ProFootballDoc: Russell Wilson Initial Optimism Dampened After Surgery

Seattle quarterback Russell Wilson has started every game to date in his 10-year career. That streak is in danger. In the Thursday night divisional loss to the Rams, he suffered a gruesome looking finger injury when his hand collided with defensive end Aaron Donald's wrist.

Wilson returned for one series and even threw the ball before Geno Smith replaced him for the remainder of the game. Most worried about a fracture or dislocation, but our video analysis in real time indicated a mallet finger (extensor tendon rupture) to the middle finger. 

After the game, head coach Pete Carroll indicated a "bad sprain" and we projected the need for surgery.

The mallet finger and surgery have now been confirmed. Normally, the singular pin in place allows tendon healing while preventing the "droop." It could be possible to play football in short order. I have personally treated dozens of NFL players who have not missed time with mallet fingers (including without surgery). However, the issue here is Wilson's ability to grip the football and throw it accurately. With the joint stabilized, it typically would give Wilson a chance at early return but that may not be the case here.

Ordinarily, immediate news after surgery is framed positively (like a GM speaking about his new draft picks), but in this case the surgery news brings pessimism.

Usually only one pin/screw is needed, but the surgery reportedly was "more complicated than expected" and Wilson's finger required multiple screws. This casts doubt on the quick return I originally anticipated.

If the fixation is stable, Wilson still has a chance to alter his grip and return to start in short order. If the multiple screws indicate complications, Wilson will start a new streak, this time missing multiple games.

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Written by
David Chao, MD -- known digitally as Pro Football Doc -- is an expert contributor for Outkick. Chao spent 17 seasons as the team doctor for the San Diego Chargers (1997-2013) and is part of the medical team at OASIS in San Diego where he treats and specializes in orthopedic sports injuries, working with high-profile professional athletes from the NFL, NBA, and MLB.