United States men’s national team defensive midfielder James Sands faces a lengthy layoff with a serious right ankle injury and broken calf bone sustained while playing for St Pauli.

Sands, who only joined the German club on loan from New York City FC in January, had to be helped off the field in stoppage time of the team’s 1-0 Bundesliga loss at home to Freiburg on Saturday. He was then taken to a local hospital.

“Sands suffered a complex ankle injury with a torn medial ligament as well as a broken fibula,” the club said Sunday on the social network Bluesky. “Our midfielder has already undergone surgery at the University Hospital Hamburg-Eppendorf and will be out for an indefinite period.”

St Pauli coach Alexander Blessin already feared the worst after the game.

“It looks really bad,” Blessin said. “At first I thought, the knee. But it doesn’t look good for the ankle.”

Sands had made his fifth consecutive start for St Pauli in his seventh appearance since joining in the winter transfer period, indicating how important he had become for the promoted team in just over a month.

“It really hits me to the core,” Blessin said of Sands’s injury. “He was very strong in challenges and brought Jackson Irvine into a better position beside him. That’s why it hurts very, very much. The hope is that he’ll be back as soon as possible.”

Sands had only last week told journalists how he hoped his move to St Pauli could help put him back in the mix for a national team place before next year’s World Cup. He will now be ruled out for the upcoming Concacaf Nations League finals in March, in which the US will face Panama in the semi-final before facing either Canada or Mexico in the final or third-place game.

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New York City FC said in a statement that “everyone at the club wishes James all the best in his recovery.”

St Pauli, who are fighting for Bundesliga survival after their sixth promotion to the top division, also have Connor Metcalfe, Robert Wagner, Elias Saad, Karol Mets and Morgan Guilavogui out with injuries.