Under The Knife 4/12/23

I’m working on something longer for Friday so today, let’s get right to the injuries:

ONEIL CRUZ, SS PIT (fractured ankle/high ankle sprain)

Oneil Cruz had surgery to fix the damage done on that awkward and painful slide. We don’t have specifics, but the Pirates did give a four month return time for Cruz, which is on the long side. While I don’t know it - sources conflict - the likeliest surgery was an ORIF and a tightrope, fixing both the fractured fibula and the sprained high ankle (syndesmosis.)

An ORIF - open reduction, internal fixation - is common for a displaced fracture. Basically, that means the broken bone wasn’t in line. It snapped and moved. If you watch the old westerns where the doctor “sets the bone”, that’s it, but surgically performed and a lot more delicate. The fixation part of it is hardware, either pins, screws, plates, or a combination, as appropriate to hold the bone in place so that it heals properly over the next six to eight weeks.

The “tightrope” is a device and technique developed to help with the repair of the syndesmotic ligament. It’s easier to see than explain, so click that link - there’s no surgical pictures, just a drawing. It can be removed once things are healed, but it normally takes about eight to ten weeks to heal.

So yeah, the math doesn’t really work here. How did two injuries that should heal concurrently in about ten weeks get quoted out as four months, even with a rehab assignment? I think there was something more in that surgery, perhaps some nerve involvement. The fact that the surgery happened so quickly isn’t a pure indicator of this, since it could be done for the reduction, but there is some unknown factor that’s drawing this out. I expect we’ll learn what that is in the coming days.

As for Cruz’s future, I’m concerned about the stability of the ankle for multiple reasons. As you can see above, he has a cannon arm and he’ll need stability on his plant leg to keep making those. You can also see that while any shortstop is going to need lateral quickness and stability, Cruz’s unique physiology makes it more so, given his center of gravity and long levers. The same is true at the plate and on the base paths. Modern medical technology makes it likely that Cruz can come back and come back well, but there’s simply no comp for this anywhere.

ZACH EFLIN, SP TBR (strained back)