HANG TIME SOUTHWEST – The “Jones fracture” Kevin Durant sustained to his right foot is hardly unique to basketball players. However the bone in question — the fifth metatarsal — is unique, which is why pinpointing Durant’s return, plus potential complications, is met by sports medicine professionals with a certain level of caution.
“We don’t worry about this if it was, for example, the bone to the middle toe, because 100 percent of the time those heal. You never have the remote chance of nonunion when you’re considering the third or fourth metatarsals,” said renowned orthopedic surgeon Dr. T.O. Souryal, the Dallas Mavericks team physician and president of the NBA Team Physicians Association. “The fifth [metatarsal] is very unique and it’s unique because there are tendons that attach there that are constantly pulling in the opposite direction that you want the healing to take place. None of the other metatarsal bones have that stress on them. Because of the mechanics, because of the blood supply, there is that little shadow of uncertainty.
“Those of us who do sports medicine on a regular basis have a tremendous respect for Jones fracture because it looks relatively innocuous, and 95 percent of them heal uneventfully, relatively quickly. But there are a few tricky ones that don’t heal uneventfully and don’t heal very quickly.”
Thunder general manager Sam Presti said on Sunday that Durant will likely undergo surgery, and he estimated the NBA’s reigning MVP will be sidelined six to eight weeks. Souryal said surgery is the most common treatment for athletes with a “Jones fracture,” and that Presti’s timeframe is on target for this type of injury.
The fifth metatarsal bone is the long bone on the outside of the foot that connects to the little toe. A “Jones fracture” occurs toward the back end of the bone in an area that receives less blood and therefore can be more prone to difficulties in healing. For most athletes, the “Jones fracture” is caused by overuse, repetitive stress or trauma. Presti said Durant alerted the Thunder’s medical staff to discomfort in his foot following Saturday’s practice.
Because of the tricky nature of the bone, Souryal said the actual time an athlete misses can vary, sometimes healing before the six-week timetable, but also sometimes taking longer than eight weeks.
“There are some [Jones fractures] that heal in four to five weeks, absolutely, but there are some that take three, four months,” Souryal said. “And it’s difficult to tell which is which in the beginning. It’s just difficult to tell. As a result, we all have a healthy respect for this injury. In Oklahoma City, they have an excellent medical staff and I will give them tremendous credit for making the diagnosis early, and I am sure that they are in deliberations right now trying to decide what is the best course of action.”
Once the bone heals, Souryal said it will be as good as new. That’s not a guarantee that Durant can’t re-injure the foot, but odds are in his favor that he will continue on with his career with no further difficulties.
Mavs fans remember up-and-coming guard Rodrigue Beaubois, who fractured the same bone while working out with the French national team several summers ago. Beaubois underwent surgery and was on the comeback trail, but he re-fractured the bone during a workout as his return date neared and missed another significant chunk of time.
“He was one of the few percentages that did not heal fully and re-broke,” Souryal said.
The fact that basketball players are constantly running and jumping, the factors that likely led to Durant’s injury in the first place, means there is always a risk of re-injury. However, most athletes returning from the fracture, Souryal said, do not experience a setback.
“The positive spin is that the vast majority heal this fracture uneventfully and come back on time,” Souryal said. “It’s only those tricky ones, those few percentage points, that don’t. So if you play the odds, I think six to eight weeks is exactly right.”