This article is part of our NBA Injury Analysis series.
Marcus Smart
The Celtics will be without one of their key backcourt members after Smart suffered an injury in a collision with Brooklyn's Thomas Robinson on Friday. The injury was initially ruled a right knee contusion but further evaluation revealed he suffered a subluxation of the proximal tibiofibular (tib-fib) joint.
The description of the injury provides great insight regarding the extent of the damage and precisely where it occurred. A subluxation means the involved joint, in this case the tib-fib joint, temporarily shifted out of its normal alignment. A subluxation is often reported as a partial dislocation with the surrounding ligaments and musculature forcing the joint back into alignment.
The specific joint Smart involved is the tibiofibular joint, an articulation formed by the two lower leg bones, the tibia and fibula. The tibia and fibula actually form two tib-fib joints, one at the distal end near the ankle and the other at the proximal end near the knee. The proximal joint is formed where a bony rim of the tibia touches the round head of the fibula and is strengthened with multiple ligaments.
Fortunately, the proximal tib-fib joint is not a major weight-bearing joint and is well vascularized. The fact that medical assistance to re-align the area was not needed is also a plus and it appears any accompanying damage in Smart's case is minimal. As a result, surgery will not be needed and the current plan for treatment is rest and rehab.
That being said, ensuring a complete recovery
Marcus Smart
The Celtics will be without one of their key backcourt members after Smart suffered an injury in a collision with Brooklyn's Thomas Robinson on Friday. The injury was initially ruled a right knee contusion but further evaluation revealed he suffered a subluxation of the proximal tibiofibular (tib-fib) joint.
The description of the injury provides great insight regarding the extent of the damage and precisely where it occurred. A subluxation means the involved joint, in this case the tib-fib joint, temporarily shifted out of its normal alignment. A subluxation is often reported as a partial dislocation with the surrounding ligaments and musculature forcing the joint back into alignment.
The specific joint Smart involved is the tibiofibular joint, an articulation formed by the two lower leg bones, the tibia and fibula. The tibia and fibula actually form two tib-fib joints, one at the distal end near the ankle and the other at the proximal end near the knee. The proximal joint is formed where a bony rim of the tibia touches the round head of the fibula and is strengthened with multiple ligaments.
Fortunately, the proximal tib-fib joint is not a major weight-bearing joint and is well vascularized. The fact that medical assistance to re-align the area was not needed is also a plus and it appears any accompanying damage in Smart's case is minimal. As a result, surgery will not be needed and the current plan for treatment is rest and rehab.
That being said, ensuring a complete recovery is key to preventing a chronic instability from developing and avoiding a potential shift in Smart's overall biomechanics. This is particularly important for Smart, given his history of lower-leg injuries. Boston's initial timeline has Smart sidelined for at least two weeks, though that would appear to be a best-case scenario. Unfortunately, the rarity of the injury makes it hard to find a comparison and a four-to-six week recovery is a safer estimate.
Guards Avery Bradley and Isaiah Thomas will get a bump in usage and Evan Turner could take on an expanded role. Given the unpredictability of the injury and his poor shooting numbers thus far, dropping Smart is an option worth considering.
Jonas Valanciunas
Valanciunas suffered a fractured hand Friday and has been ruled out indefinitely. His exact injury is a fractured fourth metacarpal bone in his left hand. Metacarpal fractures are common in the NBA, with Rajon Rondo, Russell Westbrook and Robin Lopez all missing time last season with the injury. Other players to suffer broken metacarpals include Anthony Davis, Kawhi Leonard and Kevin Love.
The five metacarpal bones form the bulk of the hand and bridge the tiny carpal bones of the wrist and the long bones of the fingers. The distal ends of the metacarpals form the knuckles of the hand. This positioning makes the metacarpals vulnerable to breaking, especially following a direct blow or an axial load. For this reason a metacarpal fracture is often referred to as a Boxer's fracture.
The necessary recovery time normally depends on several factors, including the specific metacarpal fractured and the nature of the fracture. Breaks to the second and third metacarpals are easier to manage as they are anchored to the bones of the wrist and are largely immobile. The fourth and the fifth metacarpals, located beneath the ring and pinkie fingers respectively, are mobile in order to allow motion at the wrist and fifth digit. As a result, breaks to these bones often require additional healing time.
The other major influence shaping recovery time is the nature of the break. If the fragmented pieces of bone remain aligned, it is considered a non-displaced fracture, which are often treated conservatively and the injured individual can avoid surgery. This is precisely the type of injury Valanciunas suffered, as indicated by his decision to forego surgery. Four to six weeks for recovery is reasonable and history provides the perfect example. During the 2012-13 season, Valanciunas suffered a fractured fourth metacarpal in his opposite hand. He avoided surgery then as well and missed 18 games. Teammate Bismack Biyombo started on Sunday and collected 14 rebounds, though his contributions on the offensive end remain limited.
Fast Breaks
LaMarcus Aldridge
The Spurs' newest addition missed his first game with his new team after spraining his left ankle. San Antonio is notoriously conservative with their injured players so an additional missed game or two wouldn't be surprising. A four-game slate this week could make a brief absence easier to stomach but keep an eye out for a later afternoon update Monday.
Kevin Durant
The 2013-14 MVP is nearing a return from a strained left hamstring. KD has missed six straight games though his participation in practice has gradually increased over the last few days. I maintain that a few extra games missed now to ensure the injury is completely healed remains the safest play and I'm comfortable with Durant missing one or two more outings.
Zach Randolph
Randolph has missed two straight games with right knee soreness. It's hard to speculate on how long Z-Bo will be sidelined with the specifics regarding the injury still limited. However, this is the same knee that required microfracture surgery way back in the 2004-05 season and Randolph did miss nine straight games last year with similar soreness. As a result, he's a risky play this week.
Derrick Rose
The Bulls guard remains day-to-day with a sprained left ankle though he is optimistic he will be back Tuesday against the Trail Blazers. Any injury to Rose is a setback though he's in a much better position than he was two years ago when he tore his meniscus. Rose should be utilized as he normally would in daily formats though those in weekly leagues may want to give him a week to bounce back. Getting Rose back will be a big plus for Chicago, who will be without Aaron Brooks (hamstring) for the immediate future.
JaVale McGee
The Mavericks had McGee on the active roster Sunday for the first time this season. He provided a surprising spark, scoring eight points and collecting six rebounds in limited minutes. McGee will be brought back slowly from his lingering stress-related tibia injury and isn't a threat to steal Zaza Pachulia's starting spot. However, he could be an interesting speculative add in deeper formats, though patience will be required.
