Today I’ll be examining three iconic Spider Man scenes from an orthopedic perspective.
BROLL you can’t save everyone
And yes, I’m excited for No Way Home. Stop a random person on the street and ask them
who their favorite superhero is and 48% of the time, you’ll hear Spider Man– at least
according to a recent study conducted by GAME.
SOURCE:https://www.game.co.uk/webapp/wcs/stores/servlet/HubArticleView?hubId=2855754&articleId=2855755&catalogId=10201&langId=44&storeId=10151
BROLL map
Admittedly, Spidey is very easy to love: a teenage science wiz with unshakeable morals
and a heart of gold. Like any young man suddenly endowed with incredible superhuman powers,
Peter Parker struggles to balance his personal life and his newfound responsibility as a
superhero.
BROLL wiki
Since 2002, there have been 8 live action Spider Man films with different production
teams and casts– not including animated features, appearances in other Marvel films,
or earlier made for TV movies. There is something about this young man that captivates audiences
around the world. At his core, he’s just a guy trying to do the right thing… Trying
to save the people he loves… Trying not to let anyone die… The thing is, when you’re
up against villains as sinister as Norman Osbourne’s Green Goblin, that might not
be possible. Sometimes things just don’t go as planned.
BROLL Grenade to the face
After taking a pumpkin bomb to the face– which is basically a grenade, any normal human
would be toast. When the blast sends you crashing into a brick wall, double toast. In reality,
a blast of this strength would: likely be deadly as a result of the concussive force
of t shockwave of the blast. Let’s ignore for a second, the shrapnel from the grenade
itself, or the burns associated the combustion of the explosive charge, both of which are
themselves deadly. But, the ignition of the grenade would create a small explosion whose
pressure wave from the compression of the air around the explosive, would be sufficient
to cause an energetic transfer of energy to the body. What wasn’t broken, lacerated,
or burnt, would be shaken violently with irrevocable disruption of tissues at a cellular level.
Extensive soft tissue damage would result with a generally poor outcome. The subsequent
collision with the brick wall woud: Add salt to this proverbial wound. As if the soft tissue
damage caused by the blast weren’t enough, there would be extensive damage to the skeleton
as a result of the initial blast and then the subsequent collision with the wall. The
initial blast would cause frontal fractures of the chest cavity and pressure injuries
to the hollow organs contained within, primarily the lungs. The collision with the wall would
cause fractures to the back of the skull, the posterior chest wall, the pelvis, and
possibly even the long bones of the extremities as they struck, correction, as they were splatted
against the wall. But this, interns, is why we study superhumans… More bang for our
buck!
In the following sequence, good ol’ Norm uses Peter as punching bag, delivering brick-crushing
blow after brick-crushing blow, in an attempt to pulverize spider-man’s bones down into
a powder. These last two connections are especially painful, first rotating Peter’s neck sharply
and then knocking it into extension with enough force to send him flying through the air.
The first punch would impart a significant rotatory force to the cervical spine. This
could result in a serious rotatory cervical spine injury such as a unilateral or even
bilateral facet dislocation. This is an unstable injury in and of itself. However, adding a
forcible extension force to the already dislocated and unstable cervical spine would be a great
way to ensure that Peter Parker performed his friendly neighbourhood spider duties from
a wheelchair.
We must also take note that the Green Goblin’s armour is made of some type of metal – bonus
points if you can tell me what material was used down in the comments. Peter yelps like
an injured puppy as he collides with the ground. In a non-super human, I wouldn’t be surprised
to find: additional posterior rib fractures and pelvic to the pelvic wings, or the iliai,
or the sacrum itself.
Looking back, this scene is quite intense… No music, no beating around the bush. Just
blow after blow. And it really seems like Norman has it out for Peter’s neck. Just
look at that rotation…
BROLL second neck rotation punch
The neck is definitely not built to withstand recurring rotational forces of this magnitude.
Spidey tries to escape, shooting his web to safety but Norm has obviously been watching
a fair share of WWE and delivers a twisting corkscrew clothes line. The Green Goblin is
ready for Monday Night Raw… Another blow to the neck and another collision with the
ground. If Peter isn’t feeling it in the chest, head, or neck by now, then I don’t
know up from down.
Unfortunately for Norm, this is the difference between a man in a goblin-suit and a man who
has inherited accelerated healing abilities and the proportional strength of a spider.
If your genetically altered body is capable of lifting 10 tons, you can probably take
a few punches.
I really don’t think Norm likes spider webs that sound like rebar when bent. You can tell
by this Liu Kang inspired flying kick followed by the lengthy villainous diatribe. Film yourself
like you’re waiting around… And then–
BROLL stab attempt
For some reason, Spidey doesn’t want to have his face skewered by an electrified trident
and shows a little bit of his true strength. He throws Norm backwards across the arena,
and uses his webs to pull a brick wall down – flat – on top of him. Either our Goblin
is consumed by the wall, consumed by the ground, or literally flattened the thinness of a crepe.
None of the above bode well for Norm as he is still a human in a costume. In similar
accidents of this type, when a person is crushed by falling rubble there are several injurious
mechanisms to be aware of including fractures of the skull, fractures of the thorax, and
extremity fractures. Although potentially catastrophic, compressive extremity fractures
are generally survivable, however the same is not true for compression of the skull or
the thorax. Both contain organs that are extremely important to survivable, namely the brain,
the heart, and the lungs. If any one of these structures is compressed to a significant
degree then it becomes really difficult for the body to continue to function normally,
if at all. The brain is basically electrified jello. Squish it, and all the lights go out….permanently
regardless of what else might be ailing you. The heart and lungs, on the other hand, are
both pumps that move blood and air respectively. Compress the chest and you impair the ability
of the pumps to move their contents. And last I heard, if you can’t circulate blood or
air around the body…well, you can’t really do much of anything…ever.
But it isn’t over just yet. Norm climbs out of the rubble just in time for Spider-man
to administer a flying football tackle… wait, is that even possible? Maybe it’s
more Quidditch?
BROLL landing and punch followup sequence
We already know what can happen from a backbreaking throw and several unblocked punches to the
face. In this case however, we can imagine the possibility of Peter’s 10 ton strength
bending the Goblin armour which may complicate Norman’s injuries somewhat: the repetitive
blows to the face would result in injuries to the facial bones including maxilla, mandible,
or orbital fractures. With the forces that Spiderman can generate, Norman’s face could
be expected to be “well mash up.” Depending on the the tensile strength of the Goblin’s
armour and its resistance to bending, his face might also be extensively lacerated by
the bent metal.
After another villainous monologue, Norm launches a glider sneak attack in an attempt to finish
Spidey for good. But… the fool ends up finishing himself. Norman is impaled in the abdomen
by two sharp blades that protrude from the front of the glider. Now, getting stabbed
in the abdomen once is not any fun and I am pretty sure that getting stabbed in the abdomen
twice at the same time is not any better. If you thought that Jang Deok-su stabbing
his henchmen in the abdomen was bad news, well this is en worse. While Jany Deok-su
stabbed his henchmen with a straight blade, here Norman is stabbed with two scimitar-like
blades. Your abdomen is jam packed full of gastrointestinal organs, namely the stomach,
the liver, the and the large and small bowel. Laceration of any of these organs with a knife
will offer a pathway for food contents to spill out of the GI tract, into the periotoneum.
This is a potential source of peritoneal contamination, either with food contents and digestive enzymes,
or with poop in various stages of formation and bacteria. Neither of these is good for
you and both require immediate medical attention. But since Norman is stuck to a wall in a dilapidated
building somewhere, his access to urgent medical care is, shall we say, limited. Normally,
this type of injury is assessed and treated with a diagnostic laparotomy where they open
up your belly and “run the bowel”, looking for evidence of injury. Of course, if you
find food or poop in the peritoneal cavity, that needs to be removed and the peritoneal
cavity thoroughly cleaned. Of course, since the bowel was dirty at the time of laceration,
you can’t just repair the laceration and then close it up because extensive fulminant
infection would be likely to occur. Consequently, bowel surgery in this context is going to
result in a temporary stoma of some sort unless the Goblin had the foresight to clear out
his bowels with a bowel prep before his fateful encounter with Peter. A stoma is a hole where
the bowel is brought out of the belly through the skin. The stoma would empty into a bag
and would be kept in place until the intra-abdominal injuries healed. But Norman will not need
to worry about this as it appears that he quickly perishes from intra-abdominal bleeding.
This would occur if one of the blades lacerated the aorta, the vena cava, or one of e major
vascular branches off of these vessels. With a large enough laceration, the peritoneum
would fill quickly with blood leaving little to return to the heart to be pumped elsewhere
around the body. Bad news. The pump is no longer primed and that’s a problem.
And thus ends the Green Goblin. If you are gonna pick a fight with the spiderman, you
better be prepared. I feel like there is a lot that these scenes can teach us about injuries
and the human body under more realistic conditions. What othemovie breakdowns do you guys want
to see next? Be sure to let me know in the comments. As always, that’s been a word
from Dr. Chris, not your everyday ortho.