Credit: John Rhodes
The Dallas Morning News reports that Dallas Cowboys wide receiver Dez Bryant admits he needs surgery for his broken finger but wants to delay surgery until the off season. Apparently the surgery will require bone grafting. What does this involve? Is it a good idea for Dez to wait to have surgery?
Types of finger fractures
Each finger has three bones in it. I don’t know which one Dez broke, but if he needs bone graft surgery, it’s probably around a joint. This means that it’s most likely around the middle of the finger, at the PIP joint.
Remember that fractures are the same as breaks. If a bone is just cracked all the way through, a bone graft is rarely necessary. This means that the injury is probably a severe one, involving a piece of his joint.
Not good.
Doctors who treat finger fractures
Sometimes a sports medicine doctor will treat both legs and arms. More commonly, players will go see a hand specialist, a hand surgeon. I’m guessing Dez saw one or two hand surgeons to get opinions about a plan to fix his finger.
Hand surgeons certainly can treat things differently – one may fix a finger fracture in a slightly different way than the next guy.
However, the bottom line is that the broken pieces of a finger joint must be lined up and stabilized with metal if the player wants to use that finger in a game. They may even recommend that he not play at all if the fracture is fragile after surgery and the risk of re-breaking it is too high.
Here’s an x-ray of a finger, fractured, completely broken and deformed through the joint.
What if Dez refuses to have surgery until after the season ends?
Delaying surgery on a broken finger joint will create several problems.
Pain, stiffness, and deformity may be the consequences.
Some players are tough enough to play through almost any discomfort. But if a finger joint is left to heal in a crooked position, the jagged edges of the joint will start to wear away like two sandpaper-covered surfaces over a period of months. This will cause arthritis, and potentially a very stiff and painful joint.
On the other hand, Dez may have a joint that’s not lined up well, but functions at 90% of normal after the bone heals. The point is that it’s unpredictable.
What is predictable is that if you line up crooked pieces of bone, they’re going to function better.
Here are two pictures from surgery I performed on a broken finger joint – showing before and after pictures. In the first one, the bone is opened up, exploded like Pac-Man. Putting the fracture together requires closing those two pieces down and pinning them together – you can see that in the second picture.
Does a bone graft have to come from the hip?
No.
Dez says that “No one’s touching my hip.” I’d tend to agree with him. Usually the pain from the hip bone graft hurts more after surgery than the finger itself.
Bone graft is necessary when a bone is so crushed that putting it back where it should be creates an open place that needs to be filled in between the pieces.
Bone graft for a finger fracture can come from many other places in the body besides the hip bone.
Possibilities include:
- radius bone – by the wrist
- tibia bone (shin bone) by the knee
- olecranon (ulna bone) by the elbow
As mentioned in the Dallas Morning News article, we can get bone graft from cadaver bone, from the bone bank. This is generally a very safe thing to do.
Usually a small amount of bone is necessary to fix a finger fracture – even a bad one.
Therefore, I don’t think the fact that the bone graft part of the operation will slow Dez down anymore than fixing the fracture would.
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