BALTIMORE -- Orioles right fielder Nick Markakis left Saturday's game against the Yankees after getting hit by a CC Sabathia pitch in the fifth inning. Markakis has a broken left thumb and is expected to be out for about six weeks.

"It's broken. A minimum of six weeks, but it's so preliminary right now," said Orioles manager Buck Showalter after the game. "They'll get some more pictures. ... I knew when I looked at it going out there. I'm sure you guys that have been around Nicky know when he comes out of a game that quick, it's not good. It breaks my heart, personally, and for him. I know how much this time of the season means to him. We'll go forward from there."

Markakis already missed about six weeks following surgery for a broken hamate (wrist) bone in his other hand earlier in the summer. He returned and moved to the leadoff spot in the lineup and really gave the offense a jolt.

For now, Showalter's hope is Markakis does not need another operation. He's already had two earlier this season.

"We're hoping that there's not going to have to be another surgery. Nicky had some stuff with his abdomen in the offseason and had a hamate [injury], so the last thing I want him to go through, or any of our guys, is a third surgery. We're hoping for good news for him in the next day or two."

Markakis immediately jumped away from the plate and out of the box when Sabathia nailed him with an inside pitch.

"I knew it was broken," said Markakis. "I knew it as soon as he hit me. I knew how it hit me, and I couldn't bend my thumb."

Trainer Richie Bancells and Showalter came out to check on Markakis right away, but the right fielder left the game.

Nate McLouth took over for Markakis in the leadoff spot. McLouth moved to left field, and Lew Ford shifted to right.

The big question now is who -- or how -- the vacant outfield spot and leadoff duty gets filled. That could mean more playing time for someone like Ford or even a shift for McLouth, who's been hot of late, to the leadoff spot.