Thanks to Trauma Team, Wounds are Nearly Invisible

The kick came without warning.

One moment Green Valley horse trainer Katie LeDoux, 27, was walking a horse from its stall to the training ring, and the next she was facedown in the dirt.

“I started to cry when I saw blood and realized I was spitting out my teeth.”
~ Katie LeDoux

The tall warmblood gelding had been stall-bound due to an injury and weeks of rainy February weather, and was just returning to work. Full of pent-up energy, it suddenly bucked and gave a joyful kick of freedom. Unfortunately for Katie, a hind hoof landed below her chin, breaking her jaw in three places.

“I didn’t know what happened, but I started to cry when I saw blood and realized I was spitting out my teeth,” Katie said. The accident happened so quickly that she had to rely on nearby witnesses for the full story.

A horse can deliver a potentially deadly kick with the force of up to one ton. Fortunately Katie was wearing a helmet and never lost consciousness. Within a few seconds, help was at her side and 9-1-1 called. Paramedics rushed her to NorthBay Medical Center for the kind of complex medical treatment that didn’t exist anywhere in Solano County just a few years ago.

That’s because NorthBay’s Level II Trauma team—already providing a level of acute care close to that offered at teaching hospitals—keeps even the most complex injuries here for treatment, thanks in part to the depth of support found on NorthBay’s “call list.”

“The American College of Surgeons requires Level II Trauma Centers to maintain a ‘call list’ of sub-specialists as part of their Level II designation,” explained J. Peter Zopfi, D.O., NorthBay Medical Center Trauma director.

Subspecialists are physicians whose training gives them expertise in the more complex aspects of a certain area within their specialty. The collaboration of such experts is helping Katie make an excellent recovery.

“Our list of subspecialists is long, and we’ve been able to attract some very talented physicians to our program,” Dr. Zopfi explained. “We also collaborate with medical personnel at Travis Air Force Base. Having so many specialists available means NorthBay Healthcare treats many kinds of injuries that would have been sent to hospitals outside the county in previous years.”

Katie arrived at the NorthBay Trauma Center with an open fracture and many broken and twisted teeth. A CT scan revealed that not only had her jaw been broken in three places, but she also had a small skull fracture. Trauma physician Haroon Mojadidi, M.D., called upon a neurologist for her skull fracture, an ear/nose and throat specialist, and an oral and maxillofacial specialist for the jaw fractures. Jason Marengo, M.D., was called in to provide a plastic surgery consult for her facial wounds, and has since taken the lead in her care.

“Our call panel is fantastic,” Dr. Marengo observed. “The subspecialists are highly regarded physicians in our community who contribute greatly to our trauma program. Having access to their expertise means we are able to deliver another level of care.”

“Facial injuries are inherently complex,” explained Tyler Nelson, D.M.D., M.D., the oral and maxillofacial surgeon who worked with Dr. Marengo to develop a plan of care for Katie’s injuries. “There is a lot of anatomy involved—teeth, bones, nerves—but most importantly is the fact that her face has been injured and your face is how you interact with the world. I reviewed the films and saw the fracture patterns, missing and broken teeth and discussed with the team the nuances of the case. We all wanted to develop a treatment plan that would provide her with the best possible outcome. NorthBay’s trauma team is very organized and fosters great lines of communications between all the specialists.”

In the weeks immediately following the injury, Dr. Marengo performed two surgeries—one to place plates on her jaw to stabilize it, and a second surgery to reset the plates and realign her bite.

“The arch bars and bands I have now will stay in place until Dr. Marengo is certain my jaw fracture is stable enough without them,” Katie said, “and then we will head into the tooth extractions, root canals and braces.”

But to see her today, it’s hard to believe she endured such an injury.

“At first I couldn’t even move my jaw, but now I can and the nerves have come back,” Katie explained. Fortunately, she didn’t have headaches or much bruising after the accident. All that remains is a barely noticeable scar under her chin. It’s only when she smiles wide—and she smiles a lot—that a visitor sees the bands and some missing teeth. Her dimpled smile and a positive and grateful attitude shine through.

“I am thankful, so thankful. It could have been so much worse. I really appreciate the team effort in my care. Dr. Marengo even came to my appointment with Dr. Nelson. I was really impressed. I trust my team. They all talk to each other and it makes this whole ordeal so much easier.”

Katie holds no animosity toward the horse. In fact, she is really looking forward to riding again—as soon as her care team approves it—as well as moving off a liquid diet and enjoying a good dinner that includes steak and corn on the cob.