Cowboys second-round draft pick Jaylon Smith working out

Bizwah

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There were no reports that it was torn that I saw. The doctor that did the surgery said it was elongated, not stretched, and the exterior of the nerve was intact.
Early reports said it was torn....but you are right. I had forgotten the doctor say it was stretched. Couldn't remember who had said it. Seems like he has a good chance.
 

FuzzyLumpkins

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Palsy is just another word for paralysis. For a quick and easy diagnosis you go by whether or not the patient can feel anything. If they cannot then the success rate is poor. Reports are that Smith could not feel his foot. That means the Cowboys are stupid right? Maybe.

Thing is that all palsies are not created equal. First caveat to remember is that when a nerve is palsied all of the interior of the nerve dies from the point of injury to the outer region aka the distal region. So in this case all of the synapses from Smith's knee to his foot died. He couldn't feel anything. There was much despairing.

If you cut the nerve it's a palsy and without surgical intervention the nerve has no route to grow the synapses along. The prognosis is extremely poor.

If you stretch the nerve and damage the exterior then it impacts the bloodflow to the area. There are several complications that can arise from this. The cells that feed the neurons can atrophy and die. There is no bloodflow to allow lymphocytes (re: white blood cells), to the interior to transport out the dead cells. This leads to scar tissue and if there is too much scarring it will block the passage leading to a partial or blocked recovery.

If the exterior of the nerve is intact and blood flow is preserved then the nerve should regrow. The issue is reconnecting to the axonal exchanges with the muscle. There is a lot of theory about this process and I couldn't find anything definitive. Then again the research stuff you can find for free on the interwebs is typically a few years old at best. I cannot tell you what the current state of medicine is. I am not a doctor.

The thing is that 40% success rate from the study above conflated all three of these nerve injuries. A partial palsy is type 1 and has a very good success rate. I listed in order types 4, 3, and 2 here. That 40% is balanced by a less than 5% success rate with type 4s.

Now the thing is when we drafted him he was nearly 5 months post op. There are special MRI called MRNs that look at nerves so we at the very least could see whether or not scar tissue had been forming and the rate or regeneration. It is unlikely that the axonal junctions had been happening. Now that has likely changed.

The point being is that it appears that Smith had a type 2 injury. I can understand why the Cowboys would be relatively bullish on a complete recovery. I won't guess at a prognosis. If I do certain people harass me to no end. The above however is how I would inform my guess.
 

Zekeats

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Palsy is just another word for paralysis. For a quick and easy diagnosis you go by whether or not the patient can feel anything. If they cannot then the success rate is poor. Reports are that Smith could not feel his foot. That means the Cowboys are stupid right? Maybe.

Thing is that all palsies are not created equal. First caveat to remember is that when a nerve is palsied all of the interior of the nerve dies from the point of injury to the outer region aka the distal region. So in this case all of the synapses from Smith's knee to his foot died. He couldn't feel anything. There was much despairing.

If you cut the nerve it's a palsy and without surgical intervention the nerve has no route to grow the synapses along. The prognosis is extremely poor.

If you stretch the nerve and damage the exterior then it impacts the bloodflow to the area. There are several complications that can arise from this. The cells that feed the neurons can atrophy and die. There is no bloodflow to allow lymphocytes (re: white blood cells), to the interior to transport out the dead cells. This leads to scar tissue and if there is too much scarring it will block the passage leading to a partial or blocked recovery.

If the exterior of the nerve is intact and blood flow is preserved then the nerve should regrow. The issue is reconnecting to the axonal exchanges with the muscle. There is a lot of theory about this process and I couldn't find anything definitive. Then again the research stuff you can find for free on the interwebs is typically a few years old at best. I cannot tell you what the current state of medicine is. I am not a doctor.

The thing is that 40% success rate from the study above conflated all three of these nerve injuries. A partial palsy is type 1 and has a very good success rate. I listed in order types 4, 3, and 2 here. That 40% is balanced by a less than 5% success rate with type 4s.

Now the thing is when we drafted him he was nearly 5 months post op. There are special MRI called MRNs that look at nerves so we at the very least could see whether or not scar tissue had been forming and the rate or regeneration. It is unlikely that the axonal junctions had been happening. Now that has likely changed.

The point being is that it appears that Smith had a type 2 injury. I can understand why the Cowboys would be relatively bullish on a complete recovery. I won't guess at a prognosis. If I do certain people harass me to no end. The above however is how I would inform my guess.

Common sense.
 

hra8700

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To my understanding smith had a complete palsy meaning he lost all ability to use the muscles the nerve connects to. Based off the most recent review of all previous reports in the medical literature, there is less than a 40% chance that he will recover enough function to be able to lift his foot up against gravity (that doesnt mean he will have normal strength, jist enough to lift against gravity).

In other words, not at all promising that he will recover enough to play at a high level.
 

Bizwah

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Palsy is just another word for paralysis. For a quick and easy diagnosis you go by whether or not the patient can feel anything. If they cannot then the success rate is poor. Reports are that Smith could not feel his foot. That means the Cowboys are stupid right? Maybe.

Thing is that all palsies are not created equal. First caveat to remember is that when a nerve is palsied all of the interior of the nerve dies from the point of injury to the outer region aka the distal region. So in this case all of the synapses from Smith's knee to his foot died. He couldn't feel anything. There was much despairing.

If you cut the nerve it's a palsy and without surgical intervention the nerve has no route to grow the synapses along. The prognosis is extremely poor.

If you stretch the nerve and damage the exterior then it impacts the bloodflow to the area. There are several complications that can arise from this. The cells that feed the neurons can atrophy and die. There is no bloodflow to allow lymphocytes (re: white blood cells), to the interior to transport out the dead cells. This leads to scar tissue and if there is too much scarring it will block the passage leading to a partial or blocked recovery.

If the exterior of the nerve is intact and blood flow is preserved then the nerve should regrow. The issue is reconnecting to the axonal exchanges with the muscle. There is a lot of theory about this process and I couldn't find anything definitive. Then again the research stuff you can find for free on the interwebs is typically a few years old at best. I cannot tell you what the current state of medicine is. I am not a doctor.

The thing is that 40% success rate from the study above conflated all three of these nerve injuries. A partial palsy is type 1 and has a very good success rate. I listed in order types 4, 3, and 2 here. That 40% is balanced by a less than 5% success rate with type 4s.

Now the thing is when we drafted him he was nearly 5 months post op. There are special MRI called MRNs that look at nerves so we at the very least could see whether or not scar tissue had been forming and the rate or regeneration. It is unlikely that the axonal junctions had been happening. Now that has likely changed.

The point being is that it appears that Smith had a type 2 injury. I can understand why the Cowboys would be relatively bullish on a complete recovery. I won't guess at a prognosis. If I do certain people harass me to no end. The above however is how I would inform my guess.

Wow! Very nice post. Lots of research on your part. I think the fact that the Cowboys have him working on bands bodes well. It's interesting that they have MRI machines that can track the growth of nerves.
 

FuzzyLumpkins

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Wow! Very nice post. Lots of research on your part. I think the fact that the Cowboys have him working on bands bodes well. It's interesting that they have MRI machines that can track the growth of nerves.

Thanks for the kind words but I didn't come up with that all myself. That is just everything we found when we drafted him.
 
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Titleist

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To my understanding smith had a complete palsy meaning he lost all ability to use the muscles the nerve connects to. Based off the most recent review of all previous reports in the medical literature, there is less than a 40% chance that he will recover enough function to be able to lift his foot up against gravity (that doesnt mean he will have normal strength, jist enough to lift against gravity).

In other words, not at all promising that he will recover enough to play at a high level.

I would find it shocking if this is indeed true. I don't care if it's Joe Montana, spending a high 2nd round pick on a player who has <40% chance of lifting his foot again is absolutely insane.
 

FuzzyLumpkins

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I would find it shocking if this is indeed true. I don't care if it's Joe Montana, spending a high 2nd round pick on a player who has <40% chance of lifting his foot again is absolutely insane.

It's 40% if you consider type 2-4 nerve injuries which all result in palsy. Type 4 has a virtual 0% success rate without surgical intervention. I'm not sure of the other two success rate or what the proportions of incidents are but that is a very generalized prognosis whereas we know that Smith has a type 2.
 
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AbeBeta

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It's 40% if you consider type 2-4 nerve injuries which all result in palsy. Type 4 has a virtual 0% success rate without surgical intervention. I'm not sure of the other two success rate or what the proportions of incidents are but that is a very generalized prognosis whereas we know that Smith has a type 2.

Bravo Wikipedia Dr.!
 

AbeBeta

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To my understanding smith had a complete palsy meaning he lost all ability to use the muscles the nerve connects to. Based off the most recent review of all previous reports in the medical literature, there is less than a 40% chance that he will recover enough function to be able to lift his foot up against gravity (that doesnt mean he will have normal strength, jist enough to lift against gravity).

In other words, not at all promising that he will recover enough to play at a high level.

I disagree but am compelled to listen to Trout Mask nonetheless
 

Little Jr

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I have the same nerve damge as he does. Mine is worst though. I lost all ability to move my foot up and down. What the call foot drop or drop foot. Mine was from damage in my leg due to a drunk driver. Both my tibia and fibula snapped on 2 places completely and came out of my leg. Actual 6 in of my tibia was in the drs hand. When I heard he had similar damge, not as bad but to the same nerve I thought it was a wasted pick. I hope I'm wrong.
 

Little Jr

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I'm not a Dr but I live with it every day for the past 10 months and will for the rest of my life. I've talked to multiple drs about this condition and best odds I was given a 50/50 chance that I would get my movement back. If not I'll wear a brace for the rest of my life to keep my foot up or they'll fuse my foot to my ankle. Then my foot would be in the position that it is when we stand up in place.
 
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AbeBeta

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More like various medical journals, speaking with a neurologist, and webMD. I never claimed to be a doctor.

So internet Dr.

Are you qualified to evaluate evidence from a medical journal?

Reading don't mean anything
 

AbeBeta

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I'm not a Dr but I live with it every day for the past 10 months and will for the rest of my life. I've talked to multiple drs about this condition and best odds I was given a 50/50 chance that's would get my moment back. If not I'll wear a brace for the rest of my life to keep my foot up or they'll fuse my foot to my ankle. Then my foot would be in the position that it is when we stand up in place.

You are not an elite athlete

So obviously, no comparison
 

FuzzyLumpkins

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So internet Dr.

Are you qualified to evaluate evidence from a medical journal?

Reading don't mean anything

I qualified that I was not a doctor.

Care to tell me what I said that was wrong? The concepts in question are not difficult. I also noted that someone gave the 40% prognosis stating their understanding and you didn't come at them with this same take.
 

Little Jr

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You are not an elite athlete

So obviously, no comparison
Lol nerves don't have anything to do with being an elite athelete. Plus like I said it's not a complete comparison because Mine was worst. Again I talked to drs about the injury in general and its at best a 50/50 chance the nerve will fire.
 

FuzzyLumpkins

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I'm not a Dr but I live with it every day for the past 10 months and will for the rest of my life. I've talked to multiple drs about this condition and best odds I was given a 50/50 chance that I would get my movement back. If not I'll wear a brace for the rest of my life to keep my foot up or they'll fuse my foot to my ankle. Then my foot would be in the position that it is when we stand up in place.

What degree of injury did you have. What shape was the nerve in? Crushed, stretched, severed, intact?
 

Little Jr

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What degree of injury did you have. What shape was the nerve in? Crushed, stretched, severed, intact?
Mine was severed. Its gone. My leg was hanging on by skin. It was just 3 weeks ago that they actually said It was saved. No more worried about that now. Lol so mine was worst than his but my Dr and multiple others have told me that the nerve damage I had which was the same nerve as Smith is very hard to over come. 50/50 chance in general. Its been 8 months and he still has no feeling and can't lift his foot. That's not good. I'm not saying it can't happen just the odds are going down not up. And him being elite athelete is why he has a better chance than me is laughable. You don't work Your nerves out in the weight room. Lol
 
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