What does foot surgery mean for Cowboys' Bryant?

9/17/2015

Tom Pennington/Getty Images

Philly.com
Sports Doc
Posted: Thursday, September 17, 2015

I know, why in the world am I writing a blog post about a Dallas player? We know Dez Bryant is out next week after surgery on his 5th metatarsal. But will he be back for the November 8th game against Philadelphia which is 7 weeks away?

Here is what we know. He fractured his 5th metatarsal Sunday and had surgery Monday. The team is giving a time frame of 4-6 weeks to return. What we don’t know if it’s it a mid-shaft fracture, a tuberosity fracture, a Jones fracture, or a diaphyseal fracture. These are all different fractures with different treatment options, return to play considerations, and complications.

In a pro athlete, surgery to stabilize the fracture is almost always done regardless of the type of fracture. Screw fixation allows earlier weight bearing and rehabilitation, decreases the risk of malunion/non-union, and ultimately helps with a faster return to sports. Complications following surgery include malunion/non-union of the fracture, bending or breaking of the screw, re-fracture, and persistent pain that can limit athletic ability.

What does Dez’s rehab program look likely following surgery? Weight bearing typically begins around 7-10 days post-surgery. Running is often started around 6 weeks if early healing is occurring and the athlete doesn’t have pain. CT scans can be helpful to document healing of the fracture. Typical return to play in a high level athlete is 8-12 weeks. With Dez Bryant, the Cowboys will throw the kitchen sink at him to help speed up his recovery. This will likely include a bone stimulator to facilitate fracture healing; accelerated rehabilitation to regain flexibility, strength and balance as well as maintain fitness and football specific skills; and possibly other modalities that “may” influence recovery such as hyperbaric treatment, laser therapy, etc.

A study published in 2015 in Foot & Ankle International looked at 25 consecutive NFL players who underwent surgery for 5th metatarsal fractures by a single surgeon. There was a 100% return to play with an average return in 8.7 weeks (range 5.9-13.6). The fastest return to play was 5.9 weeks. However, the fastest return to play for a wide receiver was 8 weeks. Re-fracture was fairly low with only 4 players experiencing re-fractures.

So, will Dez be ready to play against the Eagles on November 8th? The statistics are not in his favor. And if he does play, it will likely be his first game back. Will he be performing at his pre-injury level by then? Time will tell but the research shows that Eagles will likely be putting together a game plan against a Dallas team that won’t include Dez Bryant.