Rooney injury was not 'typical'
Wayne Rooney made a speedy return to football because his injury was not a typical metatarsal break.
That was the information released today by the independent medical experts who passed Rooney fit to play for England yesterday.
The Manchester United striker returned as a substitute against Trinidad and Tobago, six weeks and five days after breaking the fourth metatarsal in his right foot.
Rooney, 20, has given permission for the details of his injury and recovery process to be made public in a statement from Professors Angus Wallace and Chris Moran.
The orthopaedic experts saw the original scans of Rooney's foot on June 5, the day Sven-Goran Eriksson and his England squad flew to Germany for the World Cup.
They agreed Rooney would be able to play in the World Cup finals and this proved the basis for Eriksson's enduring optimism during the first days of the tournament.
Wallace and Moran said: 'We were able to confirm that this fracture was quite different from the typical metatarsal shaft fracture.'
They consulted with the colleagues at the Queen's Medical Centre in Nottingham and decided Rooney had a chance of playing in England's final Group B game against Sweden on June 20.
Rooney's break was at the base of the fourth metatarsal bone and under the surface of another small bone, called the lateral cuneiform bone.
There was also some ligament damage but it was a fairly positive diagnosis.
The fracture was located on the spongy cancellous bone at the base of the metatarsal and this heals three times more quickly than the hard bone in the metatarsal shaft.
It was not a stress fracture, which also take longer to heal.
Rooney had another scan on June 7, after which Manchester United issued a statement to say they thought the striker would not be ready to play until after the group stage of the World Cup.
They said this was the independent medical opinion but the latest statement from Wallace and Moran contradicts this.
At no point do Wallace and Moran suggest Rooney will be ruled out until the knock-out stages of the competition.
The professors originally thought Rooney would be ready to face Sweden but then changed their minds and declared him fit to play against Trinidad and Tobago, five days earlier.
They put this quick recovery was down to the excellent medical care Rooney received from Manchester United and England.
Their statement said: 'We have been impressed with the careful management of Wayne's foot injury by the Manchester United medical team which had managed him in a totally expert manner.
'Wayne had discomfort in his foot for only five days and has now been pain free for six weeks.
'His rehabilitation programme was started after 48 hours, initially by the Manchester United medical team and later by the England medical team.'
From watching Rooney train, Eriksson started to think he could bring his striker back for the Trinidad game and asked his doctor Leif Sward to contact Wallace and Moran.
The statement said: 'Dr Leif Sward, the England team doctor, contacted us earlier this week to advise us that Wayne had, in his opinion, achieved full fitness and should be able to play in the Trinidad and Tobago group match on 15th June 2006.
'At his request we flew to Germany on Wednesday and carried out a very careful assessment of Wayne yesterday.
'We both recognised that this was a week earlier than we had anticipated declaring him fit but it is now our independent opinion that Wayne has made a full recovery from his injury and we declared him fit to play in the World Cup as from June 15.'
Wallace and Moran were invited to act as independent experts by the FA.
They both work at the Queen's Medical Centre which has treated 751 metatarsal fractures in the last 18 months.
THE FULL STATEMENTProfessor Wallace and Professor Moran were invited by the England FA to provide an expert medical opinion on the fitness of Wayne Rooney to play in the World Cup.
Both consultants work at Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus (QMC), and both are professors appointed by the University of Nottingham.
QMC is the biggest trauma centre in England and treats over 16,000 fractures per year.
In the past 18 months 751 metatarsal fractures have been treated by the medical team at QMC. Seventy of these were due to sports with 50 of these related to football.
Professor Wallace was invited because of his extensive knowledge of both orthopaedic surgery and sports medicine - he has been a consultant orthopaedic surgeon for 22 years working as a consultant trauma surgeon from 1984 to 1996.
In addition he has been actively involved in sports medicine for over 16 years and has an in-depth understanding of rehabilitation and fitness loss in relation to sportsmen.
Professor Moran is a full time trauma surgeon, has been a consultant for 15 years and has an expert knowledge of fracture management and rehabilitation which he teaches both nationally and internationally.
Wayne Rooney sustained a fracture of his fourth metatarsal on April 29, 2006.
Professor Wallace received the original scans of Wayne's foot on June 5, 2006.
Professors Wallace and Moran consulted further with their colleagues in Nottingham - Dr Robert Kerslake (radiologist - X-ray doctor), Mr Sunil Dhar, Miss Brigitte Scammell and Mr Andrew Taylor (orthopaedic foot surgeons) and Professor Mark Batt, professor of sports medicine.
The Nottingham team agreed that, depending on Wayne's clinical examination on Wednesday, June 7, he could be fit to play by June 20 - the Sweden group match.
The fractures had involved the base of the fourth metatarsal bone and the under-surface of another small bone (the lateral cuneiform bone).
Prof Moran and Wallace have been given permission by Wayne to discuss his injury. The professors were able to work out how the fracture had occurred and that in addition to the fractures there was also some ligament stretching.
We were able to confirm that this fracture was quite different from the typical metatarsal shaft fracture, but was a fracture involving the spongy (cancellous) bone at the base of the metatarsal.
This bone heals approximately three times more quickly than the hard (cortical) bone of the metatarsal shaft.
This was not a stress fracture, which often take longer to heal.
We have been impressed with the careful management of Wayne's foot injury by the Manchester medical team which had managed him in a totally expert manner.
Wayne had discomfort in his foot for only five days and has now been pain free for six weeks.
His rehabilitation programme was started after 48 hours, initially by the Manchester United medical team and later by the England medical team.
Dr Leif Sward, the England team doctor contacted us earlier this week to advise us that Wayne had, in his opinion, achieved full fitness and should be able to play in the Trinidad and Tobago group match on June 15, 2006.
At his request we flew to Germany on Wednesday and carried out a very careful assessment of Wayne yesterday (June 15).
We both recognised that this was a week earlier than we had anticipated declaring him fit but it is now our independent opinion that Wayne has made a full recovery from his injury and we declared him fit to play in the World Cup as from June 15.