Toronto Raptors

The anatomy and impact of Kyle Lowry’s left thumb fracture

Kyle Lowry sustained another thumb injury Friday night, but another look at the anatomy of the injury and its potential impact on the Toronto Raptors is necessary this time around.

The Toronto Raptors were trailing the New Orleans Pelicans by two with approximately 75 percent of the first quarter under wraps. Pelicans forward Derrick Favors had just corralled an errant 3-point attempt by guard Jrue Holiday and was rising to lay in the offensive board when Raptors point guard Kyle Lowry swiped at the ball with his right hand. Lowry immediately, and seemingly unconsciously, grabbed his left hand, staring at it with an air of bewilderment.

Being that he had undergone a procedure to surgically repair ligaments in that very same thumb only four months ago, one can only imagine the thoughts that immediately started racing through the minds of Lowry and Raptors fans alike. Lowry exited the game and an in-area X-ray revealed a fracture.

The good news, according to The Athletic’s Eric Koreen, is that the fracture is small and Lowry didn’t appear concerned about the injury when speaking with the media postgame. Additional good news, allowing for Raptors and NBA fans to take a collective sigh of relief, is that the fracture that Lowry suffered is unrelated to the surgery he had completed in July.

Let’s begin with everybody’s favorite topic – anatomy!

The thumb is one of five digits that comprise the hand. However, unlike the other fingers, the thumb is only comprised of two long bones — known as phalanges — while the other four are made up of three. Also known as the pollux, the thumb is a beautifully complex anatomical structure despite its seeming simplicity; its movements are controlled by nine muscles, it is held together by a bevy of ligaments, and its associated metacarpal bone — the long bones that make up the palm of the hand — is the most mobile thanks to one of the few saddle joints in the human body. This saddle joint is extremely important as it allows for the opposition of the thumb, which allows for the hand to firmly grasp objects, among other things.

There are two main ligaments that maintain the stability of the thumb: the UCL of the inner thumb — not to be confused with the UCL of the inner elbow — and the RCL of the outer thumb. While we were never given confirmation as to which ligament Lowry had repaired, it is possible it was the UCL, as this ligament is far and away the most frequently injured between the two. The UCL resists valgus forces to the thumb and is most often injured when the hand is fallen on with the fingers splayed, or when the thumb gets caught by an object moving in a relatively opposite direction, such as an opponent’s jersey or a basketball.

We don’t yet know the location of Lowry’s fracture, and we may never as team injury reports are usually vague. However, the bone most frequently fractured in the thumb is the metacarpal bone. This bone is located between the first knuckle of the thumb and the wrist and is described as being a long bone, as its length is much greater than its width. The metacarpal bone is most frequently broke via direct trauma, and treatment and recovery vary depending on the severity of the break. In this sense, it is not dissimilar to the fracture that Golden State Warriors guard Stephen Curry suffered, except Curry broke his second metacarpal, while the metacarpal bone of the thumb is the first.

If surgical intervention is not required, and it seems unlikely based on early reporting, bones usually heal completely in 4-6 weeks, though this doesn’t necessarily mean that Lowry would miss that much time. If the fracture is small and stable, he may be able to play through the injury to an extent as long as his pain and swelling are manageable and the thumb can be adequately supported with bracing. If surgery is required, Lowry would potentially have a return-to-play timeframe similar to that of Curry.

In essence, the mechanisms behind Lowry’s two thumb injuries are dissimilar enough that it would be appropriate to conclude that the two are unrelated. Lowry’s surgically repaired ligaments would be completely healed and healthy by now based on the timeframe of his surgery, meaning they would be able to fully support his thumb. It’s just an unfortunate circumstance that both injuries occurred to the same thumb.

Regardless of how much time Lowry ultimately misses, the Raptors will now have to rely more heavily on guard Fred VanVleet, as well as Swiss Army knife Pascal Siakam to control ball-handling and court management duties. Toronto has a bear of an upcoming schedule as it faces the Los Angeles Lakers, LA Clippers, Portland Trail Blazers and Dallas Mavericks over the next seven days, and things ease up only slightly after that.

Next: Jimmy Butler, Heat Culture and figuring things out in Miami

Perhaps some solace can be found in that the Raptors — small sample size alert! — have been performing well when Lowry is on the bench early in the season. With Lowry on the court, Toronto has a Net Rating of +4.4 and it rises to +12.3 when he is off, according to NBA.com. Perhaps even more encouraging is that the on/off disparity is even larger with VanVleet; the Raptors have a Net Rating of +10.3 when he is on and -8.0 when he is off.

Lowry is scheduled to meet with a specialist on Saturday, Nov. 9, to determine the severity of his fracture as well as an appropriate treatment option.

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