Doctors predict a very difficult recovery for Tiger Woods

The serious lower leg injuries Tiger Woods sustained in a car crash on Tuesday typically lead to a long and perilous recovery, calling into question his ability to play professional golf again, according to medical experts who have treated similar injuries.

Athletes with severe leg injuries thought to doom their careers have managed to come back.

But Woods’ injuries are more extensive, and his path to recovery is strewn with serious obstacles. Infections, inadequate bone healing and, in Woods’ case, previous injuries and chronic back problems may make a months long or even years long recovery even more difficult, and may reduce the chances that he will play again.

In the accident near Los Angeles, Woods’ lower right leg was smashed and his right foot severely injured, and his leg muscles swelled so much that surgeons had to cut open the tissue covering them to relieve pressure, Dr. Anish Mahajan, the chief medical officer at HarborUCLA Medical Center, where Woods, 45, was treated, wrote in a Twitter message posted on Woods’ account.

Doctors also inserted a rod into Woods’ shin bone, and screws and pins into his foot and ankle. Physicians familiar with these the kinds of injuries described the complications they typically bring.

The injuries are frequently seen among drivers involved in car accidents, said Dr. R. Malcolm Smith, chief of the orthopedic trauma unit at Massachusetts General Hospital in Boston. Usually they occur when the driver frantically stomps on the brake as a car careens out of control.

When the front end of the car is smashed, immense force is transmitted to the driver’s right leg and foot.

“This happens every day with car crashes in this country,” Smith said.

Such lower-leg fractures on occasion bring “massive disability” and other grave consequences, said Smith.

The crash caused a cascade of injuries. It smashed Woods’ shin bones, with primary breaks in the top and bottom parts of the bones and a scattering of bone fragments. When the bones in Woods’ shin shattered, they damaged muscles and tendons; pieces poked from his skin.

The trauma caused bleeding and swelling in his leg, threatening his muscles. Surgeons had to quickly cut into the layer of thick tissue covering his leg muscles to relieve the swelling. Had they not, the tissue that covers swelling muscle would have acted like a tourniquet, constricting blood flow. The muscle can die within four to six hours.

It is possible that some muscle died anyway, between the accident and the surgery, Smith said: “Once you lose it, you cannot get it back.”