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Bullpen blues: Toe injury could sideline Madson for a 'significant' stretch.

When Ryan Madson broke his right big toe kicking a chair in the visitors' clubhouse in San Francisco, the Phillies had an idea that the injury could be serious. A CT scan Monday showed that those concerns were warranted. Madson has a complex fracture of the toe.

Ryan Madson could miss a significant amount of time due to his injured toe. (Yong Kim/Staff file photo)
Ryan Madson could miss a significant amount of time due to his injured toe. (Yong Kim/Staff file photo)Read more

When Ryan Madson broke his right big toe kicking a chair in the visitors' clubhouse in San Francisco, the Phillies had an idea that the injury could be serious. A CT scan Monday showed that those concerns were warranted.

Madson has a complex fracture of the toe and doctors decided it was best for Madson to have pins and plates surgically inserted Tuesday, the Phillies said.

Scott Sheridan, the Phillies' head athletic trainer, declined to offer a potential timetable for Madson's recovery until after the righthander has the surgery.

"We really don't know what that's going to mean long term," Sheridan said.

Regardless, it appears Madson could miss a significant amount of time.

"We knew it was bad from the beginning," Sheridan said. "It is what it is. It's not just like a little crack. It has a couple pieces to it."

Madson will have the surgery performed by Steven Raikin at the Rothman Institute. Raikin, a foot and ankle specialist, reviewed the results of the CT scan Monday and decided surgery was necessary. The Phillies could have left the injury alone to heal, but because it was a complex fracture, the pins and plates are needed to set the toe, Sheridan said.

The most difficult part could be Madson's rehab after surgery. While the toe will affect the 29-year-old's mobility, the Phillies need to find a way to keep his arm strong. The staff will have to be "creative," Sheridan said.

"He's in a lot of pain," Phillies assistant general manager Scott Proefrock said of Madson, who is 1-0 with a 7.00 ERA.

Proefrock said the Phillies would not pursue another bullpen arm for now. He said a lot depends on how recently activated relievers J.C. Romero and Brad Lidge do as their workload increases at the major-league level.

"We've got some moving pieces," Proefrock said. "I don't think it necessarily puts us in a situation where we have to go acquire somebody."

Phillies manager Charlie Manuel said before Monday's game that he wasn't ready to use Lidge as closer. In his only appearance, Lidge faced three batters Friday against the Mets and allowed a home run.

Proefrock said both Lidge and Romero are 100 percent healthy - they wouldn't have been activated if they weren't - but need some time before they are fully comfortable on the mound.

In losing Madson, the Phillies will be without their regular setup man for the time being. Jose Contreras has been a revelation early in 2010, having allowed one run in 62/3 innings entering Monday night's game. He had 12 strikeouts and zero walks.

He could step into the eighth-inning role once Lidge reclaims the closer's spot.

"I don't think he's been a surprise," Proefrock said of Contreras. "That's why we went after him. Our scouts when we were advancing the Rockies saw him pitch out of the bullpen and really liked it. Quite frankly, we were afraid of him being used against us in the postseason because of how effective he was down the stretch. That was appealing to us."

Down the line, Proefrock said there aren't too many minor-league possibilities for the bullpen on the Phillies' radar. One is Scott Mathieson, who has a 0.77 ERA as the closer at triple-A Lehigh Valley.

"He's been doing fine," Proefrock said. "He has to work on some of the secondary stuff."

For now, though, Proefrock said the Phillies will stick with their current bullpen - which hasn't been ideal by any stretch of the imagination, he said.

"These other guys have an opportunity to step up and fill in some of the holes," he said. "We'll just have to see how they pitch before we get really concerned about it."