Aidan Hutchinson leg injury: Medical analysis and outlook

On October 13, 2024, the Lions lost their most important defensive player in Aidan Hutchinson. Video is consistent with a left tibia and fibula fracture (tib/fib).

The mechanism of this injury can be due to a leg whip action which is what happened here. In this case, Hutchinson’s left leg whipped around and impacted Alim McNeill’s tibia.

Remarkably, this is not the first time a collision of McNeill and Hutchinson at the QB has caused a significant injury. Last year in week 13 vs the Saints, Hutchinson’s left leg also whipped around and hit McNeill in the knee spraining McNeill’s MCL.

McNeill was subsequently placed on IR and missed four games while Hutchinson avoided injury during that incident.

If you compare the two videos, they are eerily almost identical. Warning: graphic.

Should Hutchinson do anything differently in the future?

Given that this dangerous leg whip mechanism has occurred at least twice, it would be a good idea for Hutchinson and the Lions to do a thorough film review to see how often it is happening compared to other elite edge rushers.

Regardless of the findings, it is worth looking into adjusting his technique at the point of contact with the QB to stop that leg from whipping around.

Other cases of tib/fib fractures

MMA fans have seen similar leg whip (kicking) mechanisms cause tib/fib fractures to Anderson Silva, Conor McGregor, and Chris Weidman.

In basketball, this injury has been seen with Paul George and Kevin Ware.

A recent example that University of Michigan fans are aware of is OL Zak Zinter who suffered a tib/fib in November 2023 while at Michigan. He was still drafted in the 3rd round and was available for the start of this season. His mechanism of injury was that of a player falling onto his leg causing a leverage point on his hard knee brace.

Michigan fans may also vividly remember RB Fitzgerald Toussaint who had a tib/fib fracture in November 2012. He was able to return for the start of the next season.

Other NFL examples include WR Tyler Lockett who in December 2016 had a compound tib/fib fracture which means the skin was lacerated by the bone. He was able to return for the start of next season.

In September 2021, OL Nick Gates had a tib/fib fracture that required multiple surgeries due to setbacks. He returned in October of 2022.

In November 2018, QB Alex Smith suffered an infected tib/fib fracture that led to a well-documented, arduous recovery. He did not return to play until October 2020.

Early reports for Hutchinson

• Multiple reports state that it is not a compound (open) fracture.
• Hutchinson has already had surgery. Emergent surgery was expected so no surprise there.
• There is a report from Nolan Bianchi and Richard Silva of the Detroit News in which a source says there is a chance he could return for the Super Bowl on February 9, 2025.

What do these early reports mean?

• The fact that this was not a compound fracture is excellent early news. A compound (open) fracture is where the broken bone lacerates the skin. The skin wound carries a risk of infection which can dramatically complicate things as evidenced by Alex Smith.
• With talk of a chance of return for the Super Bowl, that implies that there were no immediate complications such as nerve damage or vascular (blood vessel) damage.
• There is a small chance of compartment syndrome developing in the next couple days. The doctors will be keeping a close eye on this because it is a medical emergency. Compartment syndrome is when severe swelling of the calf cuts off blood flow thus damaging the leg.

OUTLOOK

The typical timeline for an uncomplicated tib/fib fracture is 6-9 months which means there is a very good chance Hutchinson will be ready in plenty of time for training camp.

The Super Bowl, which is less than 4 months away, apparently is not ruled out yet. Having a same-season target is fantastic for a player’s mental health regardless of if he makes it back or not.

While the injury looks gruesome, these bones tend to heal very well. Importantly, the injury does not appear to involve the ankle or knee joint thus the important cartilage and ligaments of those joints are preserved. If there is no joint involvement, the long-term ramifications of the injury are minimized.

There may be a mental hurdle to overcome since this is at least the second time he has had a violent, leg-whip collision at the QB. Hutchinson may spend some time refining his technique to build confidence and avoid a recurrence in the future.

If Hutchinson can overcome the mental obstacles and possibly tweak his technique, expect him to return to his elite form sometime in 2025 with no long-term concerns.