Dak Injury Update Thread
- Thread starter 1bigfan13
- Start date
- Joined
- Apr 7, 2013
- Messages
- 27,186
Dak Prescott’s ankle injury is serious but ‘very treatable’: Surgeon explains
By Saad Yousuf
Dr. T.O. Souryal, former Dallas Mavericks head team physician of 22 years and current medical director at Texas Sports Medicine and Orthopedic Group, watched as Dak Prescott took a designed quarterback draw for nine yards before a seemingly routine tackle by Giants defensive back Logan Ryan. Souryal has spent decades on football sidelines, from the high school level to arena football and has treated numerous NFL players at his practice. The minute he saw the second camera angle on the CBS broadcast, he knew what the diagnosis was going to be.
A compound fracture and dislocation of Prescott’s right angle. But what does that mean?
Compound
“Compound is actually an old word. The more modern description of compound means open,” Souryal said. “Is the fracture open and exposed to the elements, or closed, which means the skin is intact? The word compound, that’s a word we used 25 years ago. Now, we say open or closed.”
Fracture
“Fracture means at least one of the bones of the ankle is broken,” Souryal said.
Dislocation
“Dislocation means that the joint is out of place,” Souryal said.
“You have to address all three components of this injury. You have to address the fact that its open, which means it needs to be washed out urgently to prevent infection (which is what it means when it was said Sunday evening that Prescott had his right ankle splinted with a sterile dressing). The ankle dislocation has to be corrected, which means put back in place, and the fracture has to be stabilized, which usually means pins and screws. This was a very accurate description of what happened.”
Because it was an “open” fracture, the concern of possible infection becomes elevated. That’s why a sterile dressing, essentially a bandage, was immediately applied to cover the wound. After an assessment, it was straight to the operating room, as soon as possible, to perform the surgery. The reason for the swift nature of this process, as opposed to some injuries where athletes take days to weigh options and get multiple opinions, is to minimize the time that bacteria has to penetrate the injury.
A source confirmed to The Athletic Adam Schefter’s report that Prescott’s surgery was performed Sunday night by noted foot and ankle surgeon Dr. Eugene Curry of The Carrell Clinic in Dallas. The Cowboys announced Monday morning that Prescott is expected to be released from the hospital after his surgery was successfully completed. With that being the case and assuming the recovery and rehab goes smoothly, Souryal — with the disclaimer that Prescott is not his patient and he doesn’t know the details of Prescott’s specific injury — says the timeline for Prescott returning to football activities is four to six months. That would put Prescott on pace to be ready for organized team activities in May if the NFL calendar returns to normal in regards to COVID-19.
“I am optimistic for several reasons,” Souryal said. “I’m optimistic because Dak is healthy, he’s young, he’s in good physical condition, he will be getting the best medical care available, he will get the best rehabilitation and physical therapy available and he has access to the most modern equipment available. Factor all of that stuff together, I am optimistic that his recovery will be uneventful.”
It’s important to understand what Prescott’s injury is and how to view it on the spectrum of broken ankles.
Before Prescott’s nightmare injury Sunday evening, the headline of the NFL Sunday regarding gruesome injuries was a feel-good story. Washington Football Team quarterback Alex Smith played in an NFL game for the first time in almost two years since his horrific injury when he suffered a spiral and compound fracture to his tibia and fibula. The road to recovery for Smith was long, and one that included possibilities of him losing his leg, as well as his life, at one point. Because Prescott’s injury looked gruesome, some wondered if there were any parallels.
The answer is no. Aside from both being classified as compound fractures, the Prescott injury and Smith injury are completely unrelated. The biggest difference, of course, is that the fractures took place in different parts of the leg. Smith’s compound fracture was to his tibia and fibula (tib-fib). Prescott’s injury is to his ankle. This is significant to classify because the ankle is a joint while the tib-fib is not. Because of this, there is a dislocation component to Prescott’s injury that didn’t exist with Smith — or former Washington Football Team quarterback Joe Theismann, for that matter. On the plus side — and it’s a significant plus — for Prescott’s situation, the ankle joint has really good blood supply. Even though it was open, it has a much better chance to heal uneventfully. Smith’s recovery was eventful and took longer.
Having an injury to the joint does add an element to the equation, though.
“Because the Smith (and Theismann) injuries did not involve the joint (knee or ankle), all of the requirements of joint movement don’t come into play,” Souryal said. “So, you break a tibia, you put it back together, it heals, we’re done. You break the ankle, you put the joint back together but now you’ve got to make sure the ankle moves and you’ve got to make sure the ankle functions in an athletic manner.
“It’s not like a broken bone is a broken bone. If it was broken in the mid-shaft, I don’t have to ever worry about that thing moving. But if it’s broken at the joint, I’ve got to make sure that joint’s going to function when we’re done.”
Even though there is an added component of the joint in Prescott’s case, the nature of his injury is still more favorable in terms of a smooth comeback than the likes of Smith. Aside from the medical aspects, such as greater blood supply, Souryal said ankle fractures are among the more common orthopedic problems so there’s a lot of experience in treating this injury.
Just as Souryal said “it’s not like a broken bone is a broken bone,” broken ankles are also not all the same. Simply saying Prescott broke his ankle may pass in casual conversation, but literally saying he has a “compound fracture and dislocation” is the only accurate way to describe his injury.
“There’s a spectrum of ankle injuries,” Souryal said. “On one extreme, it’s a broken ankle but it’s a hairline fracture. ‘Here you go, wear the boot, you’ll be back to playing in four to six weeks weeks.’ In the other extreme, in terms of severity, is a compound ankle fracture and dislocation. This happens to be on the more serious side of the equation. You can’t just say ‘a broken ankle.’
“My 16-year-old can step on a crack in the sidewalk and have a hairline fracture of his ankle and that recovers completely different than an injury like (Prescott’s). It’s difficult to compare apples and oranges by just saying it’s a broken ankle.”
The big question boils down to what this means for Prescott’s future. Obviously, his season is over. The focus shifts beyond that. What does this mean for next season and beyond? Prescott isn’t a “running quarterback,” but he certainly is mobile. Will he be able to return to the record-setting form he was on prior to the injury?
“There’s no way around labeling this as a serious injury,” Souryal said. “How it’s going to impact his ability to play football down the road, time will tell, and there are various factors (involved). Initially, you have to make sure that the ankle is medically treated appropriately — meaning no complications, no infections, bones are put back together, ligaments are put back together. Then there is time for healing, and then there is a lengthy rehab component where you restore the mobility of the ankle, the strength around the ankle and then we see how he’s going to respond on the football field. There are multiple steps with an injury like this between today and him playing next season.
“My experience is that this is a very treatable injury with an excellent chance for recovery.”
By Saad Yousuf
Dr. T.O. Souryal, former Dallas Mavericks head team physician of 22 years and current medical director at Texas Sports Medicine and Orthopedic Group, watched as Dak Prescott took a designed quarterback draw for nine yards before a seemingly routine tackle by Giants defensive back Logan Ryan. Souryal has spent decades on football sidelines, from the high school level to arena football and has treated numerous NFL players at his practice. The minute he saw the second camera angle on the CBS broadcast, he knew what the diagnosis was going to be.
A compound fracture and dislocation of Prescott’s right angle. But what does that mean?
Compound
“Compound is actually an old word. The more modern description of compound means open,” Souryal said. “Is the fracture open and exposed to the elements, or closed, which means the skin is intact? The word compound, that’s a word we used 25 years ago. Now, we say open or closed.”
Fracture
“Fracture means at least one of the bones of the ankle is broken,” Souryal said.
Dislocation
“Dislocation means that the joint is out of place,” Souryal said.
“You have to address all three components of this injury. You have to address the fact that its open, which means it needs to be washed out urgently to prevent infection (which is what it means when it was said Sunday evening that Prescott had his right ankle splinted with a sterile dressing). The ankle dislocation has to be corrected, which means put back in place, and the fracture has to be stabilized, which usually means pins and screws. This was a very accurate description of what happened.”
Because it was an “open” fracture, the concern of possible infection becomes elevated. That’s why a sterile dressing, essentially a bandage, was immediately applied to cover the wound. After an assessment, it was straight to the operating room, as soon as possible, to perform the surgery. The reason for the swift nature of this process, as opposed to some injuries where athletes take days to weigh options and get multiple opinions, is to minimize the time that bacteria has to penetrate the injury.
A source confirmed to The Athletic Adam Schefter’s report that Prescott’s surgery was performed Sunday night by noted foot and ankle surgeon Dr. Eugene Curry of The Carrell Clinic in Dallas. The Cowboys announced Monday morning that Prescott is expected to be released from the hospital after his surgery was successfully completed. With that being the case and assuming the recovery and rehab goes smoothly, Souryal — with the disclaimer that Prescott is not his patient and he doesn’t know the details of Prescott’s specific injury — says the timeline for Prescott returning to football activities is four to six months. That would put Prescott on pace to be ready for organized team activities in May if the NFL calendar returns to normal in regards to COVID-19.
“I am optimistic for several reasons,” Souryal said. “I’m optimistic because Dak is healthy, he’s young, he’s in good physical condition, he will be getting the best medical care available, he will get the best rehabilitation and physical therapy available and he has access to the most modern equipment available. Factor all of that stuff together, I am optimistic that his recovery will be uneventful.”
It’s important to understand what Prescott’s injury is and how to view it on the spectrum of broken ankles.
Before Prescott’s nightmare injury Sunday evening, the headline of the NFL Sunday regarding gruesome injuries was a feel-good story. Washington Football Team quarterback Alex Smith played in an NFL game for the first time in almost two years since his horrific injury when he suffered a spiral and compound fracture to his tibia and fibula. The road to recovery for Smith was long, and one that included possibilities of him losing his leg, as well as his life, at one point. Because Prescott’s injury looked gruesome, some wondered if there were any parallels.
The answer is no. Aside from both being classified as compound fractures, the Prescott injury and Smith injury are completely unrelated. The biggest difference, of course, is that the fractures took place in different parts of the leg. Smith’s compound fracture was to his tibia and fibula (tib-fib). Prescott’s injury is to his ankle. This is significant to classify because the ankle is a joint while the tib-fib is not. Because of this, there is a dislocation component to Prescott’s injury that didn’t exist with Smith — or former Washington Football Team quarterback Joe Theismann, for that matter. On the plus side — and it’s a significant plus — for Prescott’s situation, the ankle joint has really good blood supply. Even though it was open, it has a much better chance to heal uneventfully. Smith’s recovery was eventful and took longer.
Having an injury to the joint does add an element to the equation, though.
“Because the Smith (and Theismann) injuries did not involve the joint (knee or ankle), all of the requirements of joint movement don’t come into play,” Souryal said. “So, you break a tibia, you put it back together, it heals, we’re done. You break the ankle, you put the joint back together but now you’ve got to make sure the ankle moves and you’ve got to make sure the ankle functions in an athletic manner.
“It’s not like a broken bone is a broken bone. If it was broken in the mid-shaft, I don’t have to ever worry about that thing moving. But if it’s broken at the joint, I’ve got to make sure that joint’s going to function when we’re done.”
Even though there is an added component of the joint in Prescott’s case, the nature of his injury is still more favorable in terms of a smooth comeback than the likes of Smith. Aside from the medical aspects, such as greater blood supply, Souryal said ankle fractures are among the more common orthopedic problems so there’s a lot of experience in treating this injury.
Just as Souryal said “it’s not like a broken bone is a broken bone,” broken ankles are also not all the same. Simply saying Prescott broke his ankle may pass in casual conversation, but literally saying he has a “compound fracture and dislocation” is the only accurate way to describe his injury.
“There’s a spectrum of ankle injuries,” Souryal said. “On one extreme, it’s a broken ankle but it’s a hairline fracture. ‘Here you go, wear the boot, you’ll be back to playing in four to six weeks weeks.’ In the other extreme, in terms of severity, is a compound ankle fracture and dislocation. This happens to be on the more serious side of the equation. You can’t just say ‘a broken ankle.’
“My 16-year-old can step on a crack in the sidewalk and have a hairline fracture of his ankle and that recovers completely different than an injury like (Prescott’s). It’s difficult to compare apples and oranges by just saying it’s a broken ankle.”
The big question boils down to what this means for Prescott’s future. Obviously, his season is over. The focus shifts beyond that. What does this mean for next season and beyond? Prescott isn’t a “running quarterback,” but he certainly is mobile. Will he be able to return to the record-setting form he was on prior to the injury?
“There’s no way around labeling this as a serious injury,” Souryal said. “How it’s going to impact his ability to play football down the road, time will tell, and there are various factors (involved). Initially, you have to make sure that the ankle is medically treated appropriately — meaning no complications, no infections, bones are put back together, ligaments are put back together. Then there is time for healing, and then there is a lengthy rehab component where you restore the mobility of the ankle, the strength around the ankle and then we see how he’s going to respond on the football field. There are multiple steps with an injury like this between today and him playing next season.
“My experience is that this is a very treatable injury with an excellent chance for recovery.”
Angrymesscan
DCC 4Life
- Joined
- Apr 7, 2013
- Messages
- 3,796
Simpleton
DCC 4Life
- Joined
- Apr 8, 2013
- Messages
- 17,541
Smith's was different because he basically broke his entire leg up to his knee and I believe had some ligament damage to the knee, this is just an ankle. And even then Smith probably would've been back on the field last season if the Redskins doctors hadn't botched his various surgeries and damn near let him die.
If Prescott's situation is generally cut and dry without the infections/complications Smith had I don't see any reason why he wouldn't be ready to go early on next year, even if not Week 1.
p1_
DCC 4Life
- Joined
- Apr 10, 2013
- Messages
- 26,636
I heard them say that when he was stomping his ankle back into socket is a dangerous move, possibly introducing dirt into the wound and possibly bone marrow.
- Joined
- Apr 7, 2013
- Messages
- 27,186
If there's any positive in this I guess you could say the timing of the injury gives the Cowboys time to adjust and get everyone used to playing with Dalton. An argument can be made that if you have to lose your QB it's better to lose them earlier than late in the season.
Plus Dak's recovery timeline suggests he should be ready by training camp next season. Whereas if this injury occurred in December I think his availability for Week 1 in 2021 would be in doubt.
Plus Dak's recovery timeline suggests he should be ready by training camp next season. Whereas if this injury occurred in December I think his availability for Week 1 in 2021 would be in doubt.
Simpleton
DCC 4Life
- Joined
- Apr 8, 2013
- Messages
- 17,541
I agree about Dak but as far as Dalton and this season goes, does it really matter?
If we had an average defense and at least one of our OT's I could probably talk myself into this team making a run to perhaps the NFCC with Dalton, but with a bottom 5-10 defense (bottom 2-3 until LVE is back) and two backup OT's, where are we going?
Of course it'd be nice to win the division and make the playoffs just for the sake of it, but there's exactly a 0.0% chance we win more than one playoff game.
- Joined
- Apr 7, 2013
- Messages
- 27,186
DFDC.
But I completely agree. With some luck they finish 7-9 and that's probably enough to win the NFCE. But I think it's safe to say they'll be 1 and done if they make the playoffs.
- Joined
- Apr 7, 2013
- Messages
- 19,638
He is poking fun at the outlier discussion.
- Joined
- Apr 7, 2013
- Messages
- 53,075
Yeah Alex Smith got the infection which was the major problem. I'm not a medical expert like some on here but there is a higher risk of infection with this type of injury because obviously when it breaks the skin it opens your body up for some nasty stuff. As long as he doesn't have a serious complication like that he should be back next year and ready to go. Hopefully by then we will have Collins, maybe Tyron Smith, a seasoned stud center (Badass) and Martin. At this point I'm just trying to build for next season. I think this season is done even if we manage to be competitive in the division to the end.
Simpleton
DCC 4Life
- Joined
- Apr 8, 2013
- Messages
- 17,541
If it were me I'd push for a 2-3 year deal, if they give him a 4-5 year deal averaging 35 (which would be a discount, relatively speaking), I'd be fine with it as a gamble that he'll come back and we'll have him under market.
If they give him 4-5 years averaging 40/year and there isn't an escape hatch after the first year or two that'd be...not great.
If they give him 4-5 years averaging 40/year and there isn't an escape hatch after the first year or two that'd be...not great.
L.T. Fan
I'm Easy If You Are
- Joined
- Apr 7, 2013
- Messages
- 21,700
Oh okay. thanks. I have already forgotten that. However Anomaly is a word I may have used in this instance but outlier would never have risen to the surface. I really never have used or heard of it until recently. It just doesn’t connect as describing something abnormal or exceptional. Sounds more like a fancy outdoor toilet.
p1_
DCC 4Life
- Joined
- Apr 10, 2013
- Messages
- 26,636
I think its more of a statistics term