Thunder forward Kevin Durant will not be available to start the 2014-15 season after it was discovered the reigning MVP has a Jones fracture in his right foot. The Thunder stated they are currently considering all their options and will provide a timeline when a course of treatment has been decided.

Durant’s fracture is to the fifth metatarsal. The metatarsals are the long bones of the foot that bridge the bones of the midfoot to the bones of the toe. The fifth metatarsal is located on the outside of the foot and serves as an attachment site for several muscles. These muscles make the bone susceptible to fractures when the ankle is forced inward like when making a hard cut or landing on the foot of an opponent.

In metatarsal fractures, it is all about determining the location of the fracture. Unfortunately, the type of fracture sustained by Durant is one of most serious metatarsal fractures. Named for orthopedic surgeon Sir Robert Jones, a Jones fracture occurs when the fracture is located near the base of the 5th metatarsal. The blood flow to this area is very poor causing the fracture to take a significant amount of time to heal. Furthermore Jones fractures have a high propensity for delayed union or nonunions. In these scenarios, the two bone pieces fail to unite or take a long period of time to connect. As a result of these factors, surgery is often necessary.

Another factor to consider is the mechanism of injury. Jones fractures can occur as an acute injury following a specific incident or they can develop slowly over time and be classified as a stress fracture. If it is indeed a stress fracture, additional steps may be necessary to determine if there is biomechanical reasoning for its occurrence. Nets center Brook Lopez has battled fifth metatarsal fractures for the past few seasons and finally underwent a procedure known as an osetotomy. In this surgery, Lopez’s first metatarsal was literally cut and reshaped to help divert stress away from the fifth.

It gets worse. The inherent risk for re-injury is particularly high and surgery can’t guarantee anything. Hardware failure is a common occurrence and additional surgery could be needed. Multiple players including Lopez, Clippers forward Glen Davis and former Net Damion James are just a few examples of players who need hardware replacements after their initial surgery for 5th metatarsal fractures.

While additional information will surface in the coming days, including a final decision on surgery, history suggests Durant is fighting an uphill battle in recovery. Fortunately the Oklahoma City medical team is one of the best in the league and will be able to provide Durant with an elite level of care. Only time will tell if this is a minor setback for Durant but it clearly isn’t the way the Thunder wanted to start the new season.