Orthopedic spine surgeon rates 11 movie injuries based on chances of survival

• Dr. Antonio J. Webb takes a closer look at spinal injuries in movies and rates them for the character's chance of survival.
• He spent eight years in the US Air Force as a medic and licensed vocational nurse, including a deployment north of Baghdad in 2005. He practices in San Antonio, Texas.
• Webb addresses physical injuries from falls at a height, such as Keanu Reeves' building fall in "John Wick: Chapter 3 — Parabellum" (2019). He looks at car-crash injuries, such as in "Doctor Strange" (2016), "Anchorman 2: The Legend Continues" (2013) and "Bleed for This" (2016).

Following is a transcript of the video.

- [bones cracking] Antonio Webb: I love those sounds, but other people may cringe when they hear them. Hi, my name is Dr. Antonio Webb. I am an orthopedic spine surgeon. I've seen lots of injuries in my 11 years of training to become an orthopedic spine surgeon. Been in Iraq as a combat medic. In today's video, we're gonna be going over some movie scenes and reacting to some of the injuries.

"The Dark Knight Rises" (2012)

[Batman grunting]

Bane: Or your body!

[cracking]

Antonio: That's pretty unlikely that that will happen and cause a significant injury.

[Batman screaming]

Prisoner: There's a vertebra protruding from your back.

Antonio: Their vertebrae is actually sticking from their back. That would be a pretty morbid injury. But in this scene here, the chiropractor that was trying to push his vertebrae back in place, that usually doesn't happen. There's a new phenomenon called the Y strap, where they put you in traction and they just pull on your spine, [bones cracking] but that's usually not what happens when we're trying to push a vertebrae back in place. When we see a bone, especially a spine, sticking out in someone's body, that patient most likely will not survive. The survival rating of this, one out of 10, just because the vertebrae that the chiropractor saw sticking out of his back.

Rating: 1/10

[gunshots blasting]

[John grunting and crashing]

Antonio: That's a pretty hard fall. I can't see how big of a fall that was, but patients come in after sustaining falls. Usually we have patients that come in, they fall from their roof, or they're up on a building doing construction, and then they fall. Usually they land, what's called a FOOSH injury, fall on outstretched hands, when you're landing like this. Usually they come in with both of their wrists that are usually broken. Or they have calcaneus fractures, which is the heel bone. Sometimes when people land, they landed on their feet, their heels, and they just crush those bones. And they can have tibia fractures, which is your lower leg. We put them in what's called external fixators to stabilize that area of the bone until the soft tissue kind of, swelling goes down. So, he would have most likely had injuries to his facial bones, mandible fracture, lots of different fractures and musculoskeletal injuries. Most likely rib fractures, which are pretty common. You can have what's called a pneumothorax. The rib fracture will actually puncture the lung, requiring a chest tube, which is a tube that is put in the chest by general surgeons to reinflate the lung. The areas that he landed on, the tops of the roofs, the things that he hit on the way down may have braced him some, but there's really no correct way to fall. It's probably likely, but he would have sustained a lot of injuries. A patient getting up and walking after something like this is pretty low.

Rating: 6/10

"Bleed for This" (2016)

Jimmy: Holy shit, how much?

Vinny: Jimmy!

[crashing]

[car horn beeping]

Antonio: That's a pretty serious motor vehicle collision, is what we call it, MVC. Some patients are actually ejected from their vehicle. This type of car accident, where there's a head-on collision, you can have injuries to your chest, you can have injuries to your wrist, to your aorta. When there is a really fast deceleration of a moving object, it can actually tear your great vessels, and these vessels can bleed really fast. You can actually collect 2 liters, 3 liters of blood inside your chest cavity within minutes, within seconds. And this is gonna be very fatal for a lot of patients who have these injuries. Luckily, there's airbags with the help of seat belts. A lot of injuries can be kind of mitigated, but this is a pretty serious accident where patients will come in with multiple injuries, polytrauma is what we call it. This bone here is called your C2 or your odontoid. Can be a pretty serious injury, especially in a young patient where the bone does not heal. And the option is to put screws into there, that bone there, or to place them in a halo. So, these are kind of metal rods and clamps that we use to place on the head, and patients will actually wear this for up to eight to 12 weeks. And sometimes these screws will become loose or they become infected, and they have to be replaced. So, that's what he's doing. This can be pretty painful for a lot of patients and uncomfortable, but we usually anesthetize or give them some pain medications before. And then these bars and rods are used to stabilize the spine, the head, and then the neck until it heals. So, this is pretty realistic. But I think his survival chance is pretty good at this point, if he's getting a halo. Probably six out of 10.

Rating: 6/10

"Scream 2" (1997)

[intense music]

He did have a gush of blood that came from somewhere. I would imagine that it came from his carotid artery, maybe. You do have a vessel that's on the inside of your neck, here, that if you're stabbed or that vessel was injured, that vessel can bleed quite a bit. And patients actually can die just from if you don't hold pressure kind of over that vessel, but this is a pretty fatal injury. Your spinal cord is actually surrounded by lots of ligaments. It's surrounded by the spinal column, which is a number of different bones that protect the spinal cord. You actually can get stabbed in the spinal cord itself and sustain different, various neurological injuries depending on the location of the stab wound in the spinal cord. Is it in the ventral portion of the spinal cord, which is the front part? Is it in the posterior aspect? That will dictate what neurologic presentation that is seen, so. The kidneys are in the back, but a little bit lower, near the L1, L2 region. That can be injured. Your aorta is just off to the side of the spine. If you have a injury or stab wound to that, that can be pretty fatal. You have to actually split the chest open to actually find that tear and try to repair it. By that time, a lot of patients will die from a injury like that. But this is a pretty fatal injury, that the chance of him surviving this without attention is probably really low. Two out of 10.

Rating: 2/10

"The Revenant" (2015)

[bear growling] [Hugh screaming] And you can see he's laying on the ground there. This is a state of shock that a lot of patients, when they're undergoing certain types of injuries or trauma, your body goes into a state of shock and you basically are kind of in a fog. You really don't recall kind of what's going on. Your body is resorting all of your blood supply, all of your energy and your nutrients to the muscles and the body parts that need them for that fight-or-flight response that people talk about. We do have other bones and soft tissue skin that protects us from outside injuries, but you can imagine 200, 300 pounds that is laying on a person or on top of a person, that can essentially just crush you. Your heart, your lungs, your kidneys, these things are pretty fragile. Dogs, cats, snakes. These can cause a lot of injuries, also. A lot of the infections that can be in, like, a cat's mouth when they use their claws to get inside of a joint, this can cause a lot of damage inside the joint. So as orthopedic surgeons, we would normally take this patient to the operating room to wash out their wounds, wash out their joints, give them antibiotics, tetanus. Most likely three out of 10.

Rating: 3/10

"Million Dollar Baby" (2004)

[slo-mo cracking] I like the extra added effect that she landed right on the barstool on her neck. You know, there's a lot of injuries that you can sustain to your eye, to your facial structures. You can actually receive what's called a epidural hematoma, and these are blood collections, hematomas, that collect either on top of the dura, which is the kind of hard structure surrounding the brain, or under the dura. It's called a subdural hematoma. And this, when there's a collection of blood, can cause a lot of pressure on the brain that, as you know, the brain is responsible for a lot of our functions, a lot of our thinking, speech. So, it can affect those things. So, this is a injury that can be pretty fatal. There actually have been lots of boxers who have died from blows to their heads, from these bleeds. You do have some vessels in your neck called your vertebral arteries that can be injured. You can have fractures in your neck from that fall. You may not hear the bone fracture in your neck, but the bigger, larger bones, you'll hear that snap. [celery snapping] [bone snapping] This scene is pretty realistic in terms of the audio kind of quality or the sounds. We hear these sounds a lot, especially in the ER, when a patient comes in and let's say they dislocated their hip. Usually in car accidents, when their knees hit the dashboard and their hip dislocates, it's usually called a posterior hip dislocation. In the ER, what we do as orthopedic surgeons, I will usually stand on top of the patient, on top of their bed, and actually pull on their leg while someone is pushing down. And you can actually hear that hip just pop back in the socket.

[popping]

Chiropractor: And relax for me.

Antonio: It's a very gratifying feeling for orthopedic surgeons, especially me. I love those sounds, but other people may cringe when they hear them. I would say the survival rate in this is eight out of 10, seven out of 10, depending on what type of injuries, what happens in her brain to ensure that she doesn't have any brain damage or injuries in her brain that could be deadly.

Rating: 7/10

"The Amazing Spider-Man 2" (2014)

[web stretching]

[cracking]

The chance of someone snapping their back like this and surviving is pretty slim. The major vessels in your body, your aorta and your inferior vena cava, these things are pretty fragile. And when you take a lot of force or when there's a lot of force applied to the body, it can rip these vessels pretty easily, especially from a height like this. When her body is snapped, that can actually tear and cause injury to the spinal cord and the nerves that are in the back as well. I would imagine if she would have survived, she most likely would have been paralyzed or would have sustained substantial damage. I'm a big Spider-Man fan. I think a better kind of option, he didn't have many choices at this point, would be to cast a net and she fall into the net, where just this one web didn't actually just pull on her spine and pull on her body like that, and she just forcefully went back and kinda snapped her back. This is a unsurvivable injury.

Rating: 1/10

"Doctor Strange" (2016)

[car brakes screeching]

[crashing]

So, this is another kind of bad injury. We call it a MVC rollover. These are pretty serious injuries, and sometimes they can be quite fatal. He is rolling in the stretcher through the hospital. He most likely would have a cervical collar, which is a collar that is applied by the EMS personnel to stabilize the spine. He should have had a cervical collar on. They should have immobilized him before they extricated him from the car. The seat belts are important as well as the airbag. The airbag can actually cause injuries where it can fracture your ribs, but it does protect you from the steering wheel as well as being ejected from the vehicle. So, you can have injuries to your thorax, to your chest, to your abdomen. So a lot of these patients are receiving multiple imaging studies such as a CT scan to search for a lot of these injuries when they come into the emergency room. It looks like he had injuries to bilateral wrist. You can see the gauze and the wrapping that he has on his wrist. At that point, the chance of survival... it looks like he's awake at this point. His eye is, the right eye is open. But the chance of survival, six out of 10.

Rating: 6/10

"Point Break" (1991)

[Johnny yells] [screaming]

How fast they were going from the sky to actually have landed on the ground, it looks like they slowed it down quite a bit, but I've been skydiving before. I would have thought that the impact on the ground would have been greater. Usually patients, they break their heel bone, called your calcaneus. And when this happens, it actually just crushes the calcaneus, crushes some other bones that are in the feet. Depending on the type of land, whether they're landing on their feet, whether they're landing on their hands or their back, that will dictate what type of injuries are sustained. The chance of them getting up and walking is pretty low. A lot of times we have adrenaline, our fight-or-flight response is activated and you have this adrenaline after accidents or falls, and you can still get up and do things, but you may be seriously injured. So, this was most likely what happened in this scene here. I would imagine kind of a tuck-and-roll-type fall, where you're protecting your body and you're rolling, and hopefully that will minimize some of the damage or injuries that you sustain. This is a survivable injury if it was based off of this movie scene, but if it was in real life and he had a greater impact on the ground, the chance of survival would have been six out of 10, maybe.

Rating: 6/10

"Anchorman 2: The Legend Continues" (2013)

[car brakes screech]

[crashing]

Oh, wow, bowling ball just comes out of nowhere. Just hits him in the chest. This can be a pretty serious injury as well. The injuries could be anywhere from facial trauma to lung bone injuries to injuries to their soft tissues, musculoskeletal. That bowling ball probably broke a couple ribs when it hit him in the chest right there.

[cracking]

If someone did get hit in the head with a bowling ball, that's a pretty heavy ball. That would have caused a lot of injury to the face itself, to the brain. There is really not much that kind of surprises me at this point. I had a patient come in after a airplane crash. He had a small airplane and he took it up, and it crashed for some reason. He had multiple fractures and had a lot of other bad injuries, but he was actually still talking to me when I saw him in the emergency room. We've had attacks by different metal objects, brooms, gunshot wounds, explosions. I've seen it all. I've seen a lot of bad injuries. A gentleman who came in who had leg amputations from a motorcycle accident. His body was on the stretcher, and his legs, both legs were in the bag in the corner. So, that's a pretty typical day in the trauma emergency room. And as orthopedic surgeons, we treat all of these patients. Surviving a bowling ball injury to the face when it's going that fast is pretty slim. The areas that he landed on, the tops of the roofs, the things that he hit on the way down may have braced him some, but there's really no correct way to fall.

Rating: 5/10