Hand Injuries - Portis Vs Owens (1 Viewer)

[Joe Bryant]

Any hand experts out there?

Discuss the differences and situations.

J

 

[ATC1]

hand anatomy

TO broke one of the 4th (ring finger) phalanges. He needed a plate to hold the fracture so it heals. The plate probably made the bone stronger than the phalange next to it, but it still must have hurt. Hence the pain medication scandal.

4th metacarpal phalange fracture

Portis broke the longer shaft 4th metacarpal bone in his hand. Portis broke the bone that stabilizes that finger, and if it breaks in a spiral frature the finger would naturally turn and surgery would be required.

metacarpal spiral fracture

metacarpal after surgery

I'm not sure if Portis' frature is a spiral frature, but if it requires surgery it may very well be, or they want the bone to heal correctly the first time

 

[Joe Bryant]

hand anatomy

TO broke one of the 4th (ring finger) phalanges. He needed a plate to hold the fracture so it heals. The plate probably made the bone stronger than the phalange next to it, but it still must have hurt. Hence the pain medication scandal.

4th metacarpal phalange fracture

Portis broke the longer shaft 4th metacarpal bone in his hand. Portis broke the bone that stabilizes that finger, and if it breaks in a spiral frature the finger would naturally turn and surgery would be required.

metacarpal spiral fracture

metacarpal after surgery

I'm not sure if Portis' frature is a spiral frature, but if it requires surgery it may very well be, or they want the bone to heal correctly the first time

Thanks ATC,I guess what I need is some definition.

From USA Today on Owens' injury: http://www.usatoday.com/sports/football/nf...-27-owens_x.htm

Doctors operated on Terrell Owens' fractured right ring finger last week. He says he'd like to play in the Dallas Cowboys' game Sunday at the Tennessee Titans, though doctors estimated his recovery at two to four weeks.

What his surgery entailed: A metal plate and screws were inserted to stabilize the fourth metacarpal of his right hand. They will be left in the hand after the break heals, unless they cause irritation or infection or excess scar tissue needs to be removed.

Keith Segalman, a hand surgeon with the Curtis National Hand Center in Baltimore, said that method of surgery would speed recovery.

"Metacarpal injuries are not uncommon," Segalman said. "For someone who is not a professional athlete, we usually manipulate the fracture and pin it externally, and it might be three to four weeks to do whatever activity you were doing. For a professional athlete, it's different. You make an incision, expose the fracture and put the plate in. You can then let them start moving the hand right away. In the first instance, you have your hand in a cast for a month. In the second, the recovery time is much quicker."

Is this injury unusual? Metacarpal injuries are common, especially among what Segalman calls "amateur boxers, guys who punch walls." Metacarpal fractures are often seen in boxers, hockey players, softball, baseball and lacrosse players.

What Owens' rehab will be: "You try to get him all of his mobility back so there's no stiffness," Segalman said. "Then you're trying to get the swelling down. Once the pain is reduced, they can try to work on strength."

Sources: Keith Segalman, Curtis National Hand Center; Mark Pruzansky, assistant professor of orthopedics at Mount Sinai School of Medicine

And from ESPN:http://sports.espn.go.com/nfl/features/bri...m?playerId=1056

News:

Owens had successful surgery on Monday to repair a broken fourth metacarpal in his right hand. Three screws and a plate were inserted to repair the broken ring finger. He is expected to miss two to four weeks, but depending on how long it takes to regain use of the finger, there is a possibility he could come back after the bye week without missing a game, reports The Fort Worth Star-Telegram.

There are tons of reports writing about Owens' fractured 4th metacarpal. But that's incorrect, right? It wasn't the metacarpal, it was the phalanx?I want to make sure I understand so I can explain it to the guys.

J

 

[ATC1]

That's the thing. The media doesn't get it right before reporting it.

If it is infact his "ring finger" that was fractured, it would be the phalanx or phalange.

If the fracture was in his "hand" it would be the metacarpal bone.

So, what was TO's real injury the metacarpal or the phalanx? It would be difficult to determine with all the bogus media opinions out there. Also, a difference might be the type of frature. a simple crack vs a spiral fracture. This could play a factor in how long it will take the bone to heal.

 

[Joe Bryant]

That's the thing. The media doesn't get it right before reporting it.If it is infact his "ring finger" that was fractured, it would be the phalanx or phalange. If the fracture was in his "hand" it would be the metacarpal bone.So, what was TO's real injury the metacarpal or the phalanx? It would be difficult to determine with all the bogus media opinions out there. Also, a difference might be the type of frature. a simple crack vs a spiral fracture. This could play a factor in how long it will take the bone to heal.

Thanks ATC,That's what I'm trying to run down. If you google Terrell Owens Metacarpal you'll find tons of articles talking about his fractured 4th metacarpal. But many also go on to talk about the broken ring finger. Our media (me included) does a poor job with the facts on stuff like this. That's what I'm trying to make sure I get right.I've even read some articles today specifically saying that Owens broke the same bone that Portis did. J

 

[Da Guru]

I broke the fourth metacarpel in my hand playing baseball.

It was quite painful. About a four week recovery, then when I got my cast off my little finger needed PT to get the range of motion back.

 

[Jene Bramel]

Here are a couple of more definitive articles from the Cowboys official site from the time of Owens injury. They read clearly enough and cite team doctors as the primary source so they're likely as trustworthy as you'll get.

Cowboys.com 9-18-06

Owens broke the fourth metacarpal, according to team doctors, the long bone on the back of his hand that leads into the ring finger. He is expected to undergo surgery either Monday or Tuesday, with doctors expected to place pins and a plate in his hand to help facilitate the healing. He likely will be out two to four weeks.

Cowboys.com 9-18-06

Doctors were expected to surgically insert a metal plate and possibly pins around the fractured bone on the back of his hand leading into the ring finger to help facilitate the healing.

Based on those excerpts, I'm comfortable assuming that Owens had a fourth metacarpal (hand) fracture.

As usual, professional athletes get special treatment. To my knowledge, most times, with a stable fracture of the hand/finger some combination of splinting with/without reduction under local anesthesia or pinning is the treatment of choice. I think it's rare that plating is done in the general population except in the most unstable of fractures. Plating is associated with a higher risk of scarring around the tendon causing stiffness, pain, and loss of function, which, unless it's necessary, is part of the reason it's not a common treatment.

In the NFL, though, like the 7-8 hour immediate surgery to fix Ben Roethlisberger's face, teams go the extra mile to get players back on the field the quickest. Plating provides a much more stable outcome sooner, and that looks to be what was done in Owens' case.

As ATC said, the hand is a complicated place and not all fractures are alike. Finger and hand fractures can be complicated by angular and rotational deformities and the ortho docs pay very close attention to both. My guess is that the location and severity of Portis' fracture accounts for the two different return to play estimates.

I'm no orthopedic surgeon, though; corrections and clarifications are welcome.

 

[SickThing]

Here are a couple of more definitive articles from the Cowboys official site from the time of Owens injury. They read clearly enough and cite team doctors as the primary source so they're likely as trustworthy as you'll get.

Cowboys.com 9-18-06

Owens broke the fourth metacarpal, according to team doctors, the long bone on the back of his hand that leads into the ring finger. He is expected to undergo surgery either Monday or Tuesday, with doctors expected to place pins and a plate in his hand to help facilitate the healing. He likely will be out two to four weeks.

Cowboys.com 9-18-06

Doctors were expected to surgically insert a metal plate and possibly pins around the fractured bone on the back of his hand leading into the ring finger to help facilitate the healing.

Based on those excerpts, I'm comfortable assuming that Owens had a fourth metacarpal (hand) fracture.

As usual, professional athletes get special treatment. To my knowledge, most times, with a stable fracture of the hand/finger some combination of splinting with/without reduction under local anesthesia or pinning is the treatment of choice. I think it's rare that plating is done in the general population except in the most unstable of fractures. Plating is associated with a higher risk of scarring around the tendon causing stiffness, pain, and loss of function, which, unless it's necessary, is part of the reason it's not a common treatment.

In the NFL, though, like the 7-8 hour immediate surgery to fix Ben Roethlisberger's face, teams go the extra mile to get players back on the field the quickest. Plating provides a much more stable outcome sooner, and that looks to be what was done in Owens' case.

As ATC said, the hand is a complicated place and not all fractures are alike. Finger and hand fractures can be complicated by angular and rotational deformities and the ortho docs pay very close attention to both. My guess is that the location and severity of Portis' fracture accounts for the two different return to play estimates.

I'm no orthopedic surgeon, though; corrections and clarifications are welcome.

That is correct. When T.O. broke his someone in the SP had linked the X-ray image.

 

[Joe Bryant]

Here are a couple of more definitive articles from the Cowboys official site from the time of Owens injury. They read clearly enough and cite team doctors as the primary source so they're likely as trustworthy as you'll get.

Cowboys.com 9-18-06

Owens broke the fourth metacarpal, according to team doctors, the long bone on the back of his hand that leads into the ring finger. He is expected to undergo surgery either Monday or Tuesday, with doctors expected to place pins and a plate in his hand to help facilitate the healing. He likely will be out two to four weeks.

Cowboys.com 9-18-06

Doctors were expected to surgically insert a metal plate and possibly pins around the fractured bone on the back of his hand leading into the ring finger to help facilitate the healing.

Based on those excerpts, I'm comfortable assuming that Owens had a fourth metacarpal (hand) fracture.

As usual, professional athletes get special treatment. To my knowledge, most times, with a stable fracture of the hand/finger some combination of splinting with/without reduction under local anesthesia or pinning is the treatment of choice. I think it's rare that plating is done in the general population except in the most unstable of fractures. Plating is associated with a higher risk of scarring around the tendon causing stiffness, pain, and loss of function, which, unless it's necessary, is part of the reason it's not a common treatment.

In the NFL, though, like the 7-8 hour immediate surgery to fix Ben Roethlisberger's face, teams go the extra mile to get players back on the field the quickest. Plating provides a much more stable outcome sooner, and that looks to be what was done in Owens' case.

As ATC said, the hand is a complicated place and not all fractures are alike. Finger and hand fractures can be complicated by angular and rotational deformities and the ortho docs pay very close attention to both. My guess is that the location and severity of Portis' fracture accounts for the two different return to play estimates.

I'm no orthopedic surgeon, though; corrections and clarifications are welcome.

Thank you, Doc. J

 

[Jene Bramel]

I believe the biggest difference that nobody is talking about is that Portis is a feature RB, while Owens is a WR. Some may believe at first glance that this is an apples to apples comparison, but it's really not.

Portis at the RB position is getting the rock at a much higher ratio, and has much bigger hands and arms (+ many more of them) ripping away at his injured hand...while Owens at the WR position, is getting between 25-50% of the touches the RB gets, along with much less constant pressure applied to the previously injured hand.

This was mentioned in some published reports as well, although the concern was pain tolerance and grip strength given that the injury is to Portis' right hand, which is presumably the hand he'd carry the ball with more often. It may have as much to do with the difference in injury estimates as the type of fracture, but catching a ball from an NFL quarterback and absorbing tackles was an issue in Owens' case too.

 

[Joe Bryant]

Another thing worth noting - Owens initial diagnosis had him missing up to 4 weeks.

J

 

[FootballFreakX]

There are tons of reports writing about Owens' fractured 4th metacarpal. But that's incorrect, right? It wasn't the metacarpal, it was the phalanx?I want to make sure I understand so I can explain it to the guys.J

Well, if you guys recall, the first images of Owens after the surgery had him wearing a small rectangular bandage in the middle of his hand and nothing on any of his fingers. So it would have to be a metacarpal injury. Portis' injury sounds like it could be the same thing, but what running backs go through is a lot different from what wide receivers go through during a game. So I would think that Portis may have to miss the full 3 to 4 weeks. btw ATC you really know your stuff. Athletic Trainers do not get enough credit for their knowledge. I have found that there are times when they know more about injuries than Doctors. The guy reporting on injuries at The Huddle is a trainer too and he's usually on top of the injury info as well. Keep dropping knowlege on us partner. The more the merrier.

 

[dgreen]

I'm not sure if Portis' frature is a spiral frature, but if it requires surgery it may very well be, or they want the bone to heal correctly the first time

I'm not sure if this sheds any light on the extent of Portis' injury, but he did have surgery today.

 

[ATC1]

There are tons of reports writing about Owens' fractured 4th metacarpal. But that's incorrect, right? It wasn't the metacarpal, it was the phalanx?I want to make sure I understand so I can explain it to the guys.J

Well, if you guys recall, the first images of Owens after the surgery had him wearing a small rectangular bandage in the middle of his hand and nothing on any of his fingers. So it would have to be a metacarpal injury. Portis' injury sounds like it could be the same thing, but what running backs go through is a lot different from what wide receivers go through during a game. So I would think that Portis may have to miss the full 3 to 4 weeks. btw ATC you really know your stuff. Athletic Trainers do not get enough credit for their knowledge. I have found that there are times when they know more about injuries than Doctors. The guy reporting on injuries at The Huddle is a trainer too and he's usually on top of the injury info as well. Keep dropping knowlege on us partner. The more the merrier.

Thanks for the kind words. I like posting reports. It keeps me sharp and I like trying to shed light on the media's confusing ways. I write a medical column for another fantasy site as well, but I visit several sites under different names mostly because I'm not to busy at work and I, like you guys, like talking football. I figured if I can try to explain injuries on the message boards it helps trying to explain athletic injuries to my patients or patient's parents. If I can explain injuries to a bunch of crazy football, media strictened (sp), fans I can explain injuries to anyone. Keep posting...

 

[Faust]

I also believe that the Redskins will feel less pressure to rush Portis back, given that their season is more or less done.

Owens injured his hand earlier in the season, when there would have been more pressure to "hurry back"

Faust

 

[ATC1]

I also believe that the Redskins will feel less pressure to rush Portis back, given that their season is more or less done.Owens injured his hand earlier in the season, when there would have been more pressure to "hurry back"Faust

Thought the same myself. Now they are starting Campbell at QB as well. You have to feelbad for Portis. Shoulder subluxation, got poped in the jewels and had a high ankle sprain in the same game, and now he breaks his hand. And just think if he was on the cover of Madden.

 

[gocats]

Nice thread here Joe

 

[Ditka is God]

Good info here - thanks!!!!

 

[FootballFreakX]

Thanks for the kind words. I like posting reports. It keeps me sharp and I like trying to shed light on the media's confusing ways. I write a medical column for another fantasy site as well, but I visit several sites under different names mostly because I'm not to busy at work and I, like you guys, like talking football. I figured if I can try to explain injuries on the message boards it helps trying to explain athletic injuries to my patients or patient's parents. If I can explain injuries to a bunch of crazy football, media strictened (sp), fans I can explain injuries to anyone. Keep posting...

Well with the news that Portis is out for the year this discussion has basically become null and void. ATC, what fantasy site do you write for? I know you probably want to avoid being slammed or flamed for advertising but I certainly would like to check it out.

 

[ATC1]

Thanks for the kind words. I like posting reports. It keeps me sharp and I like trying to shed light on the media's confusing ways. I write a medical column for another fantasy site as well, but I visit several sites under different names mostly because I'm not to busy at work and I, like you guys, like talking football. I figured if I can try to explain injuries on the message boards it helps trying to explain athletic injuries to my patients or patient's parents. If I can explain injuries to a bunch of crazy football, media strictened (sp), fans I can explain injuries to anyone. Keep posting...

Well with the news that Portis is out for the year this discussion has basically become null and void. ATC, what fantasy site do you write for? I know you probably want to avoid being slammed or flamed for advertising but I certainly would like to check it out.

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