News
Lowrie to miss bit of time, not bit of bone
Injured Red Sox infielder had ulnar styloid removed
By Gary Gillis / Special to MLB.com
04/29/09 11:34 AM ET
As enjoyable as it had been to watch the Red Sox reel off 11 straight wins, including a series sweep of the Yankees, it was impossible to gloat the entire time. So I suppose I shouldn't have been surprised when the conversation took a turn from insults (directed towards the Bronx) to injuries -- Jed Lowrie's in particular."Didn't I tell you last year that I thought excising the ulnar styloid was the best approach?"
"No Gary, I specifically recall you saying that it was likely an issue with the triangular fibro cartilage complex, and you were wrong about that."
"I said nothing about the TFCC! If anything, I thought if there was any soft tissue involved, it was the scapholunate ligament, and you'll note they did repair that."
OK, so that conversation never took place. At least not in my house, among my friends. But all of those medical terms were in the newspaper and broadcast reports. I jumped on the computer and discovered that the ulnar styloid was a small bony protrusion at the end of your ulna. Apparently, Lowrie can get by without one. It got me to thinking about how much information we've come to expect these days and how much more is available.
"I find that my patients are generally very well educated about their injuries when they come to me," says Dr. Arun Ramappa, chief of sports medicine in the department of orthopedic surgery at Beth Israel Deaconess Medical Center. "Once they get an initial diagnosis, they head right to the internet and start surfing."
And is that a good thing?
"I think the more informed a patient is the better prepared they are to make decisions," explains Ramappa. "Sometimes they come in with folders of material -- not all of it relevant to their particular injury -- so it might take some additional time to explain why a particular procedure may or may not make sense for them, but that's what we are here for."
Ramappa has a great appreciation for the remarkable complexity and efficiency of the human body. So I asked him to explain to me why we even have an ulnar styloid if we don't really need it?
"Who says we don't?" says Ramappa. "Think about the way you can articulate your hand and wrist. It's an amazing bit of engineering, and we still have a lot to learn. But we do know that in some people, there can be impingement that causes a great deal of pain. Removing a little bit of this bone can alleviate that pain. This wouldn't be a first course of action, but it has been demonstrated that it is an effective approach."
Just how effective we won't know until Lowrie returns to action in June or July. Considering what he does for a living, he'll know soon enough whether he's going to miss his styloid.
"Swinging a bat and throwing requires a strong, stable wrist," Ramappa says. "Hopefully his rehab goes well and he finds he's able to do both, pain-free."
Maybe it's not all that unusual. There is a bunch of people walking around without appendixes, and they don't seem to miss them.
And how about the guy I met the other day? If he's telling the truth, he's a walking miracle. He's a Yankees fan and he told me they are tearing his heart out.
Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.
