It has been 34 days since they put an extension on the operating table at Kernan Hospital in Baltimore. The patient: Obinna Ekezie, the 6-foot-10 basketball center for the University of Maryland.

Upright, Ekezie engaged opponents on the court. Prone, he challenged surgeons who repaired the ruptured Achilles' tendon that ended the 23-year-old's college career last month.

How bad was Ekezie's injury?

"It looked like a rope that had been pulled apart in a tug-of-war," said Dr. Leigh Ann Curl, the Terrapins' team physician, who performed the operation.

She was referring to his Achilles, the largest and strongest tendon in the body and one of the most vulnerable for athletes. Each year, 42,000 people tear their Achilles. Many are baby boomers and weekend sportsmen, and the more famous ones range from Christian Laettner of the Detroit Pistons to Vice President Al Gore.

Generally, they undergo medical treatment and rehabilitation similar to the procedures Ekezie began that day at Kernan.

The operation lasted 40 minutes, same as a college game. Given a choice between local and general anesthesia, Ekezie chose the latter.

"Knock me out," he told doctors. "I don't want to be aware of anything."

Once unconscious, the 260-pound player was rolled onto his stomach and prepped for surgery, his right ankle swabbed clean.

To minimize bleeding, a surgical device emptied veins in his ankle, and a tourniquet stopped any flow at the thigh.

Around the table, a medical team stood poised to undo the damage Ekezie had done two days before. The tendon had popped as he drove to the basket at practice.

"When I stood up, I knew what had happened," Ekezie recalled. "My right foot felt elevated, like an extra inch had been added."

His experience was typical of those who rip their Achilles, Curl said: "They get a sense that there's no connection between the back of their calf and the foot."

For Ekezie, who hopes to play pro ball, nimblefootedness is crucial. The Achilles connects calf muscles to the heel bone and transmits muscle force, allowing ballerinas to point their toes, sprinters to crouch and tennis players to serve.

When surgeons made the incision, they exposed the tendon -- a white, fibrous tissue between muscle and bone. Ekezie's was torn in half, the raw endings frayed.

"I've never seen a ruptured Achilles that didn't look awful, and Obinna's was no different," said Dr. Claude T. Moorman III, who assisted Curl. He is director of University Sports Medicine, which cares for Maryland's teams as well as the Ravens.

For Ekezie, the stakes were high. His future would be decided under the knife rather than under the basket. Not that high-profile players receive special treatment, Moorman said.

"We don't freak out when these athletes come in," he said. "Of course, we're aware of the implications of success or failure of their surgery. But that doesn't change their level of care."

Curl worked deftly. A former basketball player, she was a first-team Academic All-America at the University of Connecticut. Now she is an orthopedic surgeon at the University of Maryland Medical Center. Curl has repaired more than 40 torn Achilles, though few on patients as young as Ekezie.

"Obinna clearly pushes the young end of the spectrum," said Curl. "He simply went to do something he'd done a million times, and the tendon went.

"Obinna just drew an unlucky straw."

Using surgical needle and thread, Curl sewed nylon sutures through each end of the torn tendon. She then tied the sutures, dragging the halves back into place.

"It's like sewing two mop ends together," said Moorman.

Ekezie's Achilles should heal in four to six months, doctors said. A full recovery is expected. "Once we cut him loose, he'll come back with a vigor," Curl said.

The non-absorbent stitches are his for life. "The sutures are cable-strength," said Moorman. "We're talking bomb-proof repairs here."

At Johns Hopkins Medical Institutions, Dr. Edward McFarland, director of sports medicine and shoulder surgery, said Achilles injuries tend to appear in two groups: "The older patient whose tendon is getting more 'mature' with time, and the younger, athletic type who just seems to tear it for no apparent reason."

Although warm-up exercises may prevent Achilles rips, even the best-conditioned athletes could be at risk.

"It may be that, in certain individuals, what tendons are being asked to do is more than a body can take," McFarland said.

"You wonder how many athletes out there are sitting on the edge."

Pub Date: 3/17/99