Clearly we need a lot more information before making too many predictions about when Eden Hazard is likely to return from ankle surgery.
At this stage, there is still quite a lot of information that we just don’t have. However, for the player himself, the main priority over the next ten days or so will just be to be happy in his own mind that the operation was successful.
That reassurance will need to come from the surgeons involved and the medical teams in Dallas and Madrid who will pick up his rehabilitation.
At this stage it’s very easy to jump to conclusions and start putting timelines on his recovery. Already people are talking about whether Eden is likely to be available for the final run-in to the league season when at the moment he’s still hobbling about on crutches.
Although Real Madrid released a statement last Thursday saying that Eden “has successfully undergone surgery today in Dallas on a fracture of the fibula in the right foot’’, we are currently unaware of the finer details of the operation.
Depending on what exactly the surgeons had to address once Eden went under the knife will determine the extent of the rehabilitation period required.
But having gone to the trouble of seeking out the Dallas surgical team in the first place, Real Madrid are unlikely to try to cut corners in those essential post-operative weeks when the risk of injury recurrence is high.
The Real Madrid man has certainly made the most of his American trip though. He’s been pictured with basketball star Luka Dončić of the Dallas Mavericks and also took in the MLS game between Dallas and the Montreal Impact at the weekend.
He’ll also have seen at first hand how high profile the surgical team who operated on him are in that part of the USA (and beyond)!
Based at the Carrell Clinic in Dallas, Eugene Curry, the orthopaedic surgeon who led the clinical team that performed Eden’s operation is a consultant to the Dallas Cowboys American Football team as well as seeing clients from other sports.
The American version of football as opposed to soccer as we know it is one sport where above average ankle injuries are common. Many of these are injuries that involve other associated structures including the bones and joint surfaces as well as the traditional ligamentous sprains.
Fractures of the fibula and the ‘high ankle sprain’ or syndesmosis injury as it is usually referred to in medical terms are frequent in American Football and these require additional care; particularly at the diagnostic stage and then again as the rehabilitation period progresses.
Fibula fractures are also quite common in our kind of football and frequently occur after a physical challenge where a direct blow is taken to the shaft of the bone; normally in the middle third if it’s an isolated break.
If the fracture occurs in the lower third of the fibula then this can be a complication of ankle injuries and usually arises from a twisting or inversion movement. Often there is no direct contact made with another player, and the lateral ankle ligamentous complex for which the fibula provides the origins, is most at risk.
The lateral ankle ligamentous complex (which includes the distal fibula) is involved in most ankle injuries (Wang et al, 2014); but a large number of associated injuries that can influence a player’s recovery from an ankle sprain can occur at the same time as the original injury.
A fracture of the distal fibula is a classic example of this.
From a rehabilitation aspect, since the fibula bone forms the point of origin for the lateral ankle ligaments to connect with the adjoining structures, repeated and recurrent injuries to this region can obviously affect the mechanics of the ankle joint itself.
If left uncorrected, this can result in complications where ankle injuries are concerned; but so too can a history of injury to this region and that too has a similar effect.
We know that the healing process involves a lengthy period where injured body tissues need time to regenerate and repair properly and this applies to bone tissue as well.
The positive side to this is that with all the technology available in medical imaging today, everyone concerned will be able to monitor Eden’s progress throughout the various stages of tissue repair to ensure that his rehabilitation protocol matches the various stages of healing.
No doubt Real Madrid will release a further update in due course and we’ll have a clearer idea at that point of when Eden Hazard is likely to be back in the team.
Wang Q, Whittle M, Cunningham J, Kenwright J (1996). Fibula and it’s Ligaments in Load Transmission and Ankle Joint Stability. Clinical Orthopaedics & Related Research. Vol. 330; 261 – 270