Joe Kanasz, Cleveland Clinic To repair a fractured or broken thumb, hand surgeons screw a thin, titanium or steel plate to the broken bone to stabilize the pieces (A). This allows the bone to heal in proper alignment. The metal plate holds the pieces of fractured bone together (B). The plate and screws are placed under the skin and are not typically removed.

CLEVELAND, Ohio — It has been an injury-prone season for the Cleveland Indians.

Center fielder Grady Sizemore went on the disabled list for nearly two weeks in May with a bruised right knee and a jammed right hip, the cost of sliding hard into second base during a game.

That was followed by right fielder Shin-Soo Choo fracturing his left thumb on June 24, and third baseman Lonnie Chisenhall sustaining a nondisplaced sinus fracture two weeks later.

Then Sizemore bruised his right knee — again — just last week.

On the surface, the injuries may seem minor, certainly nothing to keep the average person from missing muchwork. For athletes, however,such injuries affect their performance and livelihood.

Chisenhall, who was hit by a pitch underneath the right cheekbone, returned to the lineup on July 14 after missing three games.

His was a fairly unusual sports injury, said Dr. Michael Benninger, chairman of the Head and Neck Institute at the Cleveland Clinic. More often, it’s seen in victims of assault and in motor vehicle accidents.

“Nasal fractures by far are much more common [in sports],” said Benninger, who did not treat Chisenhall. In the general population (athletes and nonathletes), around 90 percent of facial injuries are broken noses.

“Because the nose sticks out at the end of the face, it’s going to get hit more than anything else,” he said.

An injury like Chisenhall’s is usually left to heal on its own. Unlike the more common displaced facial fractures, which could mean reconstructive surgery, a nondisplaced fracture to the cheek or forehead doesn’t require much more than icing to reduceswelling, and avoiding contact for a few weeks.

For Chisenhall, that meant wearing a batting helmet with a protective device attached to the earflap to get back to work.

Sizemore, on the other hand, will be out for four to six weeks following surgery last Thursday for a sports hernia he suffered when he aggravated the earlier injuries.

After placing him on the disabled list for a second time after he bruised his right knee, the Indians staff figured it would make sense to use that downtime to repair the hernia.

A sports hernia occurs in the abdominal muscles near the groin, when the inside layers of the abdominal wall weaken.

Choo will be out until late August or early September, following surgery on June 28.

To provide some perspective on Choo’s injury, The Plain Dealer talked to Dr. Peter Evans, an orthopedic surgeon with the Clinic.

Choo broke his thumb when a pitched ball hit his hand.

This injury isn’t unique to pro athletes. Usually it’s the “weekend warrior” or “do-it-yourself” home-maintenance activities that are the culprit for the rest of us.

Choo had surgery on June 28 at the Cleveland Clinic. The fracture was stabilized with a metal plate screwed into the bone. Choo’s injury — an open fracture, which means that bone pierced the skin — fit the No. 1 criteria for whether or not to operate, said Evans, who did not treat Choo.

Eight to 10 weeks of healing and rehabilitation to regain strength and range of motion.

“The thumb [accounts for] 50 percent of hand function,” said Evans. “It is significant.”

The average person would spend about the same time healing, with doctor follow-ups at three and six months. Recovery is usually at 80 percent after six months, Evans said.

“We are, in general, more aggressive with surgery for athletes than our everyday folk,” Evans said. “That may sound kind of crazy, but it’s true.”

Because athletes have short seasons, there is more urgency to treat an injury like Choo’s surgically than for mere mortals, whose jobs usually do not depend on a fully functioning thumb.

Surgery that involves stabilization with screws and plates allows for a more predictable timeline and can help quicken therapy. But if the fracture isn’t severe, waiting it out is often just as effective and sometimes preferred, because it lessens the risk of complications such as an infection from opening the wound, or more scarring, Evans said.

“We actually go through that decision when we have someone who’s a fringe player,” he said. “We’ll often treat them nonoperatively.”

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