Lehigh University’s Josie Charles Back to Bat Hours After Wide-Awake Hand Surgery

Josie Charles, 23, loves a challenge. “Outwitting the other team” has kept her interested in playing softball since she was a kid. But, in her senior year at Lehigh University, the leadoff hitter for the Mountain Hawks slid headfirst into second base during the last weekend of conference play in a game against Boston University, jamming her finger on the base. Her biggest challenge yet had arrived.

X-rays revealed that Josie had fractured the fourth metacarpal on her left hand. Her athletic trainer Amanda Crampton connected Josie with Paul Sibley, DO, Chief of Hand Surgery, Lehigh Valley Orthopedic Institute, who is also the Lehigh team’s hand physician. Josie was two weeks away from graduation, which coincided with the end of her collegiate softball career. She told Dr. Sibley she had to play the final games in the Patriot League Tournament to end softball on “her own terms.” 

“Because athletes want to get back as soon as possible, using standard incisions, sedation and plates or wires to stabilize bones for healing are not the best solutions,” says Dr. Sibley. “Josie was a good candidate for wide-awake hand surgery, which the LVHN orthopedic team has been doing for nearly 10 years.”  

Wide-Awake Local Anesthesia No Tourniquet (WALANT) surgery is an up-and-coming minimally invasive procedure for anything involving the hand or wrist. Local anesthesia minimizes pain, a hemostatic agent controls bleeding and there’s no tourniquet. It gives athletes the ability to get back to their sport quicker with more mobility and no grogginess. In Josie’s case, a titanium screw was inserted into the metacarpal canal to stabilize the bone in her hand.

“Dr. Sibley gave me the option of a cast and being a base runner in the remaining games, but I wanted to hit,” says Josie. “He said wide-awake surgery would enable me to hold a bat and swing. It was a nerve-wracking decision because of the turnaround. I was due to play two games in Boston that very night.”

Dr. Sibley completed Josie’s WALANT surgery in 20 minutes through a ¼-inch incision. He closed it with two stitches, then covered her hand with gauze and a light, self-adherent wrap for compression. Josie’s parents picked her up and made the 5-hour drive to Boston, with Josie icing her hand every 20 minutes. She arrived during the second inning of the first game, warmed up in the batting cage, then stepped up to bat.

“I didn’t have a lot of pain,” says Josie. “My ring finger and pinkie were still numb from the anesthesia. It was hard for me to close my hand, so I used the first three fingers of my left hand and my right hand to grip the bat.” Josie hit a single (up the middle) in her first at-bat post-surgery. The team lost the first game of the night but won the second.

A high point in Josie’s return to bat came during the next evening’s game. She was up to bat when the pitcher threw high, and she swung at the ball. It was a line drive to the left, so she started running. She  couldn’t slide headfirst into base as usual because she didn’t want to risk further injury to the hand she just had surgery on. So, she had to go feet-first. She made it to third, achieving a triple for her team.  

Now that Josie has had time to reflect on the events, she feels she learned a lot about persistence. “This was the beginning of a whole new chapter of my life,” says Josie. “I realized I can do anything I set my mind to.”

Dr. Sibley is equally impressed with the determination of athletes like Josie. “As sports medicine surgeons, we’re pleased to have surgical techniques that allow athletes back on the field safely and quickly. When we see our patients happy and successful, it makes it all worth it.”