Don’t Assume Max Unger Will Return to Form for the Saints

Early speculation of Max Unger’s offseason foot injury includes whispers of a Lisfranc fracture in his foot. This seems like the most likely diagnosis, as a Lisfranc fracture or dislocation typically takes 3-5 months of recovery.

Reports say Unger will be out five months from Saints action, so this makes sense. The truth is, however, he could be out even longer or even become partially disabled as foot surgeries like the one he has undergone are both difficult to recover from and prone to complications.

After reading about the Lisfranc joint complex, a few things became clear. A fracture or dislocation is hard to diagnose at first. Early diagnosis is paramount for proper management and the prevention of a poor functional outcome. There is NO existing consensus among doctors regarding the most effective treatment for this injury when the diagnosis is delayed.

Why do I keep mentioning delayed diagnosis? Well, Nola.com's Herbie Teope reported that Unger’s surgery was for the same foot injury that caused him to miss one game against Tampa Bay last year in Week 14. After the Saints managed only 46 rush yards against the Bucs, they trotted Unger back out for the remainder of the season, albeit after being limited in practice.

In classic Saints medical team fashion, an injury that takes as little as 4-6 weeks of recovery without surgery will now cost Unger up to and possibly more than 5 months. It’s true, this type of fracture is difficult to diagnose from X-Rays. A weight-bearing radiograph is necessary, because non-weight-bearing film may not reveal the injury. Hopefully Saints docs know this and elected to use a CT scan, which can be more useful during diagnosis.

Still, I find it hard to believe Saints docs properly diagnosed this injury if Unger played the remainder of the season with it and didn’t receive surgery until 4 months later. Granted, Unger may have played with a Lisfranc sprain last year only to fracture it in the offseason, but I think he has been nursing this for a while. And voluntary offseason training hasn't even begun yet, so there’s little reason Unger should have sustained a break without participating in football activities.

There are three important factors that can help us predict the possible occurrence of complications for Unger’s injury. First is the extent of local trauma (torn ligaments/dislocation/degree of fracture). Second is the degree of displacement in the joint. Third is a delay in injury recognition.

Until more information regarding the type of injury, degree of damage, and date of diagnostic recognition is made public, we will simply have to read between the lines as we hope Unger can return by mid-season. But make no mistake, this is a very serious injury that can disable someone for life. The Saints docs have instilled little faith in me so far. Maybe Unger should call Tom Brady’s trainer Alex Guerrero.