Celtics forward Gordon Hayward went up for a ball about five minutes into his first official game in a green uniform and came down awkwardly on his left leg. As he writhed in pain and scooted around on the floor, you could clearly see his left knee pointing up as his toes pointed down toward the court.

The video looks like a fracture/dislocation. It’s unfortunately not a simple subtalar dislocation. Athletes with that injury can return as early as 6-to-8 weeks (Eagles cornerback Ronald Darby, Robert Griffin III). This is likely a fracture/dislocation of the tibiotalar joint. I’m warning you in advance…the following “drawing” is almost as ugly as the injury video. I’m no professional medical illustrator.

In the subtalar dislocation on the left, the ligaments are stretched or torn, but no bones are broken. In the tibiotalar dislocation on the right, you can see that both the fibula and, often, tibia are fractured. Ligaments also commonly tear — the medial deltoid ligament and/or the syndesmosis (the long ligament connecting the tibial and fibula above the ankle, also can be torn in a high ankle sprain).

Treatment plan

The treatment for an injury like Hayward’s, most likely a tibiotalar fracture-dislocation, is surgery. The surgeon will reduce the ankle (I know they did it on the court, but it’s likely not stable), use some plates and screws to fix any fractures, scope the joint to address any cartilage injuries, and possibly repair any ligament damage. This surgery is sometimes delayed to allow swelling to go down so that soft tissue/skin healing complications can be avoided.

Return to play

We don’t know the extent of the damage to the ankle. Best-case scenario at this point is surgery within a few days, weight-bearing 6 to 8 weeks later, and a possible return to practice in 4-to-6 months. That puts us at March-April. Sadly, while I am definitely holding out hope for positive, surprising news, I do not think we will see much, if any, meaningful basketball from Hayward until next season.

I’m sorry, but I can’t write this like it’s just another NBA injury. It’s devastating and heartbreaking. I want to tell him it’s going to be okay, that he’ll play again. He will. But that’s not much comfort for a guy who moved his young family across the country to be a part of something special. Instead of being in the locker room getting to know the guys, he’ll spend his season in the training room working on his injury.

You’ll be back, Gordon.

PS: Don’t watch the video of your injury. I would like to un-watch it.

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