Brian McBride, Forward, midfielder U.S. National Soccer Team

NAME: Brian McBride

TEAM: Columbus Crew (Major League Soccer), U.S. National Team

POSITION: Forward, midfielder

INJURY: Broken cheekbone (mandible)

OTHER ATHLETES AFFECTED

Soccer: Brian McBride (the other side); Hockey: Matt Cullen, Washington Capitols; Craig Rivet, Montreal Canadiens; Basketball: A.D. Smith, Oregon Ducks (NCAA); Alonzo Mourning, Miami Heat

WHAT HAPPENED

McBride was injured when attempting to head a ball at the net. On the play, his head made contact with the head of a defensive player, and his cheekbone was broken. He is expected to miss the first two U.S. qualifying matches for the 2002 World Cup later this year.

PLAYER BIO

The 28-year-old is the Crew's all-time leading scorer, with 102 points in 90 career games (38 goals). He is a four-time All-Star and was named the All-Star MVP in 1998. His 10 game-winning goals are seventh most in MLS history. He is one of the league's best headers and is known for his fantastic header goals. He is signed to play with MLS through the 2002 World Cup.

WHAT IS A BROKEN MANDIBLE?

The mandible is broken as a result of direct contact. The injury is generally not obvious to the human eye, and there is never protrusion of bone. Usually, the area quickly swells up, and the eye can sometimes swell shut on the side of the injury. Athletes usually describe severe pain with a broken cheekbone and complain of pain when they try to chew.

DIAGNOSIS

The injury is diagnosed using an X-ray. A clinical examination can determine if there is a facial injury and what bones might be injured, but an X-ray is necessary to determine the injury's severity and exact nature.

TREATMENT

Immediately after the injury, patients are treated with ice and sometimes medication to help keep the swelling down. Once they have had X-rays and CAT scans, they will almost always have to undergo surgery. Doctors usually wait about two weeks after the injury, until the swelling has gone down, before doing any major procedure. To reconstruct the cheek, screws and plates are inserted to provide support and stability while the bone heals. During the process leading up to the surgery, physicians will draw out a plan on paper to decide what types of plates or screws will best fit the area. Wire is sometimes used because of its strength and stability.

PREVENTION

There is no sure way to prevent fractures of the mandible. McBride's style of play leaves him vulnerable to this type of injury.

RECOVERY

After the plates and screws are inserted to provide protection and stability, there is nothing the patient can do, aside from avoiding contact, to help the healing process. The patient will suffer pain for at least two to three weeks every time he tries to chew -- longer if surgery is needed. McBride is expected to miss four to eight weeks.

LONG-TERM OUTLOOK

Once the plates and screws come out, McBride will not have to worry about scarring or any altered appearance to his face, nor will there be any residual weakness in the area. This type of injury can now be treated completely and quickly without sacrificing appearance.