’s hand appears to have been crushed by some armco entering the cockpit. So the extent of the hand crush injury was likely to have been severe.

The hand has many small muscles, tendons and nerves, which if crushed are likely to reduce the ability to roll the fingers in and to make fine movements, such as picking up a pin or in the case of an F1 driver, operating the buttons and dials on the steering wheel. Damage to the nerves will impair feeling and this can take at least three months to return.

As for rehabilitation it is long and crucially there is no short cut. Sometimes when athletes break a bone they can speed up the repair by sitting in a chamber to boost oxygen or blood flow, but that will not apply in this case.

Here we are dealing with tendons and these must be protected for up to three months before any effort can be put through them, otherwise the tendons rupture again. Also if there is severe damage to nerves in the hand or forearm the ability to make fine movements can be lost forever.

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1

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2

“Get a replacment” they are saying.

“Get Kimi on-board” is my answer

3

So good to see the warm wishes to Robert. good one on the Ferrari website

4

This may already have been mentioned but I have just realised that I have been underestimating the sheer scale of this crash.

If I’m reading things right, the car is left hand drive and he hit the left hand side of the car. However, it was his *right* arm, leg and hand which suffered the injuries.

That, to me, means that not only did the armco penetrate the car, it penetrated the *middle* of the car. Either that, or something from the engine compartment was pushed far enough inside the car to do that damage.

By the way, James, can you please clarify where the accident occured? Many of the news stories phrase it to suggest along the lines of before the stage start. Is this a misinterpretation or was he actually not driving competetively when the accident happened?

5

James,

This is single most horrific news in F1 since Massa’s incident in Hungary. My prayers and wishes go out to him. I really hope he recovers well, and also comes back and duly win some World Championships that he deserves.

Kubica is probably the most ideal racer out there – completely apolitical and super good at developing a car with his team, with an ability to always drive the car beyond its capabilities.

(He is like Kimi but with additional development capacity).

On a completely different note, a thought comes to mind –

If Senna would be to now get a chacne to not only race, but establish himself, wouldn’t it be ironic that while an accident robbed us of one Senna, another equally horrible accident might “launch” another Senna?

6

It’s much worse than the Massa situation. This is more like Nannini losing an arm in helicopter accident.

7

best wishes to Robert – hope he has a good recovery

he needs to take the appropriate time off to ensure his health is 100%

8

I would just like to say that I feel it’s more important that he is well and recovers to 100%, at the end of the day if he never races again, which would be incredibly sad, his health and wellbeing is far more important. I can’t imagine how depressed he will be feeling once he is out of the induced coma. But I’m sure he is of strong mind and will be supported by family, friends, racers and fans in equal measure.

Hope for good news soon.

9

Best wishes to ‘the Robert’ as Boullier calls him. Speedy recovery.

I think Senna deserves the drive if its available, the added spotlight and responsibility of a Renault-Lotus drive hopefully will be the spark that ignites his career in F1.

De la Rosa could also be considered as a suitable replacement driver in the short-term as he has KERS and Pirelli experience.

10

Kubica is like Raikonen, personality wise, not looks. Down to earth-ish, caustic, purposely oblivious to F1 glamor and consistently fast.

I remembered a comment on a youtube video where Alonso and Kubica were karting in Shanghai, apparently, the two have been friends since age 7. That’s the age when bonds made last a lifetime.

Here’s wishing RK speedy recovery.

11

wow….what can i say that hasnt been said? Im gutted. Kubica had such a promising year ahead of him. 2010 was his breakout season, not to mention topping the timesheet in Valencia testing. Thanks for taking the time to explain the injury to us, and not just the usual ”omgwtf baibai hand” that other F1 sites (planetf1 pops to mind) give us.

As for his replacement, i think it should be Senna. Give him some time in a decent car, and see how he does….how can you judge him based on his HRT performance? If not him, then i think Hulkenburg should be the go-to guy.

I can also see this being a ”lucky break” (no pun intended) for Petrov, so to speak. Because regardless who they bring in, he has a real chance to solidify his position in the team, without living in his eastern european compatriots shadow.

And to everyone begging for Kimi….it wont happen. Ever.

All the best Robert, and hopefully, with a strong mind, and resolution…we will see you down pit lane

12

James,

First of all, I hope Kubiza has a full and speedy recovery. I was really excited to see what he would do with that renault this yr.

However, now that he is out, what are the chances of the Hulk driving for renault? Would Force India let him do that?

13

The accident is really crappy news. It sounds like a very serious injury. Modern medicine is pretty good these days though and you’d expect a multi million pound a year driver like Kubica would get the best care possible.

I’m no expert but i think that it may be possible to control an F1 car with one good hand and one slightly numb hand. I hope that’s the case anyway. You just need one dial (maybe used with the thumb) to switch between functions and then some other button/switch/dial to select for example what you want the differential to be set to. It would be slower to use, but a good designer could work out a way to get it to work.

…Anyway, I hope it doesn’t come to that and he makes a full recovery and can maybe do a few races at the end of this season.

This accident i think shows why it doesn’t make sense to have a pay driver driving for you if your a big team with aspirations to win races. There driver line up suddenly looks very weak, and that’s a terrible shame because i was hoping that this car might be very competitive.

14

Terrible news for F1 and Kubica, as the dark horse for the title is already out before the season has begun. Let us hope he recovers and gets the car he deserves in 2012 and challenges for the title. On a different note I suspect Bruno Senna cannot believe his luck, being out of job just over a week ago and could now inherit a top drive; if he blows this he will be out of Formula One and deservedly so.

15

He was the great hope to inject a bit of personality into formula one, which is lacking and balls & heart at present – which TV viewing numbers pretty much back up. Where is the rivalry, the anger, the Senna vs Prosts, Schumis vs Hill. You are now rewarded in F1 for being a dull, non aggressive pilot who never overtakes. If Ayrton started in F1 now he probably who never have made it…too aggressive, too much controlled violence on track. not banker enough like, not boring enough, speaks his mind too much, just too damn interesting. Time for F1 to get its balls back or there will be no-one watching prertty soon. Oh Lets have more Buttons who are goody two shoe bores, or no talent brats like Vettel. Robert, robert, robert, speedy recovery.

16

What a valuable contribution to our understanding of the situation.

With all the controls a driver now has to master it must be even more important that they have full dexterity.

This is a tragic incident and we must just hope that Robert can get back into F1 and perform as we know he can.

It’s interesting that Rossi is saying that his shoulder injury costs him half a second a lap.

If the lasting effects of Robert’s accident are anything like as bad, he would not be able to be competitive.

17

I’m gutted for Robert. I love all out racers like him and I was dearly hoping he would win a race or two this year, this makes me very sad, along with how much I actually like him being in the sport!! Great explanation though James as usual, once more you put some flesh on the bones of a story that other sites never do.

18

Obviously we all wish Kubica well, but ther is little chance of him racing this season and even if he did, he may not be competitive. After an accident like that is one stupid to want to do it again? Ok F1 is a lot safer in many ways, which I still feel is why Kimi left it.

However this would have been an ideal slot for Nico or Nick both of who are far better qualified to replace Kubica than either of the official reserve drivers.

19

Regarding contracts, it is all for negotiation. I am sure if Renault/Lotus had said to Kubica ” no rallying, no skiing, no motorbikes etc etc etc ” he would probably have not signed or wanted something else in return.

Very sad, but maybe he should just write of 2011 and have 2012 as a goal. You only get one chance to heal and you should take it. Time is on his side after all and better a good comeback rather than a poor one and all the pressure that puts on a person.

20

Regarding contracts, it is all for negotiation. I am sure if Renault/Lotus had said to Kubica ” no rallying, no skiing, no motorbikes etc etc etc ” he would probably have not signed or wanted something else in return.

Very sad, but maybe he should just write of 2011 and have 2012 as a goal. You only get one chance to heal and you should take it. Time is on his side after all and better a good comeback rather than a poor one and all the pressure that puts on a person.

21

Firstly let me say that my thoughts are with Kubica and I wish him a speedy and full recovery!

On a side topic James, do drivers have to ask their team permission to engage in others sports? And do you think that this will prompt the teams to prevent their top drivers from engaging in other activities, the last few seasons Mark Webber has had unfortunate cycling accidents and now this horrific crash of Kubicas.

22

Thanks for the great article James. Just what I was looking for tonight.

Horrible news about Kubica; he looked so promising this year. Hope he recovers and that we’ll get to see his magic again.

Bad news for Renault as well. If their car is as good as it looks a star like Robert would be the difference between a great year and a good one.

23

we’ll see what happens. The fact that nowadays there are levers to do the gear changes help him. But there are so many buttons to activate, that hand control it’s extremely important.

I think he will come back racing…in rally.

24

I think a smart person could find a lot of work arounds. The left foot isn’t doing anything between braking. I’m thinking of a system where the left foot somehow controls brake bias. Functions are selected by scrolling with the left thumb. A voice or beeps in your ear tell you what function your on, and then you select the setting for that function with another selector with your left thumb again. It could be workable. Another way to go would be to bring back a foot clutch.

It all depends what he can manage when he is recovered and how flexible Renault are prepared to be.

25

James, given the insight you’ve been able to get regarding the possible effects of this for Robert (loss of “fine” motor capability etc), how would this relate to the F1 rulebook if your findings turn out to be accurate in this case?

For instance, assuming that the strength in Robert’s arm and leg (both skeletal and muscular) would allow him to return to F1 and it’s only the “fine control of fingers” aspect that remains a problem, are there any technical issues in the rulebook which would prevent Renault from creating a special steering wheel which could either be mostly operated from the left hand or have some sort of accessory which would allow someone with impaired motor function to operate it?

To anybody who thinks it might be out of order discussing this right now, I think that now the possibility of amputation has apparently been ruled out that Robert’s probably thinking along the same lines … 🙂

Anyway, all the best to RK for a good recovery (doesn’t have to be “speedy” ;)) – in my top 3 of current drivers, and the one I was most expecting to shake things up this year …

26

one of the top driver in f1 the renault just got a lot less competitive. get well soon Kubica hope to see you back soon

27

http://www.ivg.it/2011/02/incidente-di-robert-kubica-i-medici-una-settimana-per-vedere-se-la-mano-sopravvive/

Next 7 days crucial to have a clear understanding of the actual neurological and vascular status of the hand. At best, if all goes well, the rehabilitation will likely take about a year.

28

Adam Cooper has linked an English interview with hand specialist Professor Igor Rossello discussing various details regarding the surgery which took place earlier today. It can be viewed here:

http://www.youtube.com/watch?v=hEe0084HoT4&feature=player_embedded

He also points out that during the next 5-7 days there is a danger of vascular problems (i.e relating to blood supply and circulation) which may be rectified by further surgery.

At this stage it doesn’t seem prudent to completely rule out the chance that Kubica might yet have to lose his hand.

The details of the damage to his arm are unnerving to say the least, particularly Rossello’s comments that the median and ulnar nerves in his wrist were severed.

Now I’m certainly no expert when it comes to the anatomy of the wrist and hand but having studied information about these nerves in detail as a consequence of my own concerns relating to RSI, I know that the integrity of these nerves and surrounding structures is of paramount importance to the functionality and sensation of the forearm, wrist and hands.

A full recovery with no ongoing long term problems seems extremely unlikely in my opinion.

Even if Kubica does regain functionality sufficient to give him the strength, dexterity and sensation required to effectively operate a race car, there are still considerable doubts in my mind over whether his arm will be capable of enduring the physical exertion which racing in F1 demands in absence of substantial pain, numbness and/or progressive weakening of the hand.

If you read up on RSI which is directly related to median and/or ulnar nerve damage, you will begin to understand why physical endurance is an important factor to consider in addition to psychosomatic considerations.

Here’s to hoping he can make a startling full recovery and race amongst the top tier in F1 again, although there are many potential hurdles he must overcome in the near, mid and long term future if this is to happen.

Undoubtedly he would be sorely missed as an incredible driver with unfulfilled potential should it turn out that he is unable to return to F1. Best wishes to him.

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