As Golden State Warriors guard Stephen Curry fell to the ground Wednesday at an angle that would cause his left hand to absorb the bulk of the force, an impact injury seemed likely. But when 6-foot-10, 260-pound Phoenix Suns center Aron Baynes then came crashing down on top of Curry's exposed hand, the injury was inevitable. It was a crushing blow -- literally for Curry and figuratively for the Warriors -- and therein may lie the reason that Curry's absence is projected to be a lengthy one.
ESPN's Ramona Shelburne reported Curry's injury as a fracture of the second metacarpal. The metacarpals are the long bones of the hand that connect the fingers to the wrist. They are numbered, in order, from the thumb side to the pinkie side; the second metacarpal is the bone that runs from the base of the index finger to the small bones of the wrist.
Metacarpal fractures are not uncommon in basketball. They are often the result of impact, notably via accidental contact with another player or in a fall to the ground. In recent years, a number of highly visible players such as Russell Westbrook, Kevin Love, Rajon Rondo and Anthony Davis have suffered metacarpal fractures and have returned to play without limitation. Coincidentally, Baynes fractured his fourth metacarpal just last year while with the Boston Celtics after his hand accidentally struck the hand of the Suns' Deandre Ayton. Baynes underwent surgery and missed approximately one month of game action.
As is the case with most injuries, there are numerous variations with these fractures in both location and complexity. The type that perhaps sports fans are most familiar with are the fractures of the shaft (long portion of the bone) of the metacarpal that either result in immobilization until the fracture heals or, more commonly of late, surgery with plates and screws to ensure proper alignment and reinforce the bone as it heals.
When hardware is implanted, it actually increases the strength of the construct and allows the athlete to resume range of motion and, in some cases, return to playing sports at a quicker rate. In the case of metacarpal fractures, NBA athletes often return to action within three to six weeks.
If the fracture is more complex, however, the recovery can extend much longer. For example, if the bone shatters into multiple fragments, the repair is more complicated. Likewise, if the fracture extends into the joint (the area where one end of the metacarpal interfaces with an adjacent bone, both ends of which are covered by cartilage, all encased by fibrous tissue), not only is the repair more difficult, the healing is also more delicate. All of the joint tissue has to heal in order to preserve normal range of motion and to prevent accelerated degenerative changes.
In these more complex cases, the rigid fixation of plates and screws may not be the option. Surgical pins are smaller and allow for more delicate repair, but they must be removed before the athlete can begin the more aggressive elements of rehabilitation. The recovery window often extends to several months.
Then there is the surrounding soft tissue to consider. Interwoven around the bones and joints are ligaments (connecting bone to bone), muscles and tendons (their contraction pulls the bone to create motion), nerves and blood vessels. In a crowded yet highly coordination-demanding area like the hand and fingers, these structures are closely aligned without much room to yield. In the event of a crushing injury, there is the risk of both direct trauma and indirect compromise as the result of swelling.
Which brings us back to Curry's outstretched hand and wrist being crushed between the unforgiving hardwood and the force of the accelerating-via-gravity mass of Baynes. That particular mechanism of injury and the Warriors' PR department's announcement post-surgery that Curry's status would be updated in three months suggest that this metacarpal fracture was of the more complex variety.
Early reports noted Curry underwent an MRI in addition to a CT scan to determine the extent of the injury. CT scans offer detailed images of the bone and MRIs allow for visualization of soft tissue injuries. It's apparent there was concern about all the structures in the area surrounding Curry's second metacarpal fracture, further reinforcing the issuance of the longer recovery timetable.
Now that he has undergone surgery, the next order of business is optimizing healing, which may involve very little activity for his hand, at least at the outset. As the healing progresses, he will be gradually guided into restoring motion and strength with sport-specific activities coming substantially later, perhaps not sooner than two to three months.
If there is any silver lining for Curry, it has to be that this injury was not to his shooting hand. While the ambidexterity makes his ballhandling skills what they are, there is perhaps some comfort in knowing his dominant hand was not involved.
Regardless of the Warriors' record in what is sure to be a challenging season, there is no denying that Curry is central to the organization and that his long-term health is paramount. With that in mind, Warriors fans should perhaps take solace in the notion that there is no pressure for him to return expeditiously. However long it takes for him to recover, the sight of a completely healthy Curry will be well worth the wait.