Breaking Down Julius Randle’s Injury And Its Effects on Draft Night

• Post By: Jeff Stotts
• Date: June 12, 2014
• Category: Break Down, NBA, NCAA

While the Finals are still ongoing, 28 other NBA teams are already looking to next season. The primary focus is currently on the upcoming draft with teams hosting prospects and reviewing as much information on each individual as possible. A large part of these background checks include thorough medical reports on any previous injuries or preexisting conditions.

Joel Embiid’s back injury as garnered the majority of the headlines but Yahoo Sports writer Adrian Wojnarowski revealed early this morning that a red flag has emerged for Kentucky forward Julius Randle. The report suggests Randle will likely need surgery on his foot, stemming from an injury suffered during his senior year of high school. Randle’s mother has since refuted the reports but his previous injury alone should be cause for pause.

Randle suffered a fractured 5^th metatarsal in his right foot while attending Prestonwood Christian Academy in Texas. He sat for three months following surgery but returned to lead the Lions to a state title. While the foot held up during his lone season at Kentucky, the injury remains a concern. Apparently the bone healed improperly, forming what is known as a malunion. A procedure to remove the hardware may be required to insure Randle is able to compete at a high level without any fears of long-term problems.

The fifth metatarsal is situated on the outside of the foot, just below the start of the pinkie toe. The bone serves as an attachment site for several muscles, making it vulnerable to fractures when the ankle is forced inward. This motion frequently occurs in basketball following a sudden change of direction or landing on an opponent’s foot. As a result 5th metatarsal fractures are common in basketball.

In metatarsal fractures, it is all about the location of the fracture and the mechanism of injury. Possibilities include an avulsion fracture, in which a muscle pulls away a piece of bone, as well as a stress fracture or acute fracture. The most serious of these breaks is the Jones fracture, which occurs when the injury site is located near the base of the bone. The blood flow to this area is very poor, meaning the healing process is stunted. As a result, surgical intervention is often necessary.

However, surgery comes with its own set of complications. The size of the surgical screws utilized in the procedure remains debated, as the surgery has shown to have a considerably high failure rate if the wrong type of screw is utilized. The hardware can fail, bend, or even lead to a refracture. The InStreetClothes.com database has catalogued 30 different NBA players to suffer a 5th metacarpal fracture and seven (23 percent) of those athletes suffered a second fracture or needed a follow-up surgery. In the case of Brooklyn’s Brook Lopez, two additional procedures were required. These scenarios are precisely the reason some NBA teams have become hesitant about Randle’s long-term health.

In Randle’s case it appears the hardware failed and the bone healed poorly. Wojnarowski’s report suggests the procedure the 6-foot-9 forward would likely require involves removing the surgical screw. Time would then be needed to insure the bone properly heals. While the initial time line for recovery is estimated at six-to-eight weeks, a more conservative and longer window is often utilized following a revision surgery. With summer league likely ruled out, it wouldn’t be surprising if the team managing Randle’s recovery has him remain sidelined for somewhere between 12 to 14 weeks. Extra time may also be needed to address any biomechanical issues that are exacerbating the situation.

Given the associated risk, it wouldn’t be surprising to see Randle slip a bit on draft night. However, a minor fall could actually play in Randle’s favor, as dropping to a team with an elite medical staff would result in the best care possible. Sacramento (selecting eighth) and Phoenix (selecting 14^th) would be ideal destinations.

It should also be noted that Randle isn’t the only draft prospect with 5^th metatarsal injuries in their past. University of Connecticut point guard Shabazz Napier needed surgery for a fractured 5^th metatarsal in September of 2012. He played out the season but did miss two games with lingering soreness in the foot. C.J. Wilcox of the University of Washington underwent the same procedure following the 2012-13 season. Louisville’s Russ Smith had surgery on his foot during his freshmen year and missed four games, though it would not be an issue for the remainder of his collegiate career. Finally, Jordan Adams missed UCLA’s final two games, including the opening round of the 2013 NCAA tournament, after breaking his 5^th metatarsal in Pac-12 tournament play. The injury marked the second fracture of the area for Adams, having previously broken the foot in high school.

Injuries are part of draft night and help shape where prospects end up. While Randle could wind up a steal for some fortunate team, it’s important they understands the inherent risk and properly manage the situation moving forward.