Injury Breakdown: Give Willis McGahee A Hand

By Abby Sims
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Denver RB, Willis McGahee, returned to the field in Oakland on Sunday, and powered the Broncos past the Raiders.  He took some of the heat off Tim Tebow with 163 rushing yards  and two touchdowns.  Quite an accomplishment for a guy thought to be a back-up at best at the start of this season, and one whose best days were behind him. With his numbers this week, McGahee leads all NFL running backs in both rushing and TDs.

What makes McGahee's accomplishments even more remarkable is that he played less than two weeks after surgery to repair a fractured fourth metacarpal in his right hand. McGahee had suffered the impact injury against a defenders mask versus the Dolphins on October 23rd.

The procedure performed on McGahee reportedly entailed stabilizing the fracture in his ball-carrying hand with a plate and five pins.  Originally casted, he reportedly wore only padding over his incision during practice last week and was absent that at game time.McGahee was quoted as saying that he  "suffered what doctors call a boxer's fracture." but could now "bend my hand without it hurting or anything".  Improbable but we'll take him at his word.

McGahee is no stranger to an accelerated return to action.  Having ended his college career in the 2003 Fiesta Bowl with devastating tears of his left ACL (anterior cruciate ligament), PCL (posterior cruciate ligament) and MCL (medial collateral ligament), he was drafted in the first round after an early return at the combines, and went on to a brilliant rookie season with Buffalo.

So what are the Metacarpals, and what is a Boxer's Fracture?

The metacarpals (MCs) are the long bones in the hand that extend from the small carpal bones (that comprise part of the wrist) to the base of the fingers. Each metacarpal has a base near the wrist and a head at the knuckle (forming a joint with the lower bone of the finger – the proximal phalange) and a shaft and neck in between.

The MCs are most often fractured due to impact with a closed fist.  I know of too many people who've had this injury from punching a wall in anger.

Some metacarpal fractures can be treated conservatively with splinting. Others, like McGahee's, require surgery, either because they are displaced (the segments of the bone no longer line up) and involve the joint, because more than one MC is fractured, or due to soft tissue that is in the way, preventing the bone from being set. I have not seen reports of the specific nature of McGahee's fracture, but it is likely his falls into one of the first two categories.

Fractures can occur at any point in the metacarpals, though the very common Boxer's Fracture is technically considered one that occurs at the "neck"of the fifth metacarpal, which is the MC leading to the little finger.  Therefore, with his fourth MC injured, McGahee may have been misinformed.

Typically the union (mending) of a metacarpal fracture occurs in six weeks.  Indeed, that is considered to be the response time for the healing of many fractures. Generally, due to splinting of the injury, whether managed conservatively or surgically, some loss of motion is expected, and rehab to restore mobility, strength and muscle flexibility is important. Inflammation must also be managed to control swelling. McGahee's return in less than two weeks and his effectiveness is doing so is astounding.  His hand can't be feeling too good right now though.

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