Doctor: Few surprises during Barbaro's surgery

Philadelphia Daily News ^ | 10/13/2006 | DICK JERARDI

[WestNJersey]

When he watched Barbaro break down, after performing an operation in Florida, Dean Richardson was fairly certain he would get the call. He did and was on a plane early the next morning.

If he could do a few things over, he would change some of what he said before the surgery that Sunday.

What he said was, "I haven't seen this particular combination of injuries.

"People took that as, oh my God, this is the worst fracture that ever happened," Richardson said. "That's not the case. I've seen way worse injuries than this. We've treated far worse injuries than this. But the reality is that this was an interesting group of injuries that I hadn't had an opportunity to see that exactly.

"I personally haven't treated that many orthopedic injuries that were way worse. This was a very, very difficult fracture. I wasn't overstating that. I didn't want the idea to come out that this is a completely unique injury because that's not the case.

"It was an interesting combination of things and it's very challenging. It still is. It is kind of what I predicted at the outset that you can't get too excited about the initial success because there's a lot of things that could still go wrong."

They did, of course.

"I knew we were going to treat [the injury]," Richardson said. "I'd seen the films. They were e-mailed to me. I had a pretty good notion of the available options and how I was planning on treating it. As soon as you saw the way his limb was moving when Edgar [Prado] was pulling up, you knew it was more than just a simple little condylar fracture. The horse clearly had an unstable fetlock."

There were not many surprises during the surgery.

"The more severe the fracture, the more it looks like you expect it to look," Richardson said. "The less severe injuries, those are actually the ones that occasionally you find disturbing little cracks in the bone that you can't see on the radiographs. And those affect your decision-making immensely sometimes. You go in there with a plan, you're planning on putting two pieces of bone together using a relatively simple technique. And then all of a sudden you find out one of these two pieces have lots of these little hairline cracks on it which can alter, especially in a horse. It isn't as much of a problem in humans and dogs. In a horse, that affects your decision-making immensely.

"With Barbaro, we knew pretty much. The only thing that was a little surprising was when we opened the fetlock joint up, he'd blown the back of his joint out so badly that the tendons which are normally behind the sesamoids were actually inside the joint.

"As soon as I opened that up and saw that, I said, ‘This is bad.' And it is bad. It doesn't change what you're going to do because we still knew we had to fuse the joint."

After 7 hours of surgery, repairing the fractures, fusing the joint and having the colt recover from the anesthesia, Richardson explained the operation was a success. But major hurdles, predictable and unpredictable, were ahead.

"Technically, I was fairly happy with the procedure," Richardson said. "If you're any kind of a surgeon, you look at your job that you did and you know that there's things you could do better almost every surgery. And that's true in his case. There's certain elements in his repair that if I had to do it over ... There's a few little details that if I had to do it over, I'd do it slightly different."

There are no do-overs.

"That's the nature of surgery," Richardson said. "It's not machine work. You don't get to take up a part, order new parts and start all over again. It doesn't work like that."