Ishii Probably Out for Season

Kazuhisa Ishii probably won’t pitch again this season after undergoing nasal-cavity surgery early Monday morning, Kevin Brown is back in the rotation despite not being fully recovered from multiple surgeries the last two seasons, and the Dodgers are approaching the finish line with their fingers crossed.

The emergency rotation makeover occurred after Ishii suffered a fractured skull when he took a line drive off his head in Sunday’s 6-2 loss to the Houston Astros at Dodger Stadium, prompting a two-hour procedure to insert a titanium plate. The left-hander could be released from Cedars Sinai Medical Center at the end of the week, but “it may be a while before he’s back playing,” team physician Michael Mellman conceded.

Ishii leads the staff with 14 victories despite command problems in an uneven first season in the major leagues, and his departure has moved Brown back to a starting role faster than the Dodgers would prefer. The onetime staff ace has shown only flashes of his former form since being activated from the disabled list Aug. 15 after surgery to remove a herniated disk. Manager Jim Tracy had hoped to ease Brown back to be ready for the playoffs. That plan was scrapped with Ishii in the hospital, Andy Ashby struggling and experiencing blister problems, and the National League West and wild-card races seemingly getting tighter by the inning.

Brown is scheduled to make his first start since May 26 today against the San Francisco Giants in the second game of a key three-game showdown at Pacific Bell Park, and the rotation is in flux with the window closing on the season.

“We’ll take what he can give us, and we know that it will be the best he has,” Tracy said. “At this time of the year, in the position that our club is in, he’s the right guy, with health obviously being the big issue with us.”

Ashby, who had been scheduled to start today, has been pushed back to Sunday against the Colorado Rockies at Coors Field because of a blister and infection of the middle finger of his pitching hand. Omar Daal will start the opener on Thursday. Tracy said he has not determined Friday’s starter, and Odalis Perez is scheduled to start Saturday.

The Dodgers are carrying 11 relievers on the expanded 40-man roster, so they could start a reliever such a Giovanni Carrara, limit the right-hander to 75 pitches and have plenty of support behind him.

“When you are trying to go across the finish line, every club that gets itself in this position incurs roadblocks long the way,” Tracy said.

“This team has endured a hell of a lot, but this team is resilient as hell, and it’s showing characteristics of a very good team. It’s not a playoff team yet, obviously, but it’s a very good team.”

The Dodgers were tested again Sunday when Ishii was struck on the left side of his forehead by a drive off the bat of the Astros’ Brian Hunter in the fourth inning. Ishii, who turned 29 on Monday, was transported by ambulance to Good Samaritan Hospital, where a CT scan revealed he had a small fracture on top of his forehead. Tests later showed the nasal fracture.

Surgeon John Yu operated on Ishii after he was brought to Cedars Sinai. Team trainer Stan Johnston said Ishii needed the titanium plate “because the fracture was in small pieces that don’t heal very well,” and the risk of sinus problems throughout his life would have increased without the procedure.

“It could have been tremendously worse,” Johnston said. “He could have had brain trauma, which they did check, and there was no bleeding around the brain. Everything looked very good.”

Johnston said Ishii, who was eating and walking on his own Monday, would continue to be monitored for 48 to 72 hours after surgery because bleeding can still occur from concussions during that time frame after surgery. When Ishii does return, he will undergo a battery of hand-eye-coordination tests.