Surgeon overcame fracture dislocation to become cross-country ski champ

Two decades after injury, his hip proves asymptomatic, but he remains committed to exercise as a rehab technique.

Issue: July 2006

A significant injury can end an athlete’s career, but the strongest competitors overcome potentially crushing events to become something greater.

At age 62, Del Pletcher, MD, accomplished just that by winning both the 10K and 30K cross-country ski races in his class at the 2006 Masters World Cup Cross-Country Ski Championship. He also tied for first place, based on time, in the 15K event.

Additionally, the orthopedic surgeon from Idaho won two gold medals at this year’s National Masters Cross-Country Ski Championship. But what is really impressive is that he accomplished all this despite suffering a hip fracture dislocation during a mountain climb two decades earlier.

In 1986, Pletcher and some friends attempted to summit Nepal’s Dhaulagiri, planning to kayak down part of the Kaligandaki River following the ascent. But while negotiating a steep river canyon en route to the climb, Pletcher fell 20 feet from a cliff.

“[I] knocked myself out, broke my wrist, and dislocated and broke my hip,” Pletcher told Orthopedics Today.

He knew he suffered the hip dislocation but was unaware of the break. And as an orthopedic surgeon, Pletcher understood his risk for avascular necrosis increased the longer the dislocation remained.

Pletcher won two gold medals and a silver at the 2006 World Masters Cross-Country Ski Championship.

Pletcher fell 20 feet and sustained a fracture dislocation in his hip. He received medical attention 14 hours after the injury.

Images: Pletcher D

“I had some morphine that I could give myself, and I had a lot of people to help me, but we couldn’t get it reduced in the field,” he said. The team ultimately had to call for a helicopter and Pletcher was evacuated back to Katmandu. There, a British physician found him, and after a few X-rays and some ether was able to reduce the hip.

“My concern thereafter was the potential for arthritis,” Pletcher said.

“I knew that, given the fact that it was out for 13 to 14 hours, I had a high risk of [needing] a hip joint replacement or for having a lot of trouble with the hip, [which] usually develops within three to four years of the injury. I decided I would spend as much time as I could using that hip while it was still in good shape,” he said.

The decision to return

Pletcher considered the severity of his injury and his once-in-a-lifetime opportunity to scale the mountain. With some help, he managed to mount a horse and decided to rejoin the climb.

“My greatest difficulty with the horseback riding, however, was a troublesome post-concussive vertigo, which would recur frequently with a sudden shift in position,” he said. “I was sent off to the great amusement of a Nepalese audience that had spontaneously gathered to witness my awkward departure — crutches in hand — precariously perched atop the wooden packing saddle of a tiny Nepalese horse.”

Amazingly, Pletcher found his group and continued the ascent. Although the party never reached the summit, Pletcher managed to climb more than 24,000 feet. “That was the most remarkable event of my life. I didn’t think that I would have been able to do that,” he said.

Pletcher admits his decision was controversial. “It was just one of those unusual choices you make in your life where you’ve got a risk no matter which way you go. You make the choice ... that makes you feel best,” he said. “I thought giving up on the climb and going home was just something that I couldn’t consider at that time. So I turned around and went back up,” he said.

Today, Pletcher’s hip remains asymptomatic and he is still committed to exercise as a rehabilitation technique for any lower extremity injury, including joint injuries, he said.

To prepare for skiing competitions, Pletcher exercises up to four hours a day. “I’m terribly enthusiastic about it. I love to be outside. I love to run, hike and bike and so that kind of fits into my lifestyle,” he said. “The trick is finding the time, which, in a medical practice, is hard.”

Pletcher maximizes his time by scheduling small, short workouts throughout the day. He rides or hikes to his practice and exercises during his noon break. After work, he runs or skis for another 90 minutes. “I think that being fit, moving, being outside and using the musculoskeletal system — which is what orthopedists work with everyday — [is] as important to feeling good about oneself as being interested in one’s practice and being busy with the intellectual aspects of your life,” he said.

Pletcher plans to initiate a “slow retirement” to his medical career in August. But he remains dedicated to skiing and plans to compete in the 2007 Masters ski event.