Dez Bryant and why where you break your bone matters

If you are a fantasy football person like me, you are always checking your players status. Are they injured? Are they not going to play due to some suspension? Ect...But when of your players has a blatant injury like that of Dez Bryant this past weekend, the speculation monsters come out of the woodwork.  Also, now in the world of instant access and social media, the injured player might Tweet how great they feel right after surgery. (after foot surgery your foot is still pretty numb right after, so keep that in mind)  If there is any one piece of advice I can give you regarding an injured NFL player, take all the information you can take in from the most educated people talking about the player's issue.

If you follow football you are hearing a lot about 5th metatarsal fractures and surgery.  The next 6-8 weeks are going to give Mr. Bryant some time to think and invariable take up more time in my office.  NO HE IS NOT MY PATIENT, but my patients know who he is and they are coming in with more questions than normal.(I am pretty sure they are also fantasy footballers too)

We see several fractures a week in our little practice in Clermont Florida.  When I see patients who have had an injury to the outside of their foot near the 5th metatarsal region, I always thinks to myself, "Please don't let it be a Jones Fracture, let it be an avulsion fracture of the 5th metatarsal instead." An avulsion fracture is a fracture of the part of the 5th metatarsal, if you reach down and touch the outside of your foot just past your heel the boney prominence you feel is what kind of rips off the rest of the bone. A large reason I feel this way for the "normal Joe" is if the fracture is an avulsion they don't necessarily need surgery.  Most patients have jobs, family stuff and just don't want to be laid up anymore than they have to.  Surgery puts them at a new risk factor for several problems: post op infection, non-union, complex regional pain disorder and even DVT.  Many times with a non displaced avulsion fracture, a patient can go into a walking cast, no crutches and continue on with many everyday life activities in a boot for 8-12 weeks. These fractures tend to heal very well even in the worst patients.  The blood supply to this area of the bone is very good and lends itself to normal healing.

It has been reported that Dez Bryant has a Jones Fracture.  This fracture is at the base of the 5th metatarsal but a centimeter or so past the 5th metatarsal tuberosity that we mentioned above that is palpable on the outside of your foot.  This type of fracture is a much different beast due to the fact that the blood supply to this region is far less optimal. There is a high incidence of nonunion(bone not healing in this area due to lack of blood supply). The biggest problem for you if you have Dez Bryant on your fantasy football team, is that you really don't know if he had a Jones or an avulsion fracture.  See even though the the average Joe may not have surgery for an avulsion fracture, a world class athlete is going to have surgery most likely for both of these scenarios.  Their livelihood depends on getting back on the field in optimal shape ASAP.

Either way, the recovery for one, the Jones fracture, is slightly more guarded and could even be 12 weeks or more before the player makes it back to practice.  The avulsion fracture repaired could see him back practicing at 6 weeks.  I don't have Dez Bryant in my line up but if I did I would drop him, 6 weeks is a long time to have someone just sitting on your bench and 12 weeks is even worse.  But once he is fully recovered he should be back to business as usual.  Dr. Henne, the other foot doctor in my office, also my husband and in the same fantasy football league as me says he would keep him because even if he doesn't play for twelve weeks he still may be perfect for the playoffs.