Is Post-All-Star Break Derek Jeter Return Realistic After Ankle Injury Setback?

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Is Post-All-Star Break Derek Jeter Return Realistic After Ankle Injury Setback?

The New York Yankees didn't need bad news, but they got it on Thursday. MLB announced a major setback for Derek Jeter:

 

With this setback, the Yankees feel that Jeter will need another two months of healing and rehabilitation, putting his new expected return date at around nine months post-injury. That's not out of the normal range, though Jeter's fracture was not as complicated as the injuries to Buster Posey or Stephen Drew that involved more structures. 

WARNING: graphic injury.

In fact, Drew's injury might be instructive as a comparison. It took the current Boston Red Sox shortstop 153 days to return from his traumatic fracture in 2011. After he came back, he showed significant range issues, with a one-win drop in dWAR and an apparent loss of speed. Drew is several years younger than Jeter, so it is reasonable to think there will be similar issues upon Jeter's return.

Expect the Yankees to push Jeter onto the 60-day disabled list in order to free up a spot on the 40-man roster. With his initial DL date, he would be eligible to return from the 60-day in mid-May, so this move would not delay a comeback. 

Jeter injured the ankle during the playoffs in October. The dramatic injury and the image of him lying on the ground, his face twisted in pain, seemed emblematic of the rapid fall of the aging Yankees lineup. The fractured tibia is not a complicated injury, and he avoided significant damage to any other structures in the ankle.

Jeter visited with team physicians and consulted with noted ankle specialist Dr. Robert Anderson in Charlotte, N.C. They decided that the best course of action would be to fixate the ankle in order to make sure that it healed properly. The worry is that any pre-healed bone that is as weight-bearing as the tibia could have issues, even with a compliant patient and an ordinary rehab.

The fixation seemed to work, with Jeter back to workouts in January and back on the field in early February. By the opening of spring training, Jeter had already been taking grounders and showed no real problems. That led most observers, including myself and Jeter, to think that he was on track to return.

I was surprised that he seemed ready to play at short. It seemed he would need to at least occasionally slot in at designated hitter to give the ankle a rest.

Instead, the Yankees signed Travis Hafner, a sign that they were confident that the captain wouldn't need to be off the field much in the early portion of the season.

Jeter began to have problems in mid-March, about the same time he was beginning to do more running on the bases. He had issues with pain and swelling and was not recovering well between workouts. He was shut down on March 23, and at that point, it appeared that it was a mild issue more focused on making sure they had the routine of maintenance down rather than a full setback.

With this most recent episode, there is no confirmation that there was a further setback, but as Joe Girardi told the media, "put two and two together."

The CT scan also could indicate that this is a very small area, one that would be difficult to see on an X-ray or fluoroscope. That's not good, but it's more positive than a clear fracture.

Can you find the fracture in this ankle CT? (Not Jeter's)

It is unknown if this is new or whether this is a non-union where the bone simply did not heal normally. Non-unions after fixation are very uncommon, and given that Jeter was cleared for baseball activities, it's even more unlikely. Since he was tested after the initial shutdown, the most likely course here is that he pushed too hard and re-injured the area. 

The Yankees have put no definitive timeline on Jeter's return. The "post All-Star break" set is very fluid, much like the return of Alex Rodriguez. While more setbacks are possible, the positive steps made by Jeter early in the season are a good indicator for his eventual return.

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