Will play, will not play the quarter-final? The suspense surrounding the captain of the French XV, Antoine Dupont, is keeping France rugby in suspense. Victim of a fracture of the zygomatic bone following a shock during the match against Namibia on September 21, the scrum half was immediately operated on by maxillofacial surgeon Frédéric Lauwers, in Toulouse, and had a titanium plate fitted. The French team staff did not comment on the duration of unavailability, but gave reassuring news this Wednesday. The day before, forwards coach William Servat was confident, explaining that he hoped for a return for a hypothetical quarter-final against South Africa.
“This injury is quite common, since it is the second most common fracture in the face after that of the nose,” comments Doctor Ludovic Benichou, head of the maxillofacial surgery and stomatology department at Paris Saint Hospital -Joseph (who neither operated nor examined the player). “In general, we recommend that our patients not practice contact sports for 6 weeks, while the bill consolidates. And a return to gentle sport within 3 weeks after the shock. » A deadline which, if respected, sends us back to November 2, i.e. 5 days after the world final. So is an earlier recovery reasonable?
To return to rugby without risk, Antoine Dupont must wait until the fracture is completely healed. “The only purpose of the titanium plate is to stabilize the bones in the correct position, but it is not at all a protection,” explains the doctor. We are talking about six weeks of downtime, because this is the average duration for bone consolidation to be complete. » It may happen that the welding between the bones takes less time, but doctors are unable to know… Because even after six weeks, the break remains invisible on X-rays, and the X-ray still shows the features of a fracture. “The decision to restart must be taken by the medical authorities who will give an opinion,” judges Doctor Benichou. But also and above all by the player himself, who will make a fully informed decision. » By playing rugby again before the recommended time, the player’s cheekbone will remain fragile and Antoine Dupont exposes himself to the risk of the fracture moving. A shock which, normally, would not have done anything to him can send him back for a longer stay in the infirmary. “He is in fact exposed to all the serious consequences of such an injury that he was able to avoid during the first shock,” summarizes the surgeon.
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A fracture of the zygomatic bone is actually a triple fracture. The broken bones of the cheekbone stand out from the rest of the face. The after-effects can be aesthetic or functional. “The most serious consequences of such a shock are linked to vision,” explains Doctor Benichou. The muscle under the eye can become blocked; you must operate very quickly to avoid permanent visual problems. In the case of Antoine Dupont, this risk was quickly ruled out after the shock against Namibia. » Another possible consequence, the appearance of double vision. As the eyes are no longer aligned correctly, the brain is unable to combine the information they transmit. This symptom can appear immediately after the shock, or in the weeks that follow. “It is possible that edema compensates for the displacement of the orbital bone for a time,” continues Dr. Benichou. As the swelling deflates, the eye will move, and the symptom of double vision may take a month to appear. » Finally, the last functional risk is a loss of sensitivity in the cheekbone or upper lip.
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The idea of a protective helmet has been mentioned here and there. Beyond the fact that “no direct discussion with the French team about a mask” took place, according to World Rugby Director General Alan Gilpin, the prospect does not convince the specialists. “The only truly effective protection would be to use an American football helmet,” judges Dr. Benichou. But I don’t see how a flexible protection of 5 millimeters as required by rugby standards can be really useful to sufficiently absorb blows. Playing rugby means exposing yourself to shock again. A strategic player, Antoine Dupont will be targeted by his opponents, who will not care about the possible consequences of a second injury. With or without a helmet, if he resumes too soon, the scrum half will expose himself to a relapse. He will be aware of it, and so will his adversaries. So many parameters that must be taken into account and which will modify its behavior on the ground.