The 38-year-old Nabokov was playing for the first time in four games and the second in six. He did a split and fell forward as Detroit's Darren Helm scored a breakaway goal to tie it 1-1 -- nine seconds after New York took the lead.
The Islanders won 5-4 in a shootout.
Nabokov was assisted by a trainer in the crease before getting up on his skates and gingerly skating while hunched over to the tunnel leading to the dressing room.
Nabokov, who came into Saturday with a 5-5-3 record and 3.24 goals-against average, was replaced by Kevin Poulin. Poulin has received the bulk of playing time recently for the Islanders, and appears to be making a claim to be New York's No. 1 goalie.