Published December 07, 2011
A Texas model who accidentally walked into an airplane propeller faces a long rehabilitation, according to one longtime emergency room doctor.
Lauren Scruggs, 23, suffered multiple injuries Saturday night after she had just finished riding in a single-engine plane to get an aerial view of Christmas lights with a friend.
After de-boarding, Scruggs accidentally walked directly into the plane’s propeller, which was still spinning. The blades sliced the left side of her face, including her eye and cranial nerve, and severed her left hand.
Scruggs was rushed to Parkland Hospital in Dallas, where doctors reported she is now in stable condition after several surgeries.
However, recovery is still a long way off for Scruggs, said Dr. Michael Lucchesi, chairman of emergency medicine and chief medical officer at Downstate Medical Center in Brooklyn, N.Y., who did not treat Scruggs.
After dealing with any potentially life-threatening injuries, Lucchesi said trauma doctors will likely focus next on repairing her eye.
According to web updates from Scruggs’ family, Scruggs suffered damage to the globe of her eye. Doctors initially believed the eye could not be salvaged, but were able to repair the globe in a later operation.
“A ruptured globe is very difficult to repair,” Lucchesi said. “So … just to save the globe, that was a pretty good job right there. Going forward, they’re probably going have to do more reconstructive surgery, so they won’t know the degree of vision loss for quite some time. However, it would be extremely rare for her not to have some visual deficits.”
Lucchesi noted that if Scruggs does suffer total vision loss in her left eye, she would lose depth perception - the ability to tell how far away objects are – because both eyes are needed to estimate distance.
Another major focus is Scruggs’ severed left hand, which doctors successfully amputated at the wrist.
Lucchesi said Scruggs likely will be fitted with a prosthetic – meaning that she will lose function of that hand.
“If her doctors had to take all eight carpal (wrist) bones out, and the nerves and the vessels, probably at some point she would be left with just a stump, and have a prosthesis put in,” Lucchesi said. “Now keep in mind, you normally don’t see stuff like in the Six Million Dollar Man. You don’t typically see prosthetics that have anywhere close to the function of the normal hand.”
“Most prosthetics are just cosmetic, so you’ll have something that looks like a real hand and have the texture of skin, but most that are available are not functional,” he added.
The most important function of the hand is the pincer grip – bringing the index finger and thumb together. This grip allows people to hold objects and feed themselves, among other things.
Depending on whether Scruggs is left- or right-hand dominant, she may have to re-learn these functions with her non-dominant hand.
Scruggs also suffered a facial laceration, which caused damage to her left facial nerve. The facial nerve not only controls facial expressions – meaning Scruggs could lose the ability to furrow her brow or smile – it also regulates other functions like opening and closing the eye.
“The nerve acts like a hook, so if there’s damage to it, you can’t close the eye all the way,” Lucchesi said. “We blink hundreds and hundreds of times a day as a way to lubricate the eye. If you can’t do that, then the cornea can dry up and ulcerate.”
When the cornea ulcerates, it loses its transparency and can result in infection of the eye and potentially vision loss.
It’s relatively easy for doctors to spot and assess damage to the facial nerve, which runs through the cheek, but much more challenging to repair.
“Nerves are so difficult to reconstruct or repair,” Lucchesi said. “A lot of people think you can just sew them up, but it’s really not that easy. And they rarely regenerate in any form. If it’s just partially cut, that’s one thing, but if it’s completely damaged, there’s not much you can do.”
Scruggs’ family also mentioned a skull fracture, which may actually be one of Scruggs’ least threatening injuries, depending on certain factors.
“The severity really depends on whether the fracture was open or closed and whether it was depressed or not,” Lucchesi said.
An open fracture means the skin above the skull was split open, which would put Scruggs at a much higher risk of serious infection. A depressed skull fracture means the broken bones of the skull were pushed inwards, which can put pressure on the brain and potentially cause brain damage.
However, as long as the fracture is closed, and there is no brain damage, the injury is relatively not a huge concern, Lucchesi said.
Another injury that is not as big a concern in Lucchesi’s opinion, is Scruggs’ broken clavicle, which will essentially require a sling and approximately six weeks of healing time.
“Broken collarbones are very common injuries,” Lucchesi said. “You can break your collarbone in a ski accident or something like that. It doesn’t require surgery.”
Right now, a bigger concern is the potential for infection from any one of Scrugg’s open injuries.
“Infection of the skin is one thing,” Lucchesi said, “But if she has an open skull fracture and if the bone gets infected, it’s very difficult to treat. She’d have to go on antibiotics for a very long period of time. Infection can also destroy tissue, and destroyed tissue has to be removed.”
There were many opportunities for infection in Scruggs’ case, beginning with the initial inoculation in the airport field and the existing bacteria on her skin. Afterward, being brought into the ER would have exposed her to other infections.
“There are sick people in hospitals and lots of antibiotics, so you have some highly resistant bacteria,” Lucchesi said.
The doctors priorities are to fix her up and get her better, he said – adding that she’s likely in a highly-monitored area right now, but then the next step would be to downgrade her into safer areas and then move her out of the hospital. Currently, Scruggs is not allowed visitors due to the high risk of infection.
“I know it’s hard to believe,” Lucchesi said, “but there’s actually much more risk of infection in a hospital than out.”
However, it’s likely Scruggs still has weeks of recovery time before she can go home, Lucchesi said – and then she still faces follow-up visits for reconstruction surgeries and other issues.
“This poor woman is going to be in the hospital for quite a while,” Lucchesi said. “This was a terrible injury for her. I know these small private planes have regulations and things, but there are still a lot of inherent dangers surrounding them. Thank goodness she’s alive.”