today I'm talking about ridiculous injuries from the Netflix movie extraction
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today I'm going to be talking about injuries from the Netflix movie extraction featuring Chris
Hemsworth rug shacks jaiswal and randeep hooda I'll be reviewing random scenes from the movie
and giving my perspective from the viewpoint of an orthopedic surgeon I'll describe the
injuries that are most likely to have occurred in these scenes and whether or not these particular
scenes are realistic from the orthopedic point of view be sure to stick around to the end where
I contrast this movie with the action from one of my favorite film franchises John wick this
is going to be a spoiler alert because you're going to find out what happens in this movie by
watching this video so go watch that movie first and then come back to watch this video otherwise
you'll have been warned okay so this first injury comes from the first fight scene of the film where
Chris Hemsworth character Tyler takes on an entire room of gang members when he attempts to rescue
a hostage while simultaneously fighting two gang members Tyler grabs one gang member and summarily
whips him to the floor by his head and his neck the accompanying sound effects let us know that
this ended up with some kind of cervical fracture that in immediately incapacitates this gang member
shortly thereafter Tyler's attention turns to a gang member who is attempting to rise to his feet
from the floor tyler notices this and violently kicks a table in the general direction of the
gang member unfortunately for the gang member as he is rising to his feet the sliding table
crashes into the front of his head smacking it backwards into the tile countertop the
gang members head is crushed between the tabletop and the counter and still during this same fight
scene tyler is attacked from behind by another gang member who attempts a rear naked choke he
subsequently suplexes this attacker onto the back of his head and neck causing extreme hyperflexion
of his cervical spine all right so now for the orthopaedic analysis so for this first set of
injuries it appears that the theme is head and neck injuries the first gang member is
stopped when he is handily thrown to the floor the second gang member has his head crushed between
the counter top and the table depending upon the force with which the table were kicked this could
result in only a mere concussion or it could be significantly more serious causing a skull
fracture an orbital fracture or even a LeFort facial fracture unlike the first gangster who was
injured I wouldn't expect a cervical spine injury with this attacker because the head was crushed
between two structures and there was little force imparted directly onto the cervical spine the
third attacker injured during this scene suffered a forced hyperflexion injury to the cervical spine
when he was suplexed backwards onto his head on the concrete floor the most common fracture
mechanism for cervical injuries is hyper flexion or in other words excessive flexion where the chin
is forced downwards towards the chest the type of injuries that are possible with a hyperflexion
mechanism include an anterior subluxation a simple wedge fracture and unstable fracture a unilateral
Fassett dislocation bilateral Fassett dislocation flexion teardrop fracture and an anterior atlanta
axial dislocation and all of these are just different types of cervical spine injuries
none of which are good but no matter how you put it none of these three attackers is getting up to
fight with Tyler again so this next series of injuries comes from several scenes where Tyler
has rescued the hostage movie and is now trying to escape the apartment building in which the
gang members apartment is located in the first scene Tyler is fighting with one of the main
antagonists Sashi on the second floor balcony of the apartment building as Tyler Asajj you are
fighting they lose their balance and they fall over the railing of the balcony they slide down
the top of the first floor and fall from a height of approximately eight to ten feet directly onto
the pavement below both characters land directly onto their sides on the pavement after attempting
to secure a gun which has become loose on the ground during the fall they immediately
transition into a nice fight during this knife fight they are both lacerated several times by
knife strikes at what appears to be the conclusion of this fight Tyler who is standing in the middle
of the street is struck by a passing vehicle and thrown a distance of approximately five to ten
feet ouch sad you is able to get up and walk down the street where he is able to secure the hostage
ovie from the Indian police officers in a rather brutal and efficient manner as sad you walks
back down the street to make his escape a truck which is ultimately driven by Tyler summarily
smashes sad you fall striking him broadside and throwing him through the air approximately 10 to
15 feet so now for the orthopedic review first to fall Tyler and sighs you fall a distance of
approximately eight to ten feet from the awning onto the ground directly onto their sides neither
of them is knocked unconscious and they both seem to have full use of all four extremities after the
fall falls from height are generally high-energy injuries that are associated with an increased
risk of morbidity and mortality and this just means that falling from a height is bad and can
increase your chance of injury or death I think that it is amazing that neither of these fighters
has suffered a head neck spine or extremity fracture as a result of this fall although
the height was relatively low at only eight to ten feet neither fighter had an opportunity to right
themselves in the air prior to making contact with the ground they both managed to fall directly onto
their sides without injuring themselves this is unusual since it will required not one but
both fighters to land parallel to the ground in a manner that spread the force of impact over
as large a surface area as possible and that's just because it's better to fall flat onto your
side than it is to fall onto an out stretch up and egde or your head however falling directly
onto your side is not foolproof either this injury mechanism is consistent with injuries that include
shoulder separation a proximal humerus fracture that is to say a fracture where the head of the
humerus and the shaft are joined or a fracture of the glenoid which is the cup of the shoulder joint
next we have Tyler being struck by a vehicle while standing in the middle of the road here Tyler is
struck by a relatively small vehicle four-door sedan he is struck in the legs by the bumper
and as his legs are knocked out from underneath himself he rolls onto the hood and the windshield
of the offending vehicle as the vehicle breaks to a halt he is subsequently thrown off the hood
of the car onto the ground approximately five to ten feet in distance it is not immediately clear
whether he is simply unconscious badly injured or even dead when looking at this collision there are
a number of injuries that we might expect simply from the mech of injury as Tyler is struck first
in his legs while standing we might expect him to have any number of lower extremity fractures
this could include fractures of his ankles his lower extremities below the knee including his
tibia and fibula or even his femurs however the fun would not stop there in addition he
may have also suffered a fracture of his pelvis as a result of the impact with the motor vehicle
given the direction from which he was struck we would expect this to be a lateral compression
type of fracture where the main pelvic wing was pushed in towards the midline of the body
we might also expect Tyler to have fractures of the upper extremities and neck as his upper
body head and neck are whipped onto the hood and the windshield of the car with the energy
of the impact any one of these fractures might be expected to be open or compound in nature with the
bone protruding through the skin fortunately for Tyler this does not appear to be in case
after this collision we can cease as you take a moment to assess the lacerations that he has
suffered during the knife fight he has a 10 to 15 centimeter laceration on the dorsal aspect of his
forearms or in other words the back portion of his forearm this is where we would expect him to have
suffered lacerations during this type of fight typically in a fight one would use the dorsal
aspect or the rear aspect of your forearm to fend off slashes with a bladed object usually vital
nerves and arteries can be found on the inner aspect of the extremities where they are less
likely to become injured also as this laceration is primarily through muscle in this area we would
generally expect this type of laceration to bleed more slowly as the intramuscular arterioles or
smaller arteries of the muscles spasm and slow the flow of blood finally we have the pedestrian
versus motor vehicle incident where sasha is struck by the truck say that ten times bad as
is the way with action films if you can go big then you should probably go bigger while Tyler
was struck by a small commuter vehicle he steps up the game a notch and decides to drive into sazu
at speed with a delivery truck yes that's right I said delivery truck here everything that was true
when Tyler was struck by the car is true after Sachi was struck with the truck accept doubly so
if getting struck by a car is a bad thing getting struck by a delivery truck is even worse the next
injury comes from the scene where Tyler and ovie are being perceived by the teenage gang
members who are looking for them during the ensuing fight Tyler hides in a delivery van
waiting for an opportunity to ambush members of the gang as they pass by the bank as one of the
gang members walks by the open sliding door on the side of van Tyler grabs his arm and then shuts the
door on to the members outstretched arm the gang members arm is crushed in the door at the level
of the oval this type of injury mechanism could be expected to cause a fracture of the distal humerus
or the end of the upper arm bone a fracture of the radius or ulna at the level of the elbow or
in other words the forearm bones or some type of intra-articular fracture of the elbow itself
meaning that the fracture line extended into the joint rendering the joint unstable in addition
because the arm was crushed by a heavy object we might also expect significant soft tissue trauma
as a result of this mechanism crush injuries are associated with significant soft tissue trauma
that on occasion can cause compartment syndrome in the involved extremity as a result of ongoing
soft tissue bleed and this just means that the compartment in which the muscle nerves and blood
vessels are found fill with so much blood that the pressure becomes high enough to stop the further
flow of blood into the compartment and that's usually a bad thing we because if blood can't
get into the compartment then oxygen cannot get into the compartment and eventually with enough
pressure over a long enough period of time the muscle nerves and blood vessels in the
compartment will die okay so the final injury that I'm going to talk about occurs in one of
the final scenes of the movie where Tyler is working across the bridge with his companion
Obi after securely transporting Obi across the bridge to the extraction team Tyler turns back to
finish off the remaining police and gang members who are trailing him Tyler successfully clears
the remaining attackers and turns to head back over the bridge only to be shot in the back of
the neck by one of the remaining teen gang members the round appears to strike Tyler on the left hand
side of his neck in a through-and-through manner meaning that the bullet entered and exited out the
left hand side of his neck without becoming lodged in his body because the entry and exit wounds are
off to one side of the neck we can assume that many of the vital structures such as the spine
the spinal cord the trachea and esophagus and the main blood vessels of the neck have not been
damaged by the traversing round this assumption is corroborated by the lack of bright red blood
flowing from the wound or being expressed from his mouth likewise we do not see Tyler expressing any
frog or foam from his mouth which also suggests that his trachea remains intact in addition he
is able to continue walking for several steps after being shot which indicates that he did
not suffer a traumatic injury to his spine his spinal cord or the nerve roots of his upper or
lower extremities here Tyler appears to have been struck with a round from an ak-47 rifle wielded by
one of the teenage gang members the ak-47 rifle uses a 7.62 by 39 millimeter round although it
is not possible to know which variation of the was depicted to have been used here the m-43 variant
of the 7.62 round is known to be quite stable in flight and even when traversing tissue it
has been reported to yaw or waver in its flight path only after traversing over 26 centimeters
of tissue and this just means that if it hits you it's likely going straight through this was
one of the main drawbacks of this round because this tendency for stable flight greatly reduced
the wounding effectiveness of this projectile against humans in other words this wasn't really
a great round to use during wartime because its ability to wound was less than other rounds that
were used if the m-43 variant was the projectile that was depicted here it is possible that Tyler
could have been shot in the side of his neck and have only a very small entry and exit wounds in
addition with this type of round the amount of soft tissue damage that is associated with this
flight path would have been nominal or minimal that being said if you watch extraction you'll
know that this may or may not have been the end of Tyler depending on what your interpretation of the
end of the movie was at either rate I would urge you to go and watch this film if you're into this
type of action movie as a side note I think it's of interest to compare this to one of my favorite
franchises that focuses on a similar type of close quarters combat and gunplay John wick personally
I love the John wick franchise both for reasons having to deal with the storyline but also for
my appreciation of the high level of technical skill the cannon read demonstrates with both
his close quarters combat skills and with his gunman ship Keanu Reeves and his trainers have
created a definitive style of close quarters combat which interweaves striking jujitsu and
gun fighting into its own unique fighting style called gun food in this film I think that Chris
Hemsworth has done a fantastic job of portraying his own interpretation of this type of close
quarters combat fighting while I am no expert I have had some training in both martial arts
and in firearms and I think that Chris Hemsworth did an appreciable job of demonstrating bold but
that's just my opinion let me know what you think about the Navy extraction and how Chris Hemsworth
did demonstrating these martial skills and now for my favorite comments from the last video
if you liked this video be sure to let me know and perhaps I'll do a part two
or if there's another movie you want me to review let me know and I'll do
that one - better yet let me know who you think is the better fighter Tyler
or John wick as always that's been worth doctress not your everyday for it's over