Dr. Matthew Landfried

Whether Tiger Woods can ever play competitive, PGA-level golf again depends on more than just his determination to recover from injuries he sustained Tuesday in a single-vehicle accident in Los Angeles, said Dr. Matthew Landfried, an orthopedic surgeon at United Memorial Medical Center.

Landfried spoke with members of the local media about the front-page news of the past couple of days involving the world's most famous golfer.

The 15-time winner of major tournaments lost control of the SUV he was driving and it crossed a median and veered through two lanes of traffic before hitting a curb, hitting a tree, and landing on its side in the brush, according to news reports.

Woods suffered multiple leg injuries. Landfried said based on what he's read of the injuries, Woods has a long, difficult recovery ahead of him.

"The amount of energy or force that causes the injuries creates additional problems with healing, excessive tissue damage, et cetera," Landfried said.

What concerns Landfried the most, when it comes to playing on the PGA tour, is the broken bones in the golfer's feet. Such injuries may make it impossible for Woods to walk -- as required by the PGA -- over 18 holes of golf on four consecutive days.

Then there are the compound fractures in his legs, which of themselves Woods may be able to overcome, but there are potentially two complications: whether the bones were broken at the ankle and knee joints (unknown) -- making rehabilitation more difficult -- and a procedure apprarently required in this case called a fasciotomy.

Landfried explains:

There are four (compartments) in the lower leg. Around those compartments is a sheath that's called fascia and it's actually very hard. I don't want to call it stiff, but it's unforgiving. It doesn't expand. So inside each compartment, most of them, there's a nerve and muscles and blood supply or blood vessels. When the muscles get injured that much, they bleed, they swell and they expand or want to expand beyond the ability of fascia to expand.

What starts to happen is you start cutting off blood supply, muscle starts to die and the nerves can be injured or killed. So you have to split that fascia. You have to take a knife and open that up from the top to the bottom. And when you do that, a muscle kind of comes oozing out and pours out, but it's taking the pressure off.

He added:

Because it is so swollen, you never close the fascia, but you can, most times close the skin, even in the leg. ... They probably did a two incision, for four compartments. So you got two large wounds from, you know, top of your leg to the bottom of the leg, wide open now. So those have to be treated with dressing or vacuum dressings, and infections are the biggest risk.

Finally:

The ability to heal because at that level of trauma is a second problem because what happens when the bone breaks that badly, it comes through the skin, the periosteum, which is a lining around the bone. I tell people it's like the sausage, the skin on a sausage, but it's around the bone that's been torn and stripped the blood supply to those areas that are broken, have been stripped and are gone. So, you know, as long as they reestablish, then you heal. If they don't reestablish, then you get what's called a delayed union or nonunion and sometimes it never heals.

So, all of those varabiles factor in Tiger's ability to not only fully recover but recover enough to hit the links again.

Woods hadn't been playing because he recently went through his fifth back surgery and was in recovery. Landfried said he hasn't seen any reports to indicate whether Woods reinjured his back in the accident but that could be another factor in his ability to play on the tour again.

At 45, Woods is just at the start of the age where most people find it more difficult, and it takes longer to recover from injuries. What may be in his favor is his athletically maintained body and his own willingness, well demonstrated over his career, to work hard. He will also have the advantage of physical therapists working with him every day.

"He's an incredible athlete," Landfried said. "He's working hard and he's going to have the best of the best. So as long as he can walk the 18 holes, he'll be back. But I just think it'll be some loss of power."

Press release from the U.S. Dept. of Health and Human Services:

WASHINGTON, D.C. -- A physician from Batavia, Matthew Landfried, is returning home from Washington, D.C., after providing medical support during the 2020 State of the Union Address by President Donald J. Trump on Feb. 4.

Landfried is a surgeon who serves as a member of the National Disaster Medical System’s (NDMS) Disaster Medical Assistance Team. During events such as the State of the Union, NDMS personnel along with U.S. Public Health Service Commissioned Corps officers stand ready to provide advanced life support and basic medical care to everyone attending the event.

NDMS is a federally administered program that can support communities with medical care, veterinarian care, and mortuary assistance during disasters or public health emergencies.

NDMS is among the resources made available by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR). They also work behind the scenes at some of our nation’s biggest events, often at the request of the Congressional Office of the Attending Physician, the U.S. Capitol Police, or the U.S. Secret Service.

“Typically at events like this we see people who have minor cuts or sprains or other non-life-threatening injuries or illnesses,” explains Dr. Helga Scharf-Bell, NDMS acting director. “However, we also can provide initial life-saving care for more serious injuries or illnesses and stabilize patients for transportation by DC Fire/EMS to a local hospital.”

NDMS comprises approximately 5,000 physicians, nurses, veterinary staff, paramedics, fatality management professionals, and experienced command and control staff, organized into several different response teams, including, but not limited to: Disaster Medical Assistance Teams, Disaster Mortuary Operational Response Teams, National Veterinary Response Teams, and Trauma Critical Care Teams. Providing medical care during emergencies and special events, such as the State of the Union Address, can overwhelm local and state resources. ASPR looks to the expertise within NDMS from across the country to assist in the response.

During the State of the Union Address, the Vice President, First Lady, Cabinet Secretaries, both Houses of Congress, Supreme Court Justices, the Joint Chiefs of Staff, and other senior level government officials come together in the House Chamber at the U.S. Capitol. The State of the Union Address gives the President the opportunity to report on the condition of our nation and outline his legislative agenda and priorities to Congress and the American people.

As part of the U.S. Department of Health and Human Services, ASPR’s mission is to save lives and protect Americans from 21st century health security threats. ASPR leads the nation’s medical and public health preparedness for, response to, and recovery from disasters and public health emergencies. During special security events like the State of the Union Address, ASPR stands ready to serve in case of an emergency. For more information about federal medical response and NDMS, visit www.phe.gov.

File photo of Dr. Matthew Landfried taken Nov. 30, 2018 at Terry Hills in Batavia when he received the Jerome Foundation's Health and Humanitarian Award. (A month prior to that, in October 2018, he was honored by Batavia's Paolo Busti Cultural Foundation during National Italian-American Heritage Month.)

The admiration for Dr. Matthew Landfried ran deep Friday at Terry Hills for the presentation of the Jerome Foundation's Health and Humanitarian Award but there was also a bit of humor along the way, including a giant bumblebee that delivered an honorary proclamation from State Senator Michael Ranzhofer along with a bouquet of flowers.

In the end, Landfried expressed his appreciation for the award.

"This doesn’t say what I do," Dr. Landfried said. "This tells me what the community thinks of who I am. I really appreciate it. Thank you very much."

Dr. Landfried is currently the medical director of Surgical Services and chairman of the Department of Surgery at UMMC, and serves on multiple committees at UMMC and its partner Rochester Regional Health. 

He also volunteers his time with Batavia and Notre Dame high schools, assisting on the sidelines of sporting events, serving as a team doctor. He's also been involved in several community organizations and supported many local causes financially. 

Greg McAlister introduced Dr. Landfried before the award presentation and his remarks along with a tribute video recalled many of accomplishments of Dr. Landfried's medical career, including remarks by a woman who recalled how Dr. Landfried stepped in to assist with a case after her father contracted sepsis after surgery.  The woman said she didn't want to return to the original surgeon. She said Dr. Landfried spent hours researching the case and trying to assist. When her father took a turn for the worse he tried to refer the case to a specialist in Rochester but none of the doctors he contacted would take the case.

"I begged Matt to try one last time and he did and he got a specialist to take the case," McAlister said, quoting from the unidentified woman's letter. "Because of Matt’s determination, my dad lived another 15 years.”

Dr. Landfried is a member of the Trauma and Critical Care response team of National Disaster Medical System of the U.S. Department of Health & Human Services, he has volunteered in Haiti, Texas, and other disaster sites supporting the critical medical needs of the communities struck by disasters such as earthquakes and hurricanes. He assisted at an orphanage in Haiti and remains in contact with them and provides financial help as well.

As part of Friday's festivities, each guest of the luncheon received a small jar of honey and a small wooden honey wand, which, along with the bumblebee costume, recognizes one of Dr. Landfried's hobbies: raising honey bees. He and his wife also grow apples, grapes and make wine on their farm property on Shepard Road.

In addition from a proclamation from Ranzenhofer delivered by a bee, Dr. Landfried received proclamations from Assemblyman Steve Hawley's Office, the County Legislature, delivered by Legislator Shelly Stein, and the Batavia City Council, delivered by Councilman Bob Bialkowski.

"People like you," Bialkowski said, "with your commitment, your dedication, all your time and contributions, you make Batavia a great place to live."