Philadelphia 76ers

What to expect from Joel Embiid’s finger dislocation recovery

Philadelphia 76ers star Joel Embiid will be undergoing surgery to address his finger dislocation. He will be out indefinitely.

You most likely saw the pictures floating around on Twitter or some other corner of the internet. In a win over the Oklahoma City Thunder on Monday evening, Philadelphia 76ers All-NBA center Joel Embiid gruesomely dislocated the ring finger of his left hand. While he would ultimately finish the game and finish with a near triple-double — 18 points, nine rebounds and eight assists — there was a concern that Embiid may miss extended time due to the injury.

Those fears came to fruition on Thursday afternoon when the 76ers announced that Embiid had torn the radial collateral ligament of his fourth metacarpal and would undergo surgery; Embiid will reportedly be re-evaluated in 1-2 weeks to determine the extent of his progress.

The radial collateral ligament — also known as the lateral collateral ligament — is located on the thumb — or radial/lateral — side of the knuckle of the fourth finger; in actuality, all of the fingers have a radial collateral ligament. The purpose of the radial collateral ligament is to provide stability for the inherently relatively unstable metacarpophalangeal (“knuckle”) joint. If the strength of the ligament cannot compensate for the force imposed upon the knuckle joint, the finger, as in the case with Embiid, will dislocate.

Ligament injuries commonly occur with finger dislocations and can be treated in two ways: conservatively and surgically. Conservative treatment involves reducing the dislocation (putting the finger back in place) and bracing it with a splint; splinting the finger allows the frayed ligament ends to re-approximate and heal.

If the tear is large enough, however, surgery may be required to re-approximate the torn ends of the ligament. The long-term prognosis for finger dislocations, both treated conservatively as well as surgically, with concomitant ligament damage is good, with most players eventually returning to play without complication.

However, how much time an athlete will miss is up in the air. Due to surgical intervention being required for injuries with greater severity, the recovery timeline is prolonged. There is a dearth of research available regarding NBA athletes and return to play from surgically addressed finger dislocations, with only one study to my knowledge published thus far.

This study, published in the Orthopedic Journal of Sports Medicine, looked at the average return to play timeline for NBA athletes with various hand and wrist injuries. While fourth metacarpal finger dislocations with ligament damage were not specifically mentioned, an analog — thumb ligament tears — were. The authors found that all nine thumb ligament tears required surgical intervention to heal, with the average time missed being 67.5+/-17.7 days.

It is probably unlikely that Embiid will ultimately miss that much time due to the nature of the demands placed on the thumb vs. the fourth finger during typical basketball action; the fourth digit can easily be taped or braced with minimal impact on the function of the hand during shooting, passing and defense. Pain, as well as ligament healing, will be the main limiters of return to play.

At the end of the day, Embiid’s injury is unlikely to have long-term consequences for himself or the 76ers, but with Philadelphia fighting for supremacy in the Eastern Conference, the short-term consequences could be impactful.

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