March 25, 2012 7:00 PM EST: UNC point guard Kendall Marshall did not play in the team’s regional final loss to Kansas due to pain in his injured wrist.
University of North Carolina fans have anxiously followed updates of the wrist injury of their star point guard. Kendall Marshall was injured Sunday in the Tarheels’ NCAA second round win over Creighton. Marshall hit the floor hard after being fouled, but he continued to play for many minutes. Studies after the game revealed a scaphoid fracture, and Marshall underwent surgery Monday to treat it with a screw placed across the fracture. After the procedure, Marshall tweeted, “Successful morning, Im screwed.”
Marshall was placed in a cast before being switched to a removable splint Wednesday. He sat out of UNC’s Sweet 16 game against Ohio Friday night, in which the Tarheels were forced into overtime to outlast Ohio. Rob Dauster reported today that Marshall was catching, bouncing, and shooting the ball in practice but would be reassessed during the pregame shootaround to determine his availability for the regional final matchup against Kansas.
As a sports medicine physician, Marshall’s injury is interesting to follow for a number of reasons. First, it’s important to emphasize the potential danger of scaphoid fractures. This bone is located in the base of the wrist on the side close to the thumb. These fractures have a high rate of nonunion and avascular necrosis (loss of blood supply to the bone). Therefore, fractures in certain parts of the bone or those that are even slightly displaced often require surgery to hold the bone in proper position. Surgery usually involves placement of a screw across the bone through a small incision, just as Marshall supposedly had.
Many fans and basketball observers have remarked at how seemingly innocent Marshall’s fall was. His injury points out an important principle with wrist injuries in sports – namely the importance of obtaining x-rays, and even CT scans or MRIs, if needed, if there is any possibility of a scaphoid fracture. I, like many sports medicine doctors, have seen athletes who suffered wrist injuries during a season but assumed it was only a “sprain.” They would see a doctor months later when the wrists were still painful, and x-rays show scaphoid nonunions. When these bones don’t heal or the bones die from loss of blood supply, degenerative conditions of the wrist can develop. To prevent that outcome, a much bigger surgery, involving fixation and often bone grafting, is needed. The bottom line is that athletes who hurt their wrists need to have the injuries examined.
Lastly the question everyone is asking now centers on Marshall’s playing status. After surgery, athletes in some sports can play fairly quickly in a padded cast. Obviously a cast would prevent Marshall’s ability to perform his duties as a point guard. Yes, it appears that since it is his non-dominant hand, he could shoot. But dribbling, passing, and defending could all still be difficult. Even a temporary injection of a local anesthetic, which surprisingly hasn’t been suggested in the media, might not help him with these functions. We should find out Sunday afternoon whether Marshall’s wrist pain has subsided enough for him to play and help the Tarheels reach the Final Four.