Jonathan Williams, age 16, was one of two sophomores who made his high school varsity baseball team last year. When his coach called a last-minute Sunday afternoon practice, Jonathan, now a junior at Marion L. Steele High School, drove to the field.
Jonathan, who plays second base, had a good practice until an infield grounder rolled between first and second base. Jonathan and the first baseman both dove for the ball. The other boy’s knee collided with Jonathan’s face, causing him to briefly lose consciousness.
“I got a call from Jonathan’s coach,” said Melissa Bires, Jonathan’s mom and a nurse at Mercy Health – Lorain Hospital. “When he told me what happened, I quickly headed to the baseball field.”
When she arrived, the right side of Jonathan’s face was swollen and his jaw hurt. Then he started vomiting. That’s when they called an ambulance.
Sports accident causes multiple facial fractures
Jonathan was taken to Mercy’s emergency department where a doctor examined him before sending him to radiology for CT scans of his head.
“As we waited, a doctor came in every few minutes to tell us about another broken bone in Jonathan’s face,” Melissa said.
In total, Jonathan had five fractures: two maxillary sinus fractures, the wall and floor of his orbital bones and his zygomatic arch, or cheekbone.
Jonathan was given a prescription for the pain and sent home.
Getting quick and convenient access to specialty care
On Monday morning, Melissa called Jonathan’s pediatrician, Rashmi Shekhawat, MD, at Akron Children’s Hospital Pediatrics (ACHP) Amherst, to make a same-day appointment.
“The intake person was really good,” Melissa said. “I said that Jonathan might need to see a plastic surgeon, which she relayed to Dr Shekhawat. Before we even got to Jonathan’s appointment, Dr. Shekhawat messaged a doctor in the pediatric plastic and reconstructive surgery center.”
After examining Jonathan, Dr. Shekhawat told Jonathan and his mom that specialists from Akron Children’s pediatric plastic and reconstructive surgery center regularly saw patients at the Amherst Health Center. Later, Dr. Shekhawat called Melissa to let her know Jonathan had a plastic surgery appointment in Amherst on Wednesday.
Coming up with an injury treatment plan
By the time Jonathan saw pediatric craniofacial surgeon Ananth Murthy, MD, director of pediatric plastic and reconstructive surgery and medical director for the Craniofacial Center and Speech Resonance Clinic at Akron Children’s Hospital, he had trouble looking up with the right eye. Due to pain, he also couldn’t eat and only swallowed liquids.
Dr. Murthy explained to Jonathan and his mom that Jonathan had a zygomaticomaxillary complex (ZMC) fracture. It happens when the bones that provide normal cheek contour and separate the orbital contents from the temporal fossa and the maxillary sinus, are fractured.
“Like a car, our faces have ‘crumple zones’ when there is impact around the eye and on the cheekbone,” Dr. Murthy said. “Once a fracture occurs in these areas, it can trap a muscle. The trapped muscle won’t get enough blood and can be injured. That leads to other issues, such as double vision, the eye sinking back, inability to focus and problems navigating stairs. It’s important to surgically repair this quickly to avoid long-term damage.”
Repairing a zygomaticomaxillary complex fracture
Two days later, Jonathan underwent surgery to release the trapped muscle and repair the fractures. Dr. Murthy’s team accessed the fractures through Jonathan’s eyelid and mouth so he would have no visible scars from the surgery. Children’s pediatric radiology also assisted by operating an O-arm intraoperative imaging system that provides two- and three-dimensional CT scans, which ensures symmetrical results during facial fracture repair.
After his surgery, Jonathan was able to go home to recover and recuperate without any issues. After two weeks, he returned to school.
As he healed, Jonathan’s focus was on returning to baseball.
Getting back to play
Jonathan got the all-clear from Dr. Murthy in under six weeks. Soon afterwards, he regained his spot on the Steele High School varsity baseball team.
“I only have faint memories of what happened at the field last March,” Jonathan said. “I just wanted to get back to playing baseball. Drs. Shekhawat and Murthy understood that. They supported and helped me with that goal.”
Jonathan, who hopes to play baseball in college, had a great season. His team made the division semifinals, plus one of Jonathan’s plays was featured as a “Big Catch of the Night” on Fox 8 Cleveland.
For Jonathan’s mom, the proximity of and providers at Amherst Health Center made things easier for her family.
“I’m so glad they’re here,” Melissa said. “We only went to Akron for Jonathan’s surgery, but everything else was done in Amherst. We had an excellent experience. The communications and response from Children’s were wonderful. It made a difficult situation much more positive.”