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August 12, 2008

Under The Knife

A Failure to Communicate?

by Will Carroll

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Evan Longoria (21 DXL)
Things went from bad to worse for the Rays when they found out that, despite his "feeling better," Longoria has a broken wrist. Initial interpretations of the x-rays were contradictory, and when the Rays sent him back to their own specialist, his findings put Longoria on the DL. Estimates have him out from two to four weeks, with the Rays saying three is about right.

While we don't yet know which bone was broken, the usual mechanics of being hit on the wrist tend to cause breaks in the hamate or lunate bones. The effect is the same for both: painful articulation in any of the several planes, possible nerve or ligament damage with displacement, and weakness in the distal joints. Since we know that Longoria has a non-displaced fracture, we can ignore that and deal with the first and last symptoms here. Pain and swelling are present, although Longoria's pronouncements seem to indicate that he may already be past the acute stage.

According to Marc Topkin of the St. Petersburg Times this isn't the case at all, and Longoria's fracture is actually at the distal tip of the ulna. What we have here is a failure to communicate; a nomenclature problem. The specific small bones that make up the anatomical wrist are one thing, but we also reference a general area which includes the distal tips of the radius (lateral) and ulna (medial) bones of the forearm. The ulna, much larger than the smaller bones of the wrist, should heal more quickly and fully, and there's little ligament involvement, suggesting that any resulting weakness in the wrist could be reduced, though still present. The differing opinions on the films also indicate that the fracture may already be making union; one doctor indicated that it may have been an old fracture, and according to radiologists I spoke with today it would be difficult to differentiate from a fresh union. This information on the location of the fracture is the most positive news I've heard for the Rays in days.

Even when he's able to come back, wrist injuries tend to linger, sapping some power and bat control. The drop-off in run production from Longoria to Willy Aybar or Ben Zobrist is pretty steep, so getting Longoria back once he's past the danger of a re-break is the smart play, and as one source told me, the Rays realize that while they may not be able to replace Longoria with equivalent offense, "a run saved is like a run earned." Ben Franklin meets Pythagenpat? Perhaps they're looking ahead to when David Price joins the pitching staff, or some improved defense. With rumblings of a waiver-wire deal, the Rays have to hope that when Longoria returns in mid-September he'll look more like the RotY candidate he's been all year than post-injury David Ortiz. (Yes, it's a bit odd to use Big Papi as the downside comparison, but he has a 694 OPS since returning from the DL.)

Chris Carpenter (7 DXL)
I was on the air with Bernie Miklasz on St. Louis radio when word came down that Carpenter was headed back to St. Louis for tests, and if you've ever wanted to hear a host and guest scramble, I'd check to see if they have it archived. Luckily, I knew what this was: Carpenter was checked Monday morning and was a bit sore, so the team decided to send him back for imaging to see how significant the triceps strain was. The group rate on the MRI holds, and it's better to know than not know, especially given Carpenter's importance (and cost) to the Cardinals. It's neither positive or negative, it's just a smart medical precaution to gather more information. Assuming that the result doesn't give a Longoria-like surprise, it's likely that Carpenter will skip his next start, and the tests should tell us whether that's all he'll miss.

C.J. Wilson (60 DXL)
Wilson elected to have surgery to remove chips from his pitching elbow, ending his season and leaving the closer's role during the tail end of the Rangers wild-card chase to Eddie Guardado. Wilson's second-half problems can likely be blamed on the elbow and his mechanical adjustments, so there's no reason to think he can't come back and continue in whatever role is needed. He's not a typical closer, but the Rangers understand that an elite closer comes with elite pricing. They're perfectly willing to go with cheap options like Wilson or Guardado until something better comes along, such as one of their power pitchers like Tommy Hunter or Blake Beavan (assuming his fastball returns) shifting to the pen. Even then, Wilson will be one of the better lefty relievers around, just as he was in 2007.

Rick Ankiel (0 DXL)
The Cardinals are always interesting to watch when they're dealing with a mid-level injury. They tend to manage things creatively, showing a bias towards using players in whatever capacity is available-as they've done using Ankiel as a pinch-hitter for the last two weeks-rather than DL-ing them and pushing up a minor leaguer. With new management in place, it's pretty clear that this is a Tony La Russa preference, and likely goes hand in hand with his preference for veterans. He'd rather play with a guy he knows at a reduced capacity than with one he doesn't know at a theoretical 100 percent. Ankiel is expected back in the lineup on Tuesday, though he'll play left field rather than center, an attempt to reduce his workload. The abdominal strain is not yet healed up, but they feel comfortable putting him back in on a near-normal basis.

Freddy Sanchez (5 DXL)
Sanchez is expected back in the lineup on Tuesday, but it's clear that the shoulder issue he started the year with was not cleared up by surgery. He's remained weak and has needed consistent rest, and even then has been problematic. What little power he had has been sapped, and it's really affected his ability to maintain the fine bat control he exhibited when winning his batting title in 2006. This is beginning to resemble the pattern we've seen with Scott Rolen, although with the move to second base the stress on Sanchez's shoulder has been limited some. At 30, Sanchez's history of injuries isn't likely to improve, and it's likely that he's peaked. Whether the Pirates can keep him useful for a few more seasons will be a nice challenge for their medical staff.

Quick Cuts: David Ortiz is out of the lineup for the Sox. I'm told his wrist is still an issue, but that he's having dificulty "mentally much more than physically." ... Travis Hafner could take batting practice later this week, leaving the door open for a September cameo. ... Ryan Braun remains out, but the Brewers remain calm about his injury. ... Scott Olsen should make his next start, though his ankle could still be an issue. ... Jose Contreras had successful surgery to repair the Achilles rupture and should be back, if he chooses, around next year's All-Star break. ... Is Gary Sheffield trying to talk his way out of Detroit? It worked for Manny Ramirez, and there are several teams that would like to claim him when he hits waivers. ... Andruw Jones could be back on the DL with further knee problems. ... The 7'1" Loek Van Mil is headed for Tommy John surgery after injuring himself at the Olympics. ... I was at a sporting goods superstore yesterday looking at new shoes, and when I walked through the baseball section, I saw a product designed to protect the hand, a kind of gel cover. They also had the "Derek Jeter Fielding Trainer."

Related Content:  Back,  Broken Wrist

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