When the Pittsburgh Steelers took the field for the second half of their divisional rematch versus the Cincinnati Bengals, quarterback Aaron Rodgers didn’t join the offense. Instead, it was backup Mason Rudolph under center. Steelers director of communications Burt Lauten tweeted that Rodgers had a left-hand injury and was questionable to return.
Here is the play where the injury likely occurred:
It was initially described as a wrist injury. By the end of the game, NFL Network insiders Ian Rapoport and Tom Pelissero reported that X-rays performed at Acrisure Stadium showed a small fracture. Rodgers stayed in the locker room while his teammates secured a win and didn’t meet with the media after the game. He was noted to have his left hand in the pocket of his sweatshirt, likely hiding a brace on his left wrist (via NBC):
Aaron Rodgers brace injury
Rodgers was expected to undergo additional testing on Monday, which most likely included an MRI. This morning, Tom Pelissero reported that further tests showed that Rodgers won’t need surgery. This was confirmed by head coach Mike Tomlin during his weekly press conference. Tomlin added that Rodgers has a chance to play Sunday against the Chicago Bears.
“It does not require surgery,” he said Tuesday via the team’s YouTube channel Tuesday. “Really, it’s about bracing it and securing it for his comfort and safety. And then, it’s about how functional he is. So we don’t have the answers to that as we stand here today. But certainly, I would imagine we’ll get some clarity as we push through the week.”
The description of “slight fracture in his wrist” is somewhat vague because it doesn’t provide any detail regarding which bone is broken. Let’s start with the anatomy and look at the prognosis, depending on where the fracture is.
ANATOMY OF THE WRIST
https://anatomy.lexmedicus.com.au/collection/wrist-hand
The bones of the forearm, the radius and ulna, run from the elbow to the wrist and allow rotation of the forearm. The eight carpal bones form the bridge between the forearm and the metacarpal bones of the hand. The carpal bones are organized in two rows and are padded by cartilage and stabilized by ligaments. These small bones of the wrist allow for a large variety of wrist motions.
RADIUS FRACTURE
The radius is the most commonly fractured bone in the arm, and a distal radius fracture makes up most wrist fractures. The break is usually one inch from the distal end of the bone near the wrist. The most common mechanism is a fall onto an outstretched arm. Here are the various types:
https://orthoinfo.aaos.org
If the fracture is described as “extra-articular,” the break doesn’t extend into the joint.
ULNAR FRACTURE
A fall on an outstretched hand is also the most common cause of distal ulnar fractures. The ulnar styloid is the most frequently fractured part of the ulna and is associated with 80 percent of intra-articular distal radius fractures.
www.shoulder-pain-explained.com
The various types of ulnar styloid fractures (as summarized on https://www.shoulder-pain-explained.com):
Avulsion Fracture: where a small fragment of bone breaks off from the tip of the styloid process. An avulsion fracture is the most common type of ulnar styloid fracture
Transverse Fracture: a break across the base of the styloid process – rare
Ulnar styloid fractures may be classified as:
Non-Displaced: A non-displaced ulnar styloid fracture is where the bone fragments remain in their normal position
Displaced: a displaced fractured ulnar styloid occurs when the bone fragments are misaligned – have moved out of position
Stable: where the bone fragments remain aligned, ligaments are intact and the wrist joint is not significantly affected
Unstable: where either the bone fragments are not aligned and/or there are associated ligament injuries
SCAPHOID FRACTURE
Of the eight carpal bones, the scaphoid, located at the base of the thumb, is the most commonly fractured. And the most common mechanism? Yes, a fall on an outstretched hand. A scaphoid fracture is defined by the location on the bone. A break across the mid portion is most common (65 percent of cases). A break in the proximal or distal end makes up the other third of scaphoid fractures. The scaphoid does not have a good blood supply. A fracture of the proximal end can interrupt the blood flow to the remainder of the scaphoid bone, resulting in poor healing or even necrosis of the bone. Here is an example of a mid-portion scaphoid fracture:
https://orthoinfo.aaos.org
TREATMENT AND RECOVERY TIME
For non-displaced wrist fractures that do not involve the joint surface, the initial treatment is usually non-operative. The wrist is stabilized in a cast or brace. Healing time depends on the severity of the fracture and can range from six to 12 weeks. Full strength and flexibility can take up to six months to return.
If surgery is required, the bone is typically repaired with screws and/or plates. The wrist still requires immobilization with a cast or brace initially following surgery and the recovery time is not that different from non-operative management.
Scaphoid fractures are more likely to require surgical repair than simple distal radius or ulnar fractures.
Seattle Seahawks star wide receiver Jaxon Smith-Njigba almost missed the start of his rookie season in 2023 after sustaining what was described as a “slight fracture” in his left wrist during the second preseason game. He underwent surgery and was expected to miss three to four weeks. Instead, he was back at practice as a full participant less than three weeks after surgery and made his NFL debut in the regular-season opener.
Las Vegas Raiders quarterback Aiden O’Connell sustained a right-wrist fracture in the final preseason game this year. He underwent surgery and started the season in the injured reserve list. The team opened his 21-day window on Oct. 29, and he has been a full participant at practice, but he was ruled out for the Raiders’ Monday Night Football game yesterday. If he is not added to their active roster by tomorrow, he will remain of IR for the rest of the season.
SPECULATION TIME
As part of the NFL Game Day Kickoff on Monday evening, Ian Rapoport provided an update on Rodgers’ status. He reported that Rodgers is pushing to play on Sunday and is still seeing specialists to determine if he could safely play without worsening his injury. Based on that, it is likely that Rodgers’ wrist fracture is extra-articular and non-displaced. If he needed surgery, Rodgers would already have been advised of that and playing in Chicago wouldn’t be an option.
If it comes down to playing through pain, Rodgers is a strong candidate to start against the Bears. He played the entire 2018 season on an MCL sprain with a tibial plateau fracture. He has played through hand fractures as well. In 2022, he played most of the season with a fractured thumb on his throwing hand, sustained on a failed Hail Mary attempt against the New York Giants in early October:
In his first start of his college career for the Cal Bears, Rodgers broke a bone in the index finger of his throwing hand when he hit the helmet of his right tackle. He was held out of practice by his head coach on Monday and Tuesday each week and played every game. Despite the injury, he finished his first year as a starter with 2,903 passing yards and an adjusted net yards per attempt of 8.8.
The biggest concern with Rodgers playing through a wrist fracture on his non-throwing hand? Rodgers has perhaps the best play-action fake in the league, known as the “guitar fake”. Against the Seahawks, defensive end DeMarcus Lawrence was completely fooled:
The only challenge is that Rodgers uses his left hand to hide the football. If his grip strength is limited by the wrist fracture, play-action may not be an option. Mike Tomlin and Arthur Smith will need to be confident that their game plan won’t be impacted by any limitations that Aaron Rodgers is experiencing from the injury. Otherwise, the Steelers would be better off giving Mason Rudolph the start, with Rodgers as the backup.
Based on his history and the likelihood that this is a fairly minor fracture, my money is on Rodgers starting Sunday when the Steelers face the Bears.
“Melanie H. Friedlander, M.D., F.A.C.S. is a doctor at Association of South Bay Surgeons in Torrance, California. Dr. Friedlander enjoys all aspects of general surgery, but her primary areas of focus are breast surgery and advanced laparoscopic surgery. She recently adopted an advanced, minimally invasive technique that reduces scar size in thyroid surgery. Dr. Friedlander is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the Society of Laparoscopic Surgeons. She developed and published many scientific studies in highly esteemed medical journals.”
Recommended for you