Surgeons say McCaw has plenty of time to recover

Richie McCaw. Photo / Getty Images

Rugby fanatics can stop holding their breath - according to surgeons, Richie McCaw's upcoming operation will be straightforward and the All Black captain should have recovered in time for the Rugby World Cup.

Last week, McCaw experienced pain while doing a fitness test at a training session and a scan revealed a stress fracture. He will need surgery for a screw to be inserted into the fifth metatarsal bone in his right foot.

The 30-year-old will miss up to six weeks of the Super 15 season with the Crusaders, but surgeons the Herald spoke to yesterday said the injury should not linger beyond that.

"It's not the end of the World Cup," said Richard Street, orthopaedic surgeon and president of the Foot and Ankle Society.

The surgery itself was a straightforward procedure of around 15 minutes and after a short healing period the long-term prognosis was good, he said.

"You've got a question about why it might have fractured. Sometimes there's some funny mechanical things in the foot. But generally people - particularly sportsmen - can do quite well in the longer term."

That viewpoint was supported by Tony Danesh-Clough, an orthopaedic surgeon with the Waitemata District Health Board who has performed many operations like the one McCaw needs.

He said a stress fracture was a bit like a coathanger being bent until "they start getting that little change in them before they snap".

"Sometimes people get aches and pains so you get them before they snap. Or there's the ones where the thing has been going on for months and months, and they take longer to heal. It sounds as if [McCaw's] is fairly acute, so it should heal up pretty well."

Mr Danesh-Clough said the first step was to make a small incision or "stab hole" in McCaw's foot and then insert a screw "basically down the middle of the bone".

"[The screws] can be anywhere from 4mm to 6.5mm wide, depending on how big his bone is. And length can vary, anywhere from 40mm up to 60mm."

The screw would reinforce the bone and reduce the stress on it by absorbing some of the force created by movement.

Once the bone was healed the screw could be removed as it might cause irritation, Mr Danesh-Clough said.

The wound would require only one or two stitches, and McCaw would probably wear a protective boot and not put weight on the foot for one or two weeks.

It was likely a "bone stimulator" would be left in McCaw's foot, an ultrasound device that stimulates bone healing and speeds recovery.

Mr Danesh-Clough said the 211 days until the World Cup were more than enough time to make a full recovery.

"I think he'll be absolutely fine."