The severity of Cisse's injury

It was a strange one because when a player suffers a nasty fracture like Djibril did they usually lie still on the pitch. Djibril rolled over, then got up onto his knees as though he was going to try and stand up, then he sat up and then started rolling around again. From the position we had, although we saw the incident, it looked fairly innocuous and not too bad. Then some of the players started to summon us over and that's when we realised something was wrong. When we got there he was obviously in some distress and it was clear very quickly that he had done something serious. 

From our point of view there were then two things to do. Firstly we had to alleviate the pain which we managed to do with entinox and the other was to try and immobilise the fracture so that we could then transport him properly to an area where we could examine the injury properly. We took him to the treatment room where it was clean, warm and with good lighting so we could cut off his boot and sock to get to the leg and make a formal assessment.

One of the things you look for when you see an injury as bad as Djibril's is whether he has suffered either any nerve injury or any vascular injury. I found that he had lost the blood supply to his foot. He had a shortened, slightly angulated lower leg with no pulses in his foot. There are a couple of reasons why that could have happened, he could either have severed the artery or the broken bone could have been pressing against the artery. 

We were left with two options in the treatment room. We could spend an hour or two getting to the hospital and have the leg x-rayed or we could grab the leg and manipulate it. We took the second option and if we'd taken the first and gone to hospital then he wouldn't have done as well as he has since because in the time spent getting to the hospital he would have suffered even more damage. 

In order to manipulate the leg we had to give him a good analgaesic which almost put him to sleep and he honestly has no recollection whatsoever of what we did to him in that room. Fortunately, with one pull of the leg we managed to get it in a good position and at the same time return the blood flow to his foot. It meant he only had a lack of blood going to his foot for three or four minutes, which is not a big problem. 

Everything was done very quickly. The doctor at Blackburn and Dave Galley our physiotherapist were excellent and we worked as a team with one doing one thing and one doing another. 

From the treatment room we made sure he was stable and then took him to hospital for x-rays. We then found that the position we'd got his leg into was acceptable overnight and we then transferred him to a private hospital. 

When any player has what's called a commimuted fracture of their tibia and fibula then it's a potentially hazardous injury for them. I don't want to be dramatic about it but a number of players haven't been able to continue their football careers after this injury.

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