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How Giancarlo Stanton's Horrific HBP Will Impact the Star Slugger's Future

Will Carroll@injuryexpertSports Injuries Lead WriterSeptember 12, 2014

Morry Gash/AP Images

There are few things in sports more scary than watching a player, especially a star like Giancarlo Stanton, fall to the ground. An errant (and clearly unintentional) pitch from Mike Fiers tailed directly into Stanton's face, leaving the slugger on the ground until an ambulance came to take him away.

Joe Frisaro of MLB.com has the details in this tweet:

Joe Frisaro @JoeFrisaro

#Marlins Giancarlo Stanton suffered a facial laceration requiring stitches, multiple facial fractures and dental damage

If this video (warning: graphic) is too much for you, this may be all you need to know: There was enough blood that the grounds crew had to come out and work on the batter's box once he was removed.

Stanton was immediately taken to an area hospital, cared for by both the Miami Marlins' medical staff and the Milwaukee Brewers' doctors, per a team source I spoke with moments after the incident. It is common practice in MLB to have the home team's doctors care for both teams' players, especially in situations like this. Team doctors do not normally travel with the club. 

The response was lightning fast. Marlins athletic trainer (AT) Mike Kozak made it to Stanton in nine seconds. Keep in mind that I can't tell where Kozak started from. Athletic trainers are often at the end of the bench working with players and react to crowd sounds or calls from the manager or umpires before going out on the field.

Head AT Sean Cunningham took just 18 seconds to join Kozak in attending to Stanton.

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Stanton had been on the ground only 49 seconds before Brewers head AT Dan Wright was seen checking with his Marlins counterparts and calling for the cart. At the 2:20 mark, Dr. Bill Raasch made it onto the field. Dr. Raasch is one of the top orthopedists in the country, so Stanton was a bit lucky that he was at the ballpark tonight. (Team doctors often rotate, depending on their schedules.) 

Stanton was quickly transferred from the cart to an ambulance and taken to an area hospital. While I am not sure which hospital Stanton was taken to, Dr. Raasch practices out of Froedtert Hospital, which is about five miles from Miller Park. My guess is Stanton would be taken there in case he needed immediate surgery.

Morry Gash/Associated Press

Fixating the bones around his eye would be the immediate concern if needed, though there was no mention of surgery in the initial reports, such as the one above from beat writer Frisaro.

The bigger issue for Stanton or any hitter is his eyesight. Players do get hit in the face, from Jason Heyward last season to Andre Dawson in one of the worst hit-by-pitch situations I've ever seen. Heyward still wears a flap to protect his face, though he has come back from a fractured orbital with no real issue.

The best-case scenario was sitting in the Brewers dugout Thursday evening. Jean Segura was hit by an errant bat in a similar location to Stanton earlier this season. He needed several stitches but did not have any fractures. He also avoided a concussion, returning to the lineup in just days. 

A worst-case scenario would be one like what Juan Encarnacion suffered in 2007. Encarnacion's injury ranks among the most gruesome in any sport. A foul ball hit Encarnacion while in the on-deck circle, creating what is called a blowout fracture. Despite surgery to put things back in place, Encarnacion's vision was 20/400 in the affected eye, which is legally blind in many states. He was never able to play baseball again.

Doctors will use several imaging techniques, including X-ray and CT scan, to check for damage to Stanton's orbital. While it will be clear in the case of a blowout that the orbital has lost integrity, a lesser fracture can be just as serious and often requires surgery to fixate. Keeping the eye in place is key here. In addition, any swelling must be controlled to prevent damage to the eye itself and to the optic nerve.

David J. Chao, MD @ProFootballDoc

Giancarlo STANTON @Marlins hit in face w/ pitch. Main worry is zygomatic arch fracture. Orbit/eye thankfully appear ok. Scary. Hope he's ok.

Besides the orbital bone, doctors will check the zygomatic arch with both X-ray and CT. This area is to the side of the head, nearer the ear and connected to the cheekbone. This is a very weak area and one that can be very difficult to reconstruct. 

In addition to fracture and eye issues, it is very likely that Stanton was concussed. While it is a secondary problem to the other possible issues, a concussion is a serious condition and must be treated. It is very likely that Stanton will be placed into MLB's concussion protocol and will need to pass the needed steps before returning to play. 

Stanton, on top of all that, has a facial laceration. This is a fancy word for a big cut, suffered when the ball struck him. Given the amount of blood, it's a safe assumption that Stanton will have stitches to close the wound and likely some swelling. If Stanton had managed to avoid both fractures and concussion, the stitches alone would have prevented an immediate return to play.

Oddly, the location of the laceration could be a positive sign. According to the The Associated Press, Stanton was "bleeding heavily from his mouth." If the ball struck him lower on the face, his eye may have been spared some damage. The fact that there's dental (teeth) damage is another indication that the impact may have been away from Stanton's eyes.

With only weeks left in the season, it is hard to imagine that Stanton will return to the Marlins lineup if there are any issues, as Mike Redmond told the AP after the game. Given his current numbers, he is a clear favorite for MVP. Even if this closes out his season, he should get heavy consideration alongside Clayton Kershaw, Andrew McCutchen and the player who was nearest him when he was felled, Jonathan Lucroy.

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