Clay Matthews' Broken Thumb: A Look at His Bennett's Fracture, Rehab Timetable

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Clay Matthews' Broken Thumb: A Look at His Bennett's Fracture, Rehab Timetable
Thearon W. Henderson/Getty Images

According to Tom Silverstein of the Milwaukee Journal Sentinel, Green Bay Packers linebacker Clay Matthews suffered a broken thumb during a 22-9 victory over the Detroit Lions on Sunday. The injury left many wondering: Can Matthews play through the injury? Or is it more significant? Could it even end his season?

On Tuesday, Fox Sports' Jay Glazer had some answers.

Matthews sustained a Bennett's fracture and needed to undergo surgery to pin his thumb as a result. Glazer went on to say that the injury will cost Matthews at least four weeks—and likely more.

As always, exact medical details are unavailable to the public. However, generally speaking, the prognosis following a Bennett's fracture depends on a few key factors. Each can influence Matthews' recovery time—a time that may vary from the previously mentioned four-plus weeks to significantly longer.

Before getting into the nitty-gritty details, it helps to look at Bennett's fractures from the top down.

Bennett's fractures occur when an outside force pushes or pulls a partially flexed thumb backward toward the forearm. As a result, the bone making up the base of the thumb—the first metacarpal bone—fractures through the end that meets the trapezium, one of the bones of the wrist.

This image shows the basic anatomy of the carpometacarpal joint—where the thumb meets the wrist. Photo courtesy of eorthopod.com.

In other words, if the first metacarpal is a rectangular block of wood, a Bennett's fracture is a crack that starts on the side of the block and progresses downward and out through one of the square ends.

For a better picture, make a fist with one hand. Now, open it up about halfway and gently—no injuries here, please!—pull back the thumb toward the body with the other hand.

The magnitude of force applied to the thumb dictates how much damage takes place—such as the amount of fracture displacement.

Displacement refers to how far one part of a fractured bone moves in relation to the other.

Any significant amount of displacement necessitates one of a few different types of surgical intervention.

This X-ray shows a typical Bennett's fracture. Image courtesy of radiopaedia.org.

Prior to operating, doctors reduce any joint dislocation and use X-rays or other imaging to determine the precise degree of displacement. If no displacement exists, they may decide to manually manipulate the bone into a stable position—a procedure called a closed reduction—before casting it.

This X-ray shows a pinned Bennett's fracture. Courtesy: medscape.com.

A surgeon may also need to insert pins through the fracture to fix it in place while it heals. The pins keep the fractured bones aligned while they heal within a cast, and after four to six weeks—a typical time frame for bone repair—they come out.

The bone must complete the healing process after pin removal, usually requiring another week or two.

On the other hand, if closed reduction or pinning is not possible, doctors may elect to proceed with a more invasive surgery called an open reduction and internal fixation (ORIF).

During an ORIF, surgeons use incisions to directly visualize and reduce fracture before installing metal hardware to reinforce the bones while they heal.

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Based on Glazer's report, it appears as if Matthews' treatment consisted of pinning—either through the skin or with an open operation.

Over the weeks to come, the Packers star will likely remain in an immobilizing thumb cast.

As long as no complications take place—and as long as the injury is not more extensive than reports let on—Matthews could return as early as Week 11 or Week 12.

Until then, however, the Packers will certainly feel the loss of their defensive superstar.

 

UPDATE: Friday, November 8 1:45 pm ET

Even better.

According to NFL.com's Albert Breer, Matthews is probable for Week 10.

--End of update--

 

With important matchups against fellow NFC North squads—such as at the Vikings in Week 7 and at home versus the Bears in Week 8—the Pack's road isn't getting any easier. While probably not catastrophic, Matthews' injury certainly doesn't help.

 

Dr. Dave Siebert is a resident physician at the University of Washington and a medical analyst at Bleacher Report. Find more of his work at the Under the Knife blog. Information from Medscape was used to compile this report.

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