Breaking Down Julius Randle’s Tibia Fracture

• Post By: Jeff Stotts
• Date: October 29, 2014
• Category: Break Down, NBA

After back-to-back seasons wrought by bad healthy and unfortunate accidents, the Los Angeles Lakers again find themselves beset by injuries. Point guard Steve Nash will not play this season after his congenital back condition became too much to manage. Now rookie Julius Randle will miss an extended period of time after breaking his leg in the team’s first regular season game of the year.

Randle was injured while driving to the basket. He went up for a layup attempt and his right leg buckled. He slid to the baseline, instantly grabbing his leg. Randle was carted off the court and after the game players reported hearing a “pop” when the injury occurred. X-rays taken at the arena revealed a fracture to his right tibia.

The tibia, or shinbone, is the larger of the two lower leg bones and is the primary weight bearing bone in the body.  There is very little surrounding musculature and players frequently suffer tibia contusions when kicked in the area. Isolated traumatic tibia fractures occur much less frequently though are possible. Violent fractures, like the one suffered this summer by Indiana’s Paul George, are often accompanied by a fibula fracture.

While Randle’s fracture happened on an isolated play with a specific mechanism of injury, the rookie forward may actually be dealing with a stress-related injury. Bleacher Report’s Will Carroll explains that Randle’s break could be classified as stress fracture that was exacerbated on the play in which the injury appeared to have occurred.

If this is indeed the case, history shows that the necessary treatment will ultimately decide how long Randle will be sidelined. Multiple players have endured tibia stress fractures in recent seasons with JaVale McGee and Jrue Holiday the most noteworthy. Both McGee and Holiday had hardware surgically inserted to stabilize the area of concern. The average number of games missed by these two and others who needed surgical intervention is 49 games, over twice the numbers of games missed by those who did not require surgery.

Like any injury, there’s a great deal of variability to mention. The bones of the body are constantly remodeling themselves to handle the stress they are subjected to daily. In some instances, the body simply cannot keep up with these demands and the bone tissue fails.  Factors like height, weight, and age of the athlete all contribute to the cause, especially when a weight-bearing bone is involved.

Location of the fracture is also key. If you will recall, Randle’s teammate Kobe Bryant missed time last season with a tibia fracture of his own. However Bryant, as well as Lorenzen Wright and Yao Ming, suffered traumatic fractures to the proximal end of the bone, specifically the tibial plateau. The tibial plateau is closer to the knee and comes with its own set of issues. Randle’s injury, based on footage and pictures of the injury, appears to be to the distal end of the tibia closer to the ankle. This area is responsible for a large amount of weight bearing and as a result often requires additional time to heal. The distal end of the tibia, known as the plafond, is reasonable for nearly 90% of the load placed on and through the ankle joint.

Finally an athlete’s history must be considered. Randle suffered a fractured fifth metatarsal in his right foot while attending Prestonwood Christian Academy in Texas. The injury became an area of concern shortly before this year’s NBA Draft when fears about the integrity of the hardware surfaced. The Lakers were willing to assume the associated risk and the injury appeared to be a non-factor during Randle’s prep work for the new season. Now, with another fracture on the same leg, special considerations must be applied to Randle’s recovery and rehabilitation to insure this area is not aggravated.

The Lakers are expected to provide an update on Randle’s condition Wednesday, detailing the intended course of treatment. Surgery remains an option and will influence the rookie’s potential return to play date. For now the development of Randle as well as the future of the Lakers franchise has been temporarily placed on pause with injuries again wreaking havoc on the team.

UPDATE: Ramona Shelburne of ESPN Los Angeles revealed Randle underwent surgery Wednesday morning. The fracture was reportedly a complete, clean break.