Dr. Michael Horowitz Featured In Wall Street Journal

“These bones don’t just break,” said the hand surgeon of The Center For Musculoskeletal Disorders.

In a story on Paul Pierce of the Brooklyn Nets, it was revealed that the 36-year-old star had injured his hand. This caused him to miss up to a month on the court with what was determined to be a non-displaced fracture of the third metacarpal in his right hand.

Dr. Michael Horowitz was interviewed and explained that despite the seemingly mysterious nature of the injury, this type of fracture can’t just spontaneously occur.
A hand fracture such as Pierce’s is the result a powerful force, causing it to bend or break. A non-displaced fracture is one that results from a fully or partially broken bone in one spot, but that the bone still remains aligned.

As injuries have ravaged his roster, Nets coach Jason Kidd has been forced to improvise, using seven different starting lineups in the team’s last 10 games—seven of which they lost.

On Monday, Kidd was handed yet another obstacle when the Nets announced that Paul Pierce, the team’s 36-year-old star swingman, will miss up to a month with a non-displaced fracture of the third metacarpal in his right hand. That’s the bone in the lower portion of the middle finger—the forward-most bone when a fist is made.

The significance of the injury is obvious: The Nets are already without three vital players—Deron Williams (ankle), Andrei Kirilenko (back) and Jason Terry (knee)—and, at 5-12, sport the fifth-worst winning percentage in the NBA.

But its origin remains a mystery.

In its press release announcing the injury, the team stated that it occurred in the first half of Friday’s 19-point loss to the Houston Rockets. But Kidd didn’t remember it that way at Monday’s practice.

“I can’t pinpoint when he got hit,” Kidd said. “So if it was against Houston, it was Houston, but I don’t know exactly when.”

That’s peculiar, because Pierce was benched for the second half of that embarrassing defeat—and not because of a hand injury. Rather, the former All-Star was just 1-for-6 from the field and finished the game with a minus-14 rating in 15 minutes of action.

Kidd, seemingly unaware of any injured hand, believed he was benching a healthy Pierce with an eye toward Saturday’s game in Memphis. Of course, Pierce missed that game—a 97-88 win—with what the team, at the time, called “a bruised right hand.”

“The [Houston] game was a little out of hand and I needed to get some guys with some energy in there,” Kidd said. “And we never got back into the game. So going back-to-back, having those guys rested was one idea, one thought.”

Kidd said he became aware of the injury “after the game,” but declined to elaborate. Pierce didn’t speak to the media after the loss to the Rockets and hasn’t been made available since.

Meanwhile, a review of the game film didn’t reveal any injury. The right-handed Pierce missed a pair of free throws in the second quarter and he had a towel over his right hand for stretches of the second half, but there wasn’t any singular play that left Pierce nursing the limb.

It’s possible that Pierce broke the bone at some point in the first half of the Rockets game and it went undetected for a period of time. More likely, the injury occurred sometime after Pierce was benched by Kidd in the second quarter.

By way of contrast, when New Orleans Pelicans power forward Anthony Davis exited Sunday’s win over the Knicks with a similar injury—a non-displaced fracture in his left hand—it was clear when the fracture occurred. Davis had visibly smacked the hand on the rim during an alley-oop attempt, and was seen favoring it before he left the game several minutes later.

“These bones don’t just break,” said Dr. Michael Horowitz, a Brooklyn-based hand specialist who has not examined Pierce. “They don’t break spontaneously and they usually don’t break over time unless you’ve injured it and you re-injure it.”

“Generally,” he continued, “metacarpal injuries are attributed to some sort of acute fracture.”

In his first year with the Nets, Pierce has averaged career lows in points (12.4) and shooting percentage (.368). Meanwhile, potential replacements Alan Anderson and Mirza Teletovic have come alive in recent games.

The seldom-used Teletovic has averaged 14.3 points and 6.3 rebounds while making nine of 18 three-point attempts in his last three games. Anderson struggled with his shooting on Saturday, but he played solid defense and came away with seven rebounds in 28 minutes.

“You see the depth of this team and the personnel and the character of each and every guy,” Kidd said. “Mirza, Double-A, guys stepping up knowing that their time was probably a little bit shorter than if we were whole. But now, to see that they’re in for major minutes, those guys have responded.”