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Understanding Jonas Valanciunas’ Broken Fourth Metacarpal

The Toronto Raptors have bounced back from last season’s postseason disappointment and once again find themselves in the early season playoff picture. Unfortunately maintaining their position in an improved Eastern Conference got significantly harder with center Jonas Valanciunas suffering a fractured hand in Friday’s win over the Lakers.

Valanciunas’ exact injury is a fractured fourth metacarpal bone in his left hand. Metacarpal fractures are common in the NBA and have been profiled multiple times here on InStreetClothes.com but let’s review.

Five metacarpal bones form the bulk of the hand and link 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 metacarpal fractures are often known as a Boxer’s fracture.

Last season multiple players, including Rajon Rondo, Russell Westbrook, and Robin Lopez suffered fractured metacarpals. Other players to suffer the injury include Anthony Davis, Kawhi Leonard, and Kevin Love.

The necessary recovery time normally depends on multiple factors, including the specific metacarpal fractured. Breaks to the second and third metacarpals, located below the pointer and middle fingers, are easier to manage as they are anchored to the bones of the wrist and as a result are largely immobile. The fourth and the fifth metacarpals, located beneath the ring and pinkie fingers respectively, are more mobile in order to allow motion at the wrist and pinkie. The mobility here often necessitates additional healing time.

The other major factor influencing recovery time is the nature of the break. If the fragmented pieces of bone remain aligned, it is considered a non-displaced fracture. Non-displaced fractures are often treated conservatively and the effected individual can avoid surgery.

If the position of the broken bone or bones shifts upon injury, the break is considered displaced. These types of injuries are often treated surgically to insure a proper union of the bone. The InStreetClothes.com database reveals that on average players who need surgery for a metacarpal fracture miss five more games than those who avoid going under the knife.

Unfortunately for Valanciunas that gap is negligible when isolated fourth metacarpal injuries are examined. The difference between surgical and non-surgical treatments isn’t significant and the average number of missed games for these injuries is 17 games. Raptors fans looking for an even better comparison are in luck as this marks the second metacarpal fracture for Valanciunas. During the 2012-13 season, Valanciunas suffered a fractured fourth metacarpal in his opposite hand. He would not require surgery and miss 18 games recovering.

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Regardless of treatment options, the setback for Toronto remains considerable. Valanciunas is averaging 12.7 points and 9.3 rebounds through the first 14 games of the season, both career-highs for the Lithuanian center. His ability to secure rebounds will be particularly missed, as he is an integral part of the team’s top three rebounding five-man lineups. Furthermore, as Daniel Hackett of Raptors HQ recently detailed, Valanciunas’ individual impact on the teams offense and defense is crucial to the team’s on-court success.

Sustained health has been a key component of the Raptors recent return to relevancy. The team’s top ranked medical staff will now be tasked with getting Valanciunas back as quickly as possible while maintaining the health of the other members of the team. Having the previously injured DeMarre Carroll and Terrence Ross back in the lineup will help but how the team performs during Valanciunas’ prolonged absence will be critical in shaping the remainder of their season.