Surgery paying off for Flyers' Carter, Gagne

SIMON GAGNE knew the risks.

But that didn't stop him from going under the knife on April 23 to have a screw inserted into his right big toe, just 3 days after an Ilya Kovalchuk slap shot fractured the bone in the Flyers' first-round series against the New Jersey Devils.

"The whole reason was to be here, playing in the Stanley Cup finals," Gagne said. "I had two options: I didn't need surgery and they said it could have healed on its own in 10 weeks."

"The other option was [having surgery], crossing your fingers and hoping that I'm going to be ready in 3 weeks. I just hoped we would be still playing."

That was one of the risks. Gagne and Jeff Carter who had surgery on the same day by the same surgeon, Dr. Steven Raikin, could have rehabbed only to find that the Flyers had been eliminated.

Instead, Gagne returned just 15 days after his surgery and Carter - who suffered a fractured metatarsal in his right foot in the same game when Gagne got hurt - rejoined the Flyers last Saturday in Montreal. That was just 4 weeks after a surgery that should have required 6 weeks of recovery time.

And now the Flyers - who are 8-1 since Gagne's return - will face Chicago in Game 1 of the Stanley Cup finals on Saturday.

Raikin, the chief of foot and ankle services at the Rothman Institute, said yesterday the players were involved in the decision-making process from start to finish.

"What we were trying to do was allow these players to return to the ice quicker than normal," Raikin said. "Without surgery, there was no chance of that happening. Our goal was to increase the stability of the bone and to get the bone in an optimal position. It required a lot of thinking outside the box."

General manager Paul Holm-gren said the Flyers were open to any option that could bring Gagne and Carter back quicker without compromising their overall health and future well-being.

"I think when you do something like that, you want both of those surgeries to expedite the healing process," Holmgren said. "That was our goal. Conceivably, we got those guys back sooner than if we didn't.

"I'm not surprised, knowing those individuals. If you can play in the conference finals or Stanley Cup finals, you're going to do everything you can to come back."

Careful not to overstep the bounds of patient confidentiality, Raikin credited the Flyers organization for not pushing him to do anything he could not, or would not, feel comfortable with inside the operating room.

"I think when you hear about sports teams, they are notorious for being pushy and wanting their players to come back quicker than possible," said Raikin, who studied medicine in South Africa and England. "The Flyers were quite the contrary. I couldn't guarantee success. The players understood the risks and the Flyers did not increase the risk."

Though he could not elaborate on Carter and Gagne's specific procedures, Raikin said he could not be heralded for a breakthrough method or process.

"It's not something where you can take credit for the surgery," Raikin said. "We utilized very well-accepted techniques in an unusual way in order to get the players on the ice a lot quicker."

Raikin said the average person would not have been able to resume normal physical activity for at least 3 months - for either injury.

"If you or me had this injury, we would need to keep it protected for 3 months," Raikin said. "But these athletes are incredible healers, they had the optimal physical capacity to heal. In both of these cases, they also have things like monitoring and access to X-rays to make sure that they are healing that most people do not."

Without getting back for the final two games to close out the Canadiens, Carter knows it would have been near impossible to re-enter the lineup in the finals without much skating. He said the atrophy in his ankle and leg muscles was incredible because he was on crutches for a month.

"I'm feeling good," Carter said. "I feel like every day, I'm getting better - my leg gets stronger, my ankle gets stronger. I think it was huge for me to get in there and get a couple of games under my belt. It'd be pretty tough to jump right into the finals without getting any games in. It was definitely nice to get in, get a couple of wins, get a couple of goals and get the confidence going."

With all of the injuries the Flyers have sustained - only Kimmo Timonen, Mike Richards, Scott Hartnell, Chris Pronger and Claude Giroux have not missed time due to injury this season - they are extremely lucky to only be missing Brian Boucher and Ray Emery now in the playoffs.

"I think we've got to consider ourselves fortunate that when you lose guys to injuries, you get them back," Holmgren said. "It's certainly a bonus to get those guys back. We were able to continue on, which shows the resiliency and the galvanization of the other guys to win games that they needed to win when those guys were out of the lineup in order to get them back in."

But getting these players back in the lineup would not have been possible without a few screws, a deft surgeon with a brilliant mind - and the willingness to sacrifice for the team.

"In my mind, it was a no-brainer," Gagne said. "I felt like I had nothing to lose. That was an easy decision to make. I'm playing in the Stanley Cup finals."

For more news and analysis, read Frank Seravalli's blog, Frequent Flyers, at http://go.philly.com/frequentflyers.