I Drafted Bell at our very early 8/10/13 draft, as my 2nd choice of the "big three" upside backs, L. Miller, L. Bell and E. Lacy (listed in my first-to-last ranked order), and as a steal in the 8th round of our 10 team PPR league. I had him pencilled in as my FLEX starter. Totally bummed out by the news of Bell's Lisfranc injury, which seems to be an increasingly common diagnosis in the NFL lately.
I'm a Sports Medicine physician, whose brother sustained an "open", five-ray, Lisfranc fracture-dislocation (dislocation of all 5 tarsal-metatarsal joints, with the metatarsal bases poking through the skin on the top of the mid-foot in-step). Yeah, I was there to see it...pretty gruesome! While most so-called Lisfranc injuries are not this extreme, it is a BAD thing to have. The problem is it involves varying degrees of tearing of the ligaments that connect the metatarsal bones to the tarsal bones. The alignment and stability of those joints is critical to maintain the arch of the mid-foot in the vertical plane, secure the mid-foot alignment with lateral (horizontal) loads (cutting moves by RB's) and transfer power from calf/Achilles complex during push-off portion of the stride (acceleration).
Even if surgery isn't indicated at this point, that doesn't mean he won't need surgery at some point before being able to return. Any surgery carries an inherent risk. The risk/benefit analysis for surgery vs. conservative treatment (immobilize/cast with gradual rehab/physical therapy) needs to be completely assessed. This includes everything from lost income/career opportunity, statistical information about outcomes of the 2 treatment options, based upon the MRI evidence for severity of this particular injury, and even the skill of the potential surgeon. Interestingly, the anxiety level of fantasy football owners is not part of the consideration that goes into determining whether surgery is the best option.
Effective healing of any injury in the human body requires a good blood supply. Ligaments notoriously have a very poor blood supply. Successful healing by waiting for joint stability to develop with immobilization and time is predicated on at least two things. By far the most important factor is that the MRI results over-estimate the true degree of ligamentous disruption. The second variable involves the nebulous concept of post-inflammatory "scar tissue" to be incorporated as a ligamentous splint or "Bondo" within the torn ends of the frayed ligamentous fibers. This last scenario is only possible if the individual ligament is only partially torn. Remember, that there can be up to 5 of these injured ligaments involved, each with it's own issues.
Bottom line...like Snoop Dog (Lion), or whatever he's known as now, said..."Drop it like it's hot". Trust me, Bell will not be an effective NFL back this year, at least from a fantasy perspective, with regard to clogging up a roster spot for as long as it will take for "maybe" results. I predict the Steelers will be very cautious at protecting their rookie RB and hope for a solid future running the ball.
H2H PPR 2RB/2WR+Flex, TE, D/ST, K. 10 Team League
QB- Stafford, Smith
RB- J. Charles, R. Bush, G. Bernard, D. Richardson
WR- Cobb, Amendola, E. Sanders, T.Y. Hilton, J. Gordon, G. Tate
TE- J. Graham, R. Housler