Kobe Bryant's wrist injury: An orthopedic surgeon offers background
Here's a Q&A with Dr. Michael Hausman, a professor of orthopedic surgery and vice chairman of the Department of Orthopaedics at Mount Sinai School of Medicine in New York City, on Kobe Bryant's torn lunotriquetral ligament in his right wrist. Bryant suffered the injury after landing awkwardly on his right wrist in Monday's exhibition against the Clippers. Keep in mind that Bryant underwent an MRI exam and was examined by Dr. Steven Shin of the Kerlan-Jobe Orthopaedic Clinic. Hausman's answers reflect the general nature of torn ligaments.
On what Hausman makes of Bryant's original diagnosis:
He injured his ligament between the small bones and the wrist. But we don't know the severity of the injury -- is it a partial tear or full tear and whether or not there is instability between the little bones in the wrist. That shows whether it's shifted out of the normal position and normal alignment. The prognosis is completely dependent on those factors.
How does that make a difference?
There are two wrist ligaments between the little bones that are commonly injured. There's a ligament between the scaphoid bone and lunate bone called the scapholunate ligament. Then there's the ligament between the lunate bone and triquetral ligament. That's the one Kobe Bryant injured. Of the two, the potentially more serious injury is scapholunate injury, which he doesn't have. The ligament that he did injure, in general, has a somewhat better prognosis.
It's common for someone to injure it, get up, shake it a few times and continue to use it. They can then notice it's more painful the following day, especially if the injury is a more minor one. The fact that he could do that is potentially hopeful. The threshold for getting an MRI scan for a professional athlete is quite low. If you or I had similar symptoms, we would probably rest it for a couple weeks, take anti-inflammatory medicine and see what happens. But with professional athletes, they want to know everything up front and get an immediate scan.
What are the timetables for partial tears?
I can't speak for the team's physician, and recognize I haven't examined the patient. But if someone has a sprain or partial tear of the lunotriquetral ligament, I would rest that for a week or possibly two until they're comfortable and then let them use the hand and wrist as they feel capable. The most favorable scenario is he would have a minor or subtle injury, in which case he could use it within a week or so.
What about full tears?
Then the issue is whether or not there is instability. The bones are then started to shift out of position. That's the worst-case scenario. If it the alignment of the wrist bones is abnormal, you'd want to repair that surgically. You're talking three to four months after surgery before he could begin to play on it. The intermediate worst is the ligament is completely torn but the bones are still remaining in the normal alignment. In that case, it would be a discussion between the doctor, player and team management as to whether he could try playing through the season and defer treatment toward the end of the season, depending on whether or not his symptoms allowed him to do that.
-- Mark Medina
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Photo: Lakers guard Kobe Bryant stands near the bench during Wednesday's exhibition game against the Clippers at Staples Center. Bryant did not play because of torn ligament in his right wrist. Credit: Wally Skalij / Los Angeles Times / December 21, 2011