Cowboys wide receiver Dez Bryant suffered a fifth Browns Spencer Lanning Youth Jersey metatarsal fracture in his right foot and the team has initially projected his absence to be between four and six weeks, according to ESPN.com’s Todd Archer. Bryant is scheduled to undergo surgery on Tuesday. Coach Jason Garrett confirmed the initial projected timeline of four to six weeks when speaking with reporters Monday but acknowledged that “all these things are premature” and that changes can happen as the process evolves. Fifth metatarsal fractures represent a break in the long bone on the outer aspect of the forefoot that connects to the fifth (pinkie) toe. This outer forefoot bone is subjected to a significant torsional stress in an athlete during pivoting, pushing off, sharp deceleration and twisting. It is also subject to impact stress with repeated running and jumping. All of the above demands fall under the domain of a wide receiver, making this injury relatively common to the position at both the professional and the collegiate level. The challenge in trying to heal from a fracture in this area is that the bone does not have a particularly good blood supply, which results in a frequent failure to heal independently, even with immobilization. For this reason, surgical fixation of these fractures (with implantation of a screw) has become the standard of care, especially in elite athletes, who will return to high-stress activities and whose specific movements in their sport put them at an otherwise increased risk of failure. Even with the presence of hardware it is Browns Tashaun Gipson Kids Jersey important for the athlete to allow adequate healing of the bone to prevent a nonunion (failure of the bone to heal completely), which could require a secondary procedure with bone grafting. Fortunately, only about 5 to 10 percent of those who undergo surgical stabilization will go on to experience continued problems with the foot. Still, given that the risk elevates with an athlete who does too much too soon, controlled early activity consistent with bone healing is critical. The early projection for Bryant may be optimistic. While every athlete heals at a different rate and no one can say from the outset how his specific recovery will progress, even when bone healing permits a return to football activity, Bryant may have a ways to go to get to competitive form. Six weeks from the date of Bryant’s scheduled surgery will be the Tuesday following the team’s bye week. It’s hard to imagine him returning prior to the bye given all the reasons outlined above. Foot and ankle specialists with whom I have consulted offer a standard projection of six to eight weeks following this type of surgery, with the caveat that it can fluctuate either way depending on the individual. (It should be noted that none of them was speaking specifically about Bryant’s case.) It’s also worth noting that a recent study of NFL players returning following a similar procedure documented the average return to competition at 8.7 weeks with the soonest at 5.9 weeks. It is worth pointing out that sometimes returning to play is impacted by other factors, including the seasonal calendar. Garrett appears ready to remain flexible when it comes to Bryant’s status. “These are not hard and http://www.nflbrownsofficialshop.com/Authentic-Taylor-Gabriel-Jersey fast timetables,” Garrett said. “These are estimates. You evaluate the player day by day and make adjustments accordingly.”