The science behind Markel Brown’s injury

Markel Brown
Markel Brown (AP)
Markel Brown
Markel Brown (AP)

On Monday, the Nets announced that rookie guard Markel Brown sustained a non-displaced fracture in the fourth metacarpal bone of his right hand during a workout in Las Vegas. He’ll be out 4-6 weeks in a cast, and should be back for training camp.

But there’s more to it from a scientific perspective. The fourth metacarpal bone is shown here in an example x-ray (note: NOT Brown’s x-ray):

Photo from eMedicine
Photo from eMedicine

A common medical term for the injury is a “boxer’s fracture.” When a boxer clenches their fist and hits an immovable surface like a wall, the rebounding pressure reverberates in the metacarpal bones. The 4th metacarpal tends to be the leading bone in a punch, so it receives the impact, and fracture, first. That’s why boxers wear wraps and gloves on their hands, to prevent some of the rebounding intensity that comes from a punch.

The accepted treatment for this injury is immobilization. Brown had his cast fitted immediately after the injury, following the procedure verbatim.

Although the cause of Brown’s injury has been vaguely described, it’s easy to narrow down the possibilities. It’s possible he hit something in training, or fell and instinctively put out his fist, initiating the compression and rupture of the bone.

Four to six weeks should give the bone enough time to realign on its own without medical interference. The worst-case scenario is surgery if the fracture improperly aligns. That’s unlikely for a healthy athlete like Brown.

Need a comparison? Look one year back. Paul Pierce sustained a similar injury in December of 2013 with the Nets, fracturing the 3rd metacarpal in his right hand, but his expected return was 2-4 weeks. Pierce’s injury was less serious due to the fact that the 3rd metacarpal receives much less force.

Brown may have to wear a glove on his right hand like Pierce, who compared the glove to a girlfriend, during training camp. If so, it should come off by preseason.