NFL Draft Injury Impact: Illinois DT Johnny Newton

04/24/2024
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Jer’Zhan “Johnny” Newton is considered one of the top defensive tackles in the 2024 draft. The Big Ten defensive player of the year and consensus All-American is projected to be a Round 1 or early Round 2 draft pick and could be an instant starter for many teams.

While Newton appears to be a slam-dunk selection for any team, several could hesitate to know that he is still recovering from a notable injury found during the draft process. How teams view the medical concerns will dictate where Newton ultimately ends up. This includes the Buffalo Bills who based on their past injury trends, could pass or realize the talent and take a risk on what could be a game-changing player.

Read below for a full injury analysis and concerns moving forward including whether the Buffalo Bills would select him.

Injury History

Illinois

2023

Right foot Jones fracture, suffered midway through the season, missed 0 games.

Newton suffered a fracture of his proximal fifth metatarsal sometime midway through the season. He was able to finish the season before an assessment in January revealed a “partial Jones fracture” that was surgically repaired. One report indicated that this was an avulsion fracture.

He was unable to participate in any of the pre-draft testing until his Pro Day in mid-April. He participated in defensive line drills but did not do any of the traditional testing. According to reports, his foot is fully healed.

Injury Analysis

Newton had not missed any games during his collegiate career and before this foot injury, had no known medical issues. With this discovery of his foot injury comes hesitation and speculation on his health moving forward and where he could ultimately end up getting drafted. To understand the injury, the anatomy should be reviewed.

Fifth Metatarsal Anatomy & Fracture

The foot is made up of 26 bones of various shapes and sizes that allow a person to stand unsupported, walk, and run. Five of those bones, the metatarsals, connect the midfoot bones also known as tarsals to the toes.

Credit: NCBI

The fifth metatarsal has a proximal portion that the fibularis brevis connects to which allows the foot to evert and plantar flex or turn out and push down. This injury usually occurs when the foot is planted and twisted away from the body, similar to rolling an ankle. There are several types of Jones fractures including an avulsion fracture, acute fracture, and stress fracture. There are various zones within the bone where the fracture occurs which allows them to determine the best course of action. Zone 2 has a poor blood supply due to the vascularization of the bone being a watershed area. This means that the bone has blood supplies from two different arteries but they reach a point where a portion of the bone is not fully fed and that is where poor healing can occur. While these fractures can heal without surgery, an operative procedure does expedite a return to play and outcomes.

An avulsion fracture is where the tendon pulls a chunk of bone off when the injury occurs, these typically happen in Zone 1. An acute fracture is just that, a break in the bone, these are historically noted as true Jones fractures and are located in Zone 2. A stress fracture is the weakening of the bone over time due to overuse and is commonly observed in Zone 3.

Credit: Sports Injury Clinic

Newton’s Injury

Based on the sources, there are discrepancies between the type of fracture Newton suffered. One source published close to his Pro Day indicated that he had suffered an avulsion fracture. Historically, avulsion fractures historically do not require surgery and can be managed conservatively. Surgery can be performed but it is not the first option moving forward. Given the circumstances, surgery may have been performed to ensure healing for the draft. Typically, an IM screw is placed to ensure healing of the bone to prevent non-union fractures. Given the timeline, it’s also possible that Newton suffered a Zone 2 injury and required surgery.

Credit: Medline

The procedure was completed sometime in January which kept him out of much of the draft process. He was able to participate in his Pro Day but only performed positional drills, not testing. Based on a rough timeline, he was about 12-14 weeks removed from the procedure which is ample time to return to activities even after surgery.

Jones Fracture Outcomes

Looking at the functional outcomes following the injury was surprising. Rates to return to play following a Jones fracture are favorable with various publications showing rates such as 93 percent and as high as 98 percent and take on average just under 10 weeks to return to play.

Studies indicated that re-fracture rates were as high as 12 percent and non-union healing occurred at 8 percent. Five out of the six studies within the meta-analysis linked did not show any difference in performance or career length. The one study that indicated that performance went down had a small sample size and may have not had enough statistical significance.

Looking at position-specific Jones fractures, 17.2 percent of players were defensive linemen who suffered the fracture. If a player can get through a full season following their injury, their re-injury risk goes down (5.6% vs 46.7%). If they do not have a residual gap following surgery, their re-injury risks reduce (7% vs 37.5%). Finally, if a player has surgery, their re-injury risk goes down to 10.3% vs 21.1%.

Assessing NFL Combine participants between 2009 and 2015 indicated that those who were diagnosed with a Jones fracture were drafted lower than compared to controls (111 vs 99). Performance scores were lower specifically in defensive linemen and running backs compared to other positions during the first two years in the NFL.

Across the board position-wise, snap counts are down the first three years compared to controls except in quarterbacks. There have been instances where a player has been cleared radiographically and clinically and still re-fractures the area upon returning to practice which makes this a continued concern. Further studies indicated that players with a Jones fracture did have reduced participation but no change in performance.

What it boils down to is that a player with a history of Jones fracture is likely to return to play and have no impact on performance or career length. There may be a decrease in snap counts initially but no increase in missed time. There is a minimal chance for re-fracture and non-union healing, but this is seen more with a return to play <10 weeks. This was also where a significant decrease in production was noted. If the player has surgery, does not have a residual gap, and can get through the first year, then they are going to do fine. As of publication, Newton is at least 12 weeks removed and will still have some time to rehab and get back into football shape.

Injury Comparison

The most straightforward comparable is former Notre Dame and Pittsburgh Steelers DE Stephon Tuitt. The veteran defensive end saw time at defensive tackle and during the 2014 NFL Combine was found to have a left foot Jones fracture. He underwent surgery and was unable to participate in most of the NFL draft process.

He did drop down to the second round but was drafted by the Steelers where he had a solid career until 2020. He did not appear to have any further issues with the foot and only missed extensive time due to a torn pectoral in 2019.

Furthermore, while the Bills have for the most part avoided players with Jones fractures, they haven’t avoided them altogether. The Bills brought often injured CB Kevin Johnson in on a one-year deal in 2019 who had suffered a Jones fracture several years earlier.

The other player they brought in which was more telling was DT Quinton Jefferson. After dealing with injuries throughout his career, it was revealed that he suffered a Jones fracture potentially in the Wild Card round and played through the injury the following week in the loss to Green Bay. He had surgery that January after the loss and was signed two months later by Buffalo.

Looking at that timeline indicated that they saw that he had surgery, the team saw how he was healing, and signed him pretty quickly. From what I could find and recall, he was not limited during OTA’s or had any extensive missed time during training camp. He did not suffer a re-injury while in Buffalo but dealt with several smaller issues. Jefferson ultimately did not make much of an impact before getting cut after one year; this may have been more due to his production as a player rather than injury.

Bills Draft Selection

Performing the research for this article was very eye-opening. While a Jones fracture is a notable injury, the return to play rates and performance were far better than I had been led to believe. Having lived through the Jones fracture of Sammy Watkins and enduring two surgeries even after a careful rehab process the first time around makes one hesitant. Around the league, we saw both Dez Bryant and Julio Jones also require a second surgery to the area following their original injuries. Plenty of other players have dealt with this injury but notable names sometimes skew the perception of the injury when they have issues.

Tom Szczerbowski/Getty Images

While those may have been outliers in the grand scheme of things, the research indicates that many players have no long-term concerns. Several may require a second surgery but even the aforementioned receivers still had productive seasons even after their injuries.

While fractures are an injury the Bills are not a major concern in terms of drafting a player early as we’ve seen with Josh Allen, Greg Rousseau, and Dalton Kincaid, all had minimal re-injury concerns. The risks for Jones fracture complications are higher than those respective surgeries, but not alarming.

Newton’s selection may come down to how the medicals look, something I don’t have direct access to. Reports indicate that his foot is fully healed. However, if there is a residual gap in imaging, incomplete healing, screw irritation/pain, or something else the medical staff doesn’t like, he could be a pass. But if he checks out, he could be a fantastic selection in any round.

The only known interaction the Bills have had with Newton is at his pro day according to reports. It’s worth highlighting that not every Top 30 visit has been reported which means the Bills could have brought Newton in and the public did not hear about it yet.

Newton is regarded as a first or second-round draft pick by many accounts. Should he clear medically, the Buffalo Bills selecting him in the first round would be an acceptable outcome. Should he drop into the second round, the Bills would be getting a steal from a draft perspective in terms of potential performance. This is unfortunately a wait-and-see approach, but Johnny Newton is very much in play for the Bills on either Day 1 or 2 based on the current information.

 

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