The Disabled List Informer

Could the season be over for Chien Ming Wang ? MRI results today will tell us his diagnosis, and the Doctors should provide a prognosis for recovery. There has been some word circulating that this could be the dreaded Lisfranc fracture (dislocation).

The location and description of the pain (top of the foot, swelling, inability to bear weight), as well as the mechanism of injury (awkward twisting of the foot), certainly fits the profile. A Lisfranc Fracture occurs in the midfoot, where small bones (cuneiforms) articulate with the first and second metatarsal bones. These bones are anchored together by ligaments and connective tissue, and form a "keystone" wedge. Then-New England Patriots DB Ty Law had a serious Lisfranc injury in 2004.

(photo from American Academy of Family Physicians website )

George King of the New York Post , not citing his sources states, "…there is a strong belief in the Yankees’ universe that Chien-Ming Wang’s season could be over due to a Lisfranc fracture in his right foot."

Anthony McCarron of the New York Daily News described Wang’s injury as being similar to the Lisfranc injury sustained by Brian Bruney.

And Peter Abraham of The LoHud Yankees Blog reports , "No words yet on when the Yankees will reveal the extent of Wang’s injury. But based on what was learned in the clubhouse and through other sources, it doesn’t look good."

(Hat tip to Pride of the Yankees blog for source update)

If this is, in fact, a Lisfranc Fracture, he will miss an extended period of time. The treatment of this depends on the severity. If the bones are not displaced, he would be placed in a cast for 6 weeks and would not be allowed to bear weight through the foot.

With a displacement of greater than 2mm, surgery is needed to stabilize the bones in place, specifically with k-wire, and sometimes screws and pins. Strict weight bearing restrictions are in place for around 3 months. Usually after 6 weeks, the wires are removed and progressive weight bearing is allowed with a special cast, but the screws remain in place for anywhere from 6 weeks to 3 months after weight bearing is allowed.

There are differing opinions as to when the screws should be removed. Some Doctors prefer early removal, for fear of the screws breaking once weight bearing occurs, while others feel that it is essential to keep them in place to gradually allow the joints and ligaments to ‘relearn’ how to support the foot.

Overall, the recovery time frame can be quite lengthy - and in this case, season-ending - due to the period of immobilization and lack of weight bearing. The average length of time to return to sports is between 4-5 months, but can range anywhere from 3-6 months depending on severity of injury and individual healing time.

This will only intensify and stoke the fire of the rumor mill, with the Yankees apparently interested in trading for C.C. Sabathia .