From Baptist Health South Florida
5 min. read
For 13-year-old Xavier “Javy” Perez of Key West, Fla., playing sports is everything. “It’s a really big thing in my life, probably one of the most important things to me besides my family,” says the aspiring professional athlete, who plays shortstop on his school’s baseball team, point guard on the basketball team and quarterback on the football team.
(Watch now: 13-year-old student-athlete Xavier Perez credits Derek Papp, M.D., with getting him back in the game after a devastating injury to his throwing arm earlier this year. Video by Anthony Vivian.)
Earlier this year, Javy was playing at a regional baseball tournament in Tallahassee and had a ball hit to him. He fielded the ball and had to throw it awkwardly across his body over to first base. As soon as he released the ball, he felt something crack in his arm and he fell to the ground writhing in pain. “It was like I had just ripped my arm off completely,” Javy recalls. “It was the worst pain I’ve ever felt in my life.”
His mother, Terese Perez, was in the stands by the team’s dugout and saw Javy lying on the ground. “I couldn’t see what happened but I knew it was something pretty bad,” she recalls. “I was also worried it was something maybe worse than him just hurting his arm. It was scary, to say the least.”
Daryl Osbahr, M.D., an orthopedic surgeon from Winter Park whose son was on the opposing team, asked Mrs. Perez if he could take a look at her son’s arm. He suspected Javy had fractured his medial epicondyle, a part of the elbow which first appears around age 6 and doesn’t completely fuse to the shaft of the humerus, or upper arm bone, until age 14 to 17.
A medial epicondyle fracture is an avulsion injury of the attachment of the common flexors of the forearm, according to Baptist Health Orthopedic Care, and it is the third most common type of fracture seen in children, accounting for nearly 20 percent of all pediatric and adolescent elbow fractures. Three-quarters of those cases occur in boys aged 9 to 14.
Mrs. Perez was grateful for Dr. Osbahr’s offer of assistance. “He told me he thought he would have to have surgery of some kind and asked me if there was any way he could help,” she says. “He took my name and information and said he would put me in contact with someone he knows in the Florida Keys.”
A call from the Keys
That night, still in Tallahassee with her son, Mrs. Perez received a call from Derek Papp, M.D., an orthopedic sports medicine surgeon with Baptist Health Orthopedic Care who is a longtime friend of Dr. Osbahr’s. “I told him we’d be back in the Keys on Monday and he said he would meet us then,” Mrs. Perez says.
Dr. Papp provides orthopedic care to athletes of all ages and skill levels – professional, collegiate, high school and recreational – and specializes in treating shoulder and elbow injuries, particularly those suffered by pitchers, quarterbacks and other throwing athletes. He works with the Baltimore Orioles and is also a member of the MLB Team Physicians Association.
As promised, Dr. Papp met with Javy and his mother on Monday. Two days later, he was performing Javy’s surgery at Baptist Health Fisherman’s Community Hospital in Marathon. The injury Javy suffered is not uncommon but it can be difficult to recover from, according to Dr. Papp.. “For Javy, it was certainly very doable,” he says. “It was actually easier than a traditional Tommy John tear because we didn’t need to do a ligament reconstruction, being that he’s only 13.”
Named for the former Los Angeles Dodgers pitcher who in 1974 was the first to undergo the procedure, Tommy John surgery is commonly performed on college and pro athletes, especially baseball pitchers, replacing the injured ulnar collateral ligament (UCL) with a tendon from elsewhere in the body.
Dr. Papp says Javy’s injury was different, due to the fact that he is young and his bones are still growing. “The reason why Javy sustained the injury he did is that part of his growth plate actually ripped off,” he explains. “If he was a little bit older, that wouldn’t have happened. Once you turn 14, 15, 16, you don’t have that growth plate anymore. He would have had more of a traditional ligament tear which would have required Tommy John surgery.”
Today’s student-athletes bigger and stronger
According to Dr. Papp, he and his colleagues are seeing more and more of these types of injuries to throwing athletes, and he attributes the increase to several factors. “There are increased athletic demands on today’s student-athletes, who are increasingly becoming one-sport athletes,” Dr. Papp notes. “By not switching from one sport to another during the year, they’re placing repeated stress on certain joints and muscles all year long.”
Another problem, says Dr. Papp, is that today’s student-athletes are growing bigger and stronger. “That’s certainly part of it – these kids are stronger and better conditioned than ever,” he says. “They can throw harder, which puts them at higher risk. And, they’re typically training and playing at a peak level every day, so they’re not giving their joints and muscles the rest and recovery they need.”
Dr. Papp adds that, with enhanced technology, physicians are better able to diagnose and treat the type of injury that Javy suffered, along with other similar injuries. “If you think about it, we didn't really have MRIs as a modality to look for soft-tissue injuries until the mid-nineties,” he says.
Ready to get back on the field
Recently, Javy returned to the dugout with his team. “As I was sitting on the bench watching the game, I was wondering if I would ever again be able to play the sport I love. It was really hard trying to take that in,” he says. But Javy is confident – as is Dr. Papp – that he’ll be able to join his team next season,
“Javy’s rehabilitation following surgery has gone well and I fully expect him to be able to play again next season. His range of motion is already awesome, and he has no pain at all,” says Dr. Papp. “His goal is to play in high school and college and then, if everything falls into place, for longer than that. So we’re going to make sure he gets the best care possible and that he’s able to recover well.”
Rehabilitation hasn’t been easy for Javy, who says he misses being able to play all of his favorite sports. “It’s been pretty tough on some days. You go through a lot of pain but you have to work through it to get healthy again,” Javy says, adding that his arm “feels great” and he’s anxious to start playing again. “I feel like I’m ready to get back on the field but, you know, doctor’s orders.”
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