How Much Should NFL Teams Worry About James Hurst's Leg Injury, Fibula Fracture?

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistApril 22, 2014

North Carolina offensive tackle James Hurst (68) warms up before an NCAA football game between Pittsburgh and North Carolina, Saturday, Nov. 16, 2013 in Pittsburgh. (AP Photo/Keith Srakocic)
Keith Srakocic

Last year, former University of North Carolina offensive lineman James Hurst suffered a leg injury during the Tar Heels' 39-17 victory over the University of Cincinnati in December's Belk Bowl. According to The News and Observer's Andrew Carter, doctors later diagnosed the left tackle with a non-displaced fibula fracture, bringing his record-breaking, 49-start career at UNC to a close.

Like any injured college star, media attention quickly shifted toward Hurst's draft prospects and NFL future.

Fortunately—relative to other types of football injuries, at least—a non-displaced fibula fracture is actually somewhat benign and usually carries an excellent prognosis. As such, in the end, it may only minimally affect Hurst's draft stock.

Let's take a closer look.

Wikimedia Commons.

The fibula runs down the outside of the lower leg alongside the tibia—or shin bone. It connects the ankle to the very top of the tibia, supporting it and serving as an attachment point for ligaments and muscle tendons.

It does not come into close contact with the femur—or thigh bone. As a result, it does not bear much weight—that's the tibia's job.

Very broadly speaking, fibula fractures can come in one of two varieties: non-displaced and displaced.

In a non-displaced fracture, the bone breaks, but its overall alignment and anatomical position remain normal. The opposite is true for a displaced fracture.

For a better mental picture of a non-displaced injury, imagine bending and straightening a drinking straw. The straw now carries a crease—the "fracture," so to speak—but maintains the same overall shape.

Conversely, breaking a toothpick better represents a displaced injury. Not only does the break deform the toothpick, it does so permanently. Many types of displaced fractures in the body require surgical repair.

Luckily, non-displaced fibula fractures are often stable and thus do not require surgery. Rather, several weeks of immobilization and protection of the lower leg usually allow the body's repair cells to reconnect the break without issue.

Andre Brown returned from a non-displaced fibula fracture last year.
Andre Brown returned from a non-displaced fibula fracture last year.Jeff Gross/Getty Images

Furthermore, downstream complications from a non-displaced fibula fracture are rare and while no two injuries are exactly alike, athletes frequently return to top form. For example, in 2013, running back Andre Brown posted 115 yards on 30 carries during his first game back from a preseason break.

So far, it seems Hurst's fracture is following suit.

Though specific medical details are not available, news of the former Tar Heel undergoing surgery did not surface following his injury. Furthermore,'s Gil Brandt noted that he worked out in late March at UNC's pro day, just three months removed from his injury:

Hurst took the bull by the horns and worked out. He did the 40 in 5.54 and 5.60 seconds. He did the short shuttle in 4.57 seconds, had a 22-inch vertical jump and did 23 strength lifts.

Brandt also wrote that Hurst's leg wasn't "100 percent healthy" at the time.

Presumably, doctors cleared him for full-speed workouts prior to the pro day, as non-displaced fractures usually complete the lion's share of the healing process before the three-month mark. However, his rehab may have been ongoing at the time—and might still be.

In other words, he can only go up.

Assuming no additional injuries, rehab setbacks or surgical procedures took place unbeknownst to the media, the end result of Hurst's fracture may be a slight dip in his draft stock simply due to the timing of the injury.

After all, the fracture does not constitute a medical "red flag" by any means.

In fact, unlike a blown-out knee or a history of concussions, a team that sees NFL potential in Hurst may even decide to look right past it.

Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine.


    Report: Julio & Falcons Relationship in a 'Bad Place'

    NFL logo

    Report: Julio & Falcons Relationship in a 'Bad Place'

    The Falcoholic
    via The Falcoholic

    Welcome to Lane Kiffin's Charlie Weis Jr. Experiment

    College Football logo
    College Football

    Welcome to Lane Kiffin's Charlie Weis Jr. Experiment

    Andrea Adelson

    Thomas Doesn't Have Leverage in This Holdout

    NFL logo

    Thomas Doesn't Have Leverage in This Holdout

    Doug Farrar
    via Bleacher Report

    NFLPA Issues Warning About Trident Creatine

    NFL logo

    NFLPA Issues Warning About Trident Creatine

    Mike Florio
    via ProFootballTalk