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NBA Injury Analysis: Candy Cane Crutches

Jeff Stotts

Jeff Stotts works as a Certified Athletic Trainer (MAT, ATC, PES, CES). He won the 2011 Best Fantasy Football Article in Print from the Fantasy Sports Trade Association.

Kobe Bryant
Fantasy owners who gambled on draft day and invested in Kobe Bryant saw the return on their invest last just six games. After missing the start of the season recovering from offseason surgery to repair a ruptured Achilles, Bryant will again miss time after suffering a fracture to the lateral plateau of his tibia. The injury occurred in a Lakers' win over the Grizzlies when Bryant took an awkward step, hyperextending his left leg. He would finish the game, leading the Lakers with 21 points. Additional testing after the game revealed the injury.

The tibia is the bigger of the two lower leg bones and bears the majority of the body's weight. At the proximal end, near the knee, the tibia widens forming the tibial plateau. The menisci of the knee sit between the ends of the femur and the tibial plateau, allowing for proper knee articulation. Tibial plateau fractures are rare in sports and more commonly occur in car accidents or falls from a great height. The injury occurs as excessive force is driven through the femur and into the softer bone tissue of the tibial plateau. The tibia succumbs to the stress and eventually breaks.

On the plus side, Kobe's fracture is non-displaced and will not require surgery. He also avoided any significant soft tissue or meniscus damage within the knee. As a result, the basic treatment program for this injury is rest. Kobe must allow the bone to repair, and owners should expect the Lakers to take necessary steps to insure the bone forms a correct union. The use of a device known as a bone stimulator could help accelerate the process but time remains the best option. The Lakers are stating that he will miss six weeks, but that seems like a best-case scenario. For example, Knicks center Tyson Chandler's recently suffered a non-displaced fracture of his fibular head and missed five and a half weeks recovering. Chandler's injury occurred in a location of close proximity to Bryant's with one glaring difference. The tibia bears a much heavier weight load than the fibula, suggesting Bryant's injury will need additional time to recover.

The track record for previous NBA players to sustain this type of injury doesn't bode well for Bryant either. Yao Ming and Lorenzen Wright both suffered tibial plateau fractures during their NBA careers. Coincidentally, like Kobe, both players suffered their injuries in December. Wright was injured on December 9, 2001 and returned on February 14, 2002 nearly 10 weeks and 33 games later. Ming went down on December 23, 2006 and did not play for 10 weeks, returning on March 5, 2007 after a 32-game absence. The size of Ming and Wright likely contributed to their extended recovery windows, but again, a six-week recovery seems very optimistic.

Other factors to consider include the various setbacks and complications that can arise. Compartment syndrome and nerve entrapment can occur, and arthritis is often a resulting complication. These kinds of things can be problematic for a player who has logged as many minutes as Bryant.

With uncertainty surrounding Bryant, fantasy owners may want to consider moving the former MVP, though finding fair value will be difficult. Xavier Henry has assumed the point guard duties with Steve Nash, Steve Blake, and Jordan Farmar all out with injuries and is worth a roster spot in most formats. Farmar is the point guard expected to be back first and could be worth a flier if you need assists and decent percentages.

Brook Lopez
The Lakers aren't the only team being ravaged by the injury bug. Brooklyn has lost Paul Pierce, Deron Williams, Andrei Kirilenko, Jason Terry, and Kevin Garnett at various points of the season due to injury. However, no injury has been as impactful as the foot fracture sustained by Brook Lopez over the weekend.

Lopez was diagnosed with a broken fifth metatarsal in his right foot following Friday's game against Philadelphia. If you'll recall, Lopez has a lengthy history of right foot injuries dating back to the preseason of the 2011-12 season. Just before the season was slated to begin, Lopez was diagnosed with a stress fracture in his fifth metatarsal. He would undergo surgery and miss the first 32 games of the year. A second surgery would be needed in the offseason and Lopez was able to stay healthy for the majority of the 2012-13 season. However this past summer, Lopez needed a third surgery to replace the surgical hardware inserted in his first operation. The screw used to join the bone fragments had become bent and was causing him pain and discomfort. Sadly, the bone has broken yet again and surgery remains a probable option.

Fifth metatarsal fractures are one of the most difficult injuries to manage. Surgical failure is common, and the risk of re-injurying the area is high. The NBA is full of examples including Glen Davis, Damion James, Ricky Davis, Rodrigue Beaubois, and rookie C.J. McCollum, all of whom had reoccurring problems following a metatarsal fracture, each requiring multiple surgeries.

Lopez will weigh his options and visit with specialists, but it appears his season is over. He's not worth rostering in most formats and even those in keeper leagues will face a difficult decision. Given his recent history and the problems of others with the injury, I'd advise moving on. The Nets will turn to Andray Blatche and Garnett to shoulder Lopez's load and Mirza Teletovic could also benefit.

Fast Breaks

Marc Gasol: The Grizzlies are inching toward welcoming Gasol back into the fold. Out since suffering a Grade II sprain of his MCL, Gasol has shed his crutches and hopes to be back in as little as 10 days. However, the organization insists it will be closer to 20 days.

James Harden: Harden's left ankle injury continues to linger and will keep him out of Monday's contest against Dallas. The Rockets have five games scheduled this week, but the Bearded One remains a risky play.

Ersan Ilyasova: His troublesome ankle remains an issue and the Bucks have elected to shut him down until he's 100 percent. There is no established timeline, and I would prepare for a lengthy absence.

Kawhi Leonard: Leonard will be in uniform for Monday's matchup against the Raptors after missing the previous game following a dental procedure.

Jeremy Lin: While Harden sits, Lin will return after sitting out the last four games with back spasms. Houston will lean heavily on the point guard with Harden out and Patrick Beverly expected to miss at least four weeks with a broken hand.

Larry Sanders: Sanders is hoping to return to practice soon and has begun more vigorous activities after having the pins removed from his surgically repaired thumb. He hopes to be available before the new year.

Jeff Taylor: The Bobcats lost Taylor for the season after he ruptured his Achilles. He will require surgery and is droppable in all formats.