Speaking generally to protect the privacy of patients, Cryer described the types of injuries he and his team treated that night.
Besides the obvious broken arms and legs, some patients had fractures of the pelvis, spine and ribs. Those bones are especially strong, Cryer said, and a blow that is forceful enough to break them usually injures nearby organs and blood vessels as well.
One person's punctured intestine popped open. Solid organs such as the liver and pancreas were fractured and bled profusely.
Loss of blood can lead to shock, a life-threatening emergency in which not enough oxygen is circulating to cells throughout the body. The only way to save the patient is to stop the bleeding. Three of the UCLA patients needed immediate surgery to accomplish that.
Some of the surgeries were relatively simple. Surgeons removed the damaged area of intestine, for example, and sewed the healthy ends together.
Other operations had to be done in stages. Surgeons cleaned open fractures to prevent infection and put the bones back into alignment with pins and rods, then waited a few days for the inflammation to abate before closing the wound.
One of the worst injuries was a fracture in the head of the pancreas, the area of the organ that shares a blood supply with the duodenum, the first part of the small intestine. Removing the broken portion required an all-day operation, and the patient's condition was not stable enough for the ordeal.
"We learned 15 or 20 years ago that these patients don't make it if the operation is done while they're in shock," Cryer said. "You get everything fixed, but the patient dies anyway."
So Cryer's team did damage control. Surgeons stopped the patient's bleeding and cleaned the wound. A day and a half later, they removed the injured portion of the organ along with a damaged spleen and closed the abdomen.
Many organs have reserve capacity, allowing most people to survive even if a large part of an organ is removed, Cryer said.
After such surgery, it's a matter of supporting the patients in the intensive-care unit until their bodies begin to heal. For the most badly injured, that means ventilators and intravenous feedings so the energy that would go into breathing and eating can be used for healing.
Depending on the severity of the injury, Cryer said, this stage can last from a few days to months.
During that time, the patients are susceptible to pneumonia, infection and arrhythmia, or irregular heartbeats.
"Any patient injured this badly is going to have complications," Cryer said. "I tell the families this. It's one step forward and two steps back."
When patients can breathe and eat on their own, physical therapy begins. Then doctors decide which patients can continue therapy at home and which need to go to a rehabilitation hospital.
"After injuries like this, it's months until they're back to their normal selves," Cryer said.
Like fractured legs, fractured lives may never be the same.
"We take someone who was perfectly normal one minute and the next minute has a devastating injury," he said. "Our job is to get them back as close as possible to normal."
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mary.engel@latimes.com
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